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Posted: May 25, 2017 at 8:44 pm
For those who would like to avoid diet-induced trips to the doctor's office, Dr. Christi Childers, a family medicine practitioner at The Medical Center of Spearfish has a relatively simple answer.
"A dinner plate that consists of animal protein, carbohydrate/starch, 2/4 vegetables. Beverages that are calorie free (coffee, tea, water). Fish at least 3 - 5x a week. Low or no sugar daily," Childers said.
Flip side.
For those who want to end up in the doctor's office, make a habit of eating what?
"Processed food, fast food, sugar beverages and snacks," Childers said. "Our bodies are made to convert what we eat into fuel and building blocks for every part of our body including our muscles, organ systems as well as immune system function. Simply put, if we make poor food choices (processed food, high fat / high sugar foods, foods with minimal nutritional value, etc.) our body does not have the proper materials to make what it needs to keep us healthy. The result is the inability to function at our highest level leaving us open to both acute and chronic diseases."
Childers said not a day goes by that she doesn't see someone with a health problem that can be attributed to poor dietary choices.
"Overeating and consuming foods with low nutritional value have been linked to stroke, diabetes, sleep apnea, hypertension and multiple different types of cancer," Childers said. "There is a patient that comes to mind that I diagnosed with diabetes and sleep apnea that was scared to take medications including insulin. She drastically changed her lifestyle by increasing her activity, increasing the fruits and vegetables in her diet and focusing on stress reduction and within one year she was able to stop her insulin, had a normal weight and no longer needed her CPAP. By choosing to take charge of her life and her health it became unnecessary to rely on medical treatments for problems that could have been prevented."
While sugar is the best food to sabotage a healthy diet, processed foods are a close second.
"Processed foods replace fats with sugar to make it taste better and this, in my opinion, has caused a multitude of health problems," Childers said. "I often tell patients that if it can sit on a counter for 48 hours and taste the same as when you first opened it, dont eat it."
Childers said in order to be successful with a healthy diet, plan ahead and keep it real.
"Put a healthy dinner in the crock pot as opposed to picking up a pizza on the way home," she said. "Eat real food, eat often (4 5x/day) and dont overeat. Eat a moderate amount of meat and carbohydrate and a large amount of fruits and vegetables. Diets will come and go but we need to remember that we need all three macronutrients: proteins, fats, and carbohydrates."
With questions or concerns, call Dr. Childers at 559-3201 or schedule an appointment online at http://www.MedicalCenterofSpearfish.com.
The Medical Center of Spearfish is located on the second floor of 120 Michigan St.
Originally posted here:
Healthy diet a key player in preventative medicine - Black Hills Pioneer
Posted: May 24, 2017 at 5:43 pm
With MDW & summer right around the corner, its time to get in shape & we have 10 fitness tips from the most toned celebs like Demi Lovato & more!
Now that summer is creeping up on us, its time to get in some serious shape because bikini season is officially upon us. Luckily, you dont need to stress because some of our favorite stars shared with Us Weekly, their fitness tips on how to look good and feel good. From eating healthy to exercise, you have to here what the celebs do to stay in shape and look toned.
1. Demi Lovato: I feel the most confident when Im in the gym. Whenever Im training, whether its boxing, kickboxing, Muay Thai or jujitsu. And I stay confident with daily affirmations looking in the mirror, telling myself Im beautiful no matter what, just learning to accept my flaws for what they are and knowing that my curves are beautiful and I am who I am.
2. Kate Hudson: I do transcendental meditation and then I do a lot of breathing awareness and kundalini. My workout is all different kinds of things. Im all over the place, but I love to dance. Im always trying to get better. And Im obsessed with Peleton bike.
3. Simone Biles: Dancing changed my body. But I also havent worked out and Ive been eating whatever I want! Dancing helped keep me in shape, we trained 6 hours a day, and Ive stayed the same weight.
4. Lea Michele: I work out to feel food. Im that person in the front row of SoulCycle, singing songs on the top of my lungs, poorly. After, I feel great. She also said that she would love to work out with Khloe and Kourtney Kardashian because their snaps look so fun!
5. Julianne Hough: Not only does Julianne love CorePower Yoga, she said eating what you love is important, too. I think when you deprive yourself, thats when you crave pasta and pizza. Pick the right carbs and have a little bit.
6. Ashley Graham: If Im feeling heavier or not confident, I give myself affirmations. Ive really gotten good at what works for me. Everyone is different. Mine are: You are bold. You are brilliant. You are beautiful. If theres a place on my body that Im really not liking, Ill touch it and say, Its OK. I feel most confident with my body when Im treating it well.
7. Leann Rimes: Her go-to workout is SoulCycle and shes over strict diets, Now that Im older, I just want to enjoy life.
8. Jamie Chung: I used to work out to look a certain way in my 20s. But in my 30s, its working out to feel a certain way, to have the release of endorphins and feel good. Its also something very social for me now.
9. Aja Naomi King: My beauty secret is water, water and more water as well as a positive outlook. I do my best to work out a little bit every day, which includes a yoga or cycling class if I have time. I also have my own bike at home, which helps.
10. Kaley Cuoco: Kaleys go-to spot is CorePower Yoga where she goes 3 times a week to do toning moves like eagle crunches, side plank, mountain climbers, and bicycle crunches.
View original post here:
Lose 10 Pounds Before Summer: 10 Start Today Fitness Tips From Demi Lovato & More - Hollywood Life
Posted: May 24, 2017 at 5:43 pm
24 May 2017 --- On the occasion of the European Business Summit, as part of a panel on Sustainable Living: Foresights for 2050, FoodDrinkEurope launched a Call for Action to help improve diets and promote good nutrition and health. In so doing, the organisation of Europes food and drink industry calls upon all interested parties and stakeholders to join forces and look ahead to tackle together todays societal challenges related to nutrition and health.
Together with partners, we want to generate a positive move to stimulate and contribute to better nutrition, declared Gilles Morel, President of FoodDrinkEurope. Only by working hand in hand to improve diets can we make a difference and Click to Enlargeaccelerate progress; this is why we call directly upon public authorities, retail, catering, farmers, restaurants, consumers, dieticians, healthcare professionals and non-governmental organisations to join forces by sharing a common EU ambition to improve the diets of citizens all over Europe.
He added: Working with European partners, for instance by optimising the nutritional composition of food, meals and diets, can help us achieve a 10% reduction of the overall calorie intake of European consumers by 2020 and create new opportunities for business and society.
Dialogue, synergies, a coordinated approach and a more positive communication to consumers can only help reinforce all partners efforts. The food industry is committed to work, amongst others, on product formulation, innovation, choice and portion sizes, clear labelling and awareness raising to contribute to a more balanced diet, as illustrated in FoodDrinkEuropes Eat & Live Well.
Dr. Vincenzo Costigliola, President of the European Medical Association (EMA), welcomed the initiative and commented: What we eat and drink makes a vital contribution to our health - and our wellbeing. Food producers, healthcare professionals and others must cooperate to make sure that patients and consumers benefit from a balanced diet. Training, education and information about nutrition and health are essential to help patients eat properly according to their individual needs.
Business News
24 May 2017 --- A new report examining the serious pressure the UKs food manufacturing sector will be under if the labor supply of European Union migrants dries up after Brexit, urges that safeguards be put in place now to stave off a worsening of the crisis. The sector, already squeezed by shortages, will worsen, and will need to recruit up to 140,000 new workers by 2024, according to the new briefing paper co-produced by Manchester Metropolitan University for the Food Research Collaboration, an initiative of the Centre for Food Policy at City, University of London.
Business News
24 May 2017 --- Frutarom Industries Ltd one of the world's 10 largest companies in the field of flavors and specialty fine ingredients, reports another record-breaking quarter in sales, profits, cash flows from operating activities and in earnings per share.
Food Ingredients News
24 May 2017 --- DDW, The Color House, introduces a food color powder derived from a purple corn hybrid cultivated in the US. The non-GM powder exhibits a deep purple surface shade; the appearance is vibrant red in an acidic aqueous system.
Business News
24 May 2017 --- US grains trader Bunge Ltd says that it is not in talks with Anglo-Swiss multinational Glencore which has claimed to have made an informal approach sparking possible takeover speculation.
Food Ingredients News
24 May 2017 --- For the third consecutive year, Firmenich received a Gold rating from EcoVadis, establishing the company among the top 1% of all suppliers assessed on their sustainability performance, as well as the leader in the Fragrance and Flavor industry.
Read more:
FoodDrinkEurope: Call for Action to Improve Diets and Health - FoodIngredientsFirst
Posted: May 24, 2017 at 5:42 pm
Heads of UN food agencies visit famine-stricken South Sudan ReliefWeb Around 5.5 million people in South Sudan, or almost half the population, face severe hunger, not knowing where their next meal is coming from ahead of the lean season, which peaks in July. Of these around one million people are on the brink of famine ... |
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Heads of UN food agencies visit famine-stricken South Sudan - ReliefWeb
Posted: May 24, 2017 at 5:42 pm
It seems the golden grain has lost much of its luster, thanks to the gluten-free movement (now a $16-billion-dollar-a-year industry) and a broad-brush bashing that has painted it as the latest food demon.
Wheat has been found guilty without a fair trial, says Dr. John Douillard, a former NBA nutrition expert and author of Eat Wheat: A Scientific and Clinically-Proven Approach to Safely Bringing Wheat and Dairy Back into Your Diet (www.LifeSpa.com).
The grains you choose are critical to keeping your blood sugar stable, your weight down and your heart healthy.
Theres plenty of evidence that wheat isnt the monster that best-selling books like Grain Brain and Wheat Belly make it out to be, Douillard says.
Whole wheat extends life, reduces the risk of dementia by 54 percent, and in study after study prevents the onset of Type 2 diabetes, he says. The science shows health risks only with refined and processed wheats.
Other culprits include artificial sweeteners and a culture that encourages constant snacking, Douillard says, which can lead to what he calls sugar belly.
In general, processed foods are quicker to be broken down into sugar, or glucose, which enters the bloodstream faster than whole foods, he says. Excess sugar in the blood will trigger the release of excess insulin, which converts and stores the sugar in the form of unwanted fat and damaging cholesterol particles.
Its leading to the worlds next great epidemic, Douillard says, a combination of diabetes and obesity he calls diabesity.
A balanced and rebooted digestive system should be able to easily process foods like wheat and dairy, Douillard says. Here are his tips for troubleshooting your sugar belly:
Douillard isnt downplaying the devastation of celiac disease, an autoimmune disorder in which the ingestion of gluten leads to damage in the small intestine. But, he says, the push for gluten-free products and diets has gotten out of hand.
Yes, some people feel bad when they eat wheat, Douillard says. But in most cases, its because of a breakdown of the digestive system as a result of a diet of processed foods and pesticides. Taking foods out of the diet wont fix that, it just kicks the real problem down the road, leaving folks at risk for more serious health concerns.
Dr. John Douillard, DC, CAP, author of Eat Wheat: A Scientific and Clinically-Proven Approach to Safely Bringing Wheat and Dairy Back into Your Diet (www.LifeSpa.com), is a globally recognized leader in the fields of natural heath, Ayurveda and sports medicine, and is author of six previous health books. He is the creator of LifeSpa.com, the leading Ayurveda health and wellness resource on the internet. Douillard also is the former Director of Player Development and nutrition counselor for the New Jersey Nets NBA team. He has been a repeat guest on the Dr. Oz show, and has been featured in Womans World magazine, Huffington Post, Yoga Journal and dozens of other national publications.
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3 Tips For Fixing Your 'Sugar Belly' - Coos Bay World
Posted: May 24, 2017 at 5:42 pm
Paula Vogel (playwright, Indecent)
My pre-preview ritual: Eat light. Drink water. A small pad for notes. Cellphone charged.
My ritual when press comes in: Eat more substantially. Order a double vodka martini, slightly dirty, straight up. Walk around the block until fifteen minutes to curtain. Stand in the lobby in animated discussion, with the vodka running through my veins.
J.T. Rogers (director, Oslo)
Whenever Im at a play of mine, I like to drift around backstage starting at half hour, quietly watching the cast and crew going about their pre-show business. Its during this magic time, when everyone is collectively preparing, doing the secret work that only those of us in the tribe know about, that I feel most connected to the theater. And the most happy to be a part of it.
Jack Cummings III (director, Picnic)
During previews, I dont allow myself to walk into the theater without a medium coffee from Dunkin Donuts whether I want the coffee or not. I sit in the exact same seat every time. In fairness, I sit in every imaginable seat during rehearsals and tech so I know what it looks like from all sides. Also, I choose the seat where I can safely give notes to my assistant without driving audience members crazy. I am known to be a bit of a neat freak, so often, as my nerves escalate, I can be found anywhere from the theater to the lobby to the hallway to the bathrooms, cleaning, straightening, and picking things up off the ground.
Angela Pierce (cast, Oslo)
My pre-show ritual for Oslo has become: At the five-minute call to places I go backstage and listen to the audience, go check my props (I make sure Ive touched every one of them), give a quick nod and a good show! to Jefferson Mays as hes on his way to places for his start of show and Im on the way back to my dressing room to finish getting ready for the show. Whats become my fave food while working on Oslo I dont do it all the time because its more of a special treat for me is the gluten-free turkey sandwich with an additional side of pesto at Indie Food and Wine next door to Lincoln Center. It is absolutely scrumptious! And the staff knows me by name now. Big bonus!
Mia Barron (cast, The Wolves)
Actors I really admire always say that they can barely eat anything before going onstage, but Im a hungry person and if I dont eat a meal, Ill be too distracted thinking about food. So, I eat a good meal. But I dont tell anybody for fear of sounding like a hack.
Jenna Dioguardi (cast, The Wolves)
My absolute favorite part of doing eight shows a week is how much I focus on taking care of my body. I often describe my body as that of a ninety-year-old man trapped inside a twentysomething woman, so my pre- and post-show rituals are centered around transforming from that old man into a much more limber, younger person. I have a duffel bag full of physical-therapy gadgets that lives in my dressing room when Im working. Ill crack that open and begin my warm-up, which is very ritualistic. Its about 45 minutes and has been the same for years. And I always make a playlist tailored to the character Im playing, which Ill listen to very loudly while I warm up. After the show, I cover my body in ice packs and eat popcorn while watching The West Wing or Parks and Recreation. Sometimes Ill even put on an episode of Friends that Ive seen three thousand times and just stare at the wall. You know, to unwind.
Heather MacRae (cast, Come Back, Little Sheba)
I would say that like many actors I like to be at the theater early about an hour and a half before curtain. I do like to have a cup of English Breakfast tea, from whatever deli is nearby. I like it quite strong with half-and-half and two Splendas. I did have a particular craving after playing Lola in Transport Groups production of Come Back, Little Sheba: I had to have a Coke; not diet, the real thing. It was the only thing that quenched my thirst after doing the play. And I am a potato chip junkie. So Coke and chips is usually a must for me. I know, so healthy, right? And, occasionally, Cheetos!
Lizzy Jutila (cast, The Wolves)
Yes, before a performance I drink bone broth daily. When I dont have time to grab some from home, Ill go to Springbone or Brodo in the West Village. They also make a powder form where you can just add hot water. Bone broth is so good for your joints and tummy. I am always active so I have to make sure my body is running smoothly to prevent injury. Also, I love to work out before a show. It gives me more energy. When I was in The Wolves this last year I would usually take a kickboxing class prior to the performance to get my blood racing and my endorphins going. Post-shows, I will drink magnesium to help me sleep and replenish my muscles so that I can keep going the next day!
Amy Ryan (cast, Love, Love, Love)
Before the first entrance, I put one hand on my heart and one on my stomach. I find thats the only way to calm my nerves. If theres not enough time for a full vocal warm-up, a Fishermans Friend does the trick.
Matthew Broderick (cast, Evening at the Talk House and Shining City)
I usually bring a soup to the theater to eat before a performance. Sometimes half a sandwich. It might come from Green Symphony or somewhere else, depending where the theater is. What I liked most of all was the Edison caf, but its been closed for two years. I still miss it terribly.
More here:
Amy Ryan's Cough Drops (And Other Performance Rituals) - Village Voice
Posted: May 24, 2017 at 5:42 pm
For decades, technology has relentlessly made phones, laptops, apps and entire industries cheaper and betterwhile health care has stubbornly loitered in an alternate universe where tech makes everything more expensive and more complex.
Now startups are applying artificial intelligence (AI), floods of data and automation in ways that promise to dramatically drive down the costs of health care while increasing effectiveness. If this profound trend plays out, within five to 10 years, Congress wont have to fight about the exploding costs of Medicaid and insurance. Instead, it might battle over what to do with a massive windfall. Todays debate over the repeal of Obamacare would come to seem as backward as a discussion about the merits of leeching.
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Hard to believe? One proof point is in the maelstrom of activity around diabetes, the most expensive disease in the world. In the U.S., nearly 10 percent of the population has diabetes, around 30 million people. Within a decade, some experts say, the number of diabetics in China will outnumber the entire U.S. population. Most people who suffer from the disease spend $5,000 to $10,000 a year on medication, and diabetics with complications can spend hundreds of thousands of dollars on doctor and hospital bills. That and the lost wages of diabetics cost the U.S. alone more than $245 billion a year, according to the Centers for Disease Control and Prevention.
Thats an enormous problem to solve and a pile of potential cash and customers to be wonwhich is why diabetes is attracting entrepreneurs like ants to a dropped ice cream cone. One of those entrepreneurs is SamiInkinen. He was a co-founder of the real estate site Trulia and has long been an endurance athlete, competing seriously in triathlons and Ironman events. In 2014, he and his wife rowed from California to Hawaii. None of this fits the typical profile of a diabetic, yet in 2011, soon after yet another triathlon, Inkinen was diagnosed with Type 2 diabetes. And like many driven, super-smart data geeks, he dove into research to understand everything about his condition.
Soila Solano injects herself with insulin at her home in Las Vegas on April 18. Solano was diagnosed with Type 2 diabetes six years ago. Nearly 10 percent of the U.S. population has diabetes, the most expensive disease in the world. John Locher/AP
That journey led him to Dr. Stephen Phinney, a medical researcher at the University of California, Davis, and Jeff Volek, a scientist at Ohio State. Phinney and Volek wrote two books together about low-carbohydrate diets and published scientific papers describing how constant adjustments to diet and lifestyle can reverse diabetes in many patients. Diabetes is almost never treated that way because the program is too hard for most people to stick to. It requires so much coaching and scrutiny by medical professionals, youd pretty much have to hire a live-in doctor.
Inkinen convinced Phinney and Volek that technology could essentially re-create a live-in doctor and diabetes coach in a smartphone. Together, the three founded Virta Health in 2014. The company stayed in stealth mode until now, launching in March. It felt like a duty to do this, Inkinen tells Newsweek . Here is an epidemic of epic proportion, and nothing is working. We can combine science and technology to solve the problem at much lower cost and do it safely.
Heres how Virta works and why its approach is so important to the future of health care. On the front end, Virta is software on a smartphone. Diabetics who sign up agree to regularly enter data: glucose levels, weight, blood pressure, activity. Some do this by manually entering information; others use devices like a Fitbit or connected scales to automatically send it in. The app also frequently asks multiple-choice questions about mood, energy levels and hunger more data that the AI software crunches to learn about the patient, look for warning signs and symptoms and guide Virtas doctors.
On the back end, Virta hires doctors who get streams of updates from Virtas software and use the data to help them make decisions about how to adjust each patients diet and medications or anything else that might affect that persons health. Any clinical decision is always made by a doctor, Inkinen says. But the software increases productivity by 10-X. (Thats 10 times, in Silicon Valleyspeak.) When all this works and the patient follows the programs strict dietary and medical controls, diabetes can be reversed, clinical trials of Virtas system have shown. Around 87 percent of patients who had been relying on insulin to control their condition either decreased their dose or eliminated their use of insulin completelya success rate that matches that for bariatric surgery, which is an expensive, invasive, last-ditch effort for severe diabetics.
Virta leverages AI software, smartphones and cloud computing to allow its doctors to continually interact with many times more patients than they can in a clinic or hospital, and it gives its diabetic patients a cross between a pocket doctor and a guardian angel. The result is a promising treatment for diabetes that could get many sufferers off medication and keep them out of doctors offices and hospital emergency rooms. And that, in turn, would greatly lower the overall cost of diabetes.
Virta is just one startup of many attacking diabetes. Livongo is a more automated but less doctor-oriented version of Virtas program. The company, which raised $52.5 million in March, makes a wireless glucose-reading device that uploads the diabetics data. AI software learns about the patient and sends a stream of tips and information intended to help the diabetic manage the disease and stay out of hospitals. Yet another new startup, Fractyl, takes a more medical approach. It invented a type of catheter that seems to cause changes in the intestines that result in reversing diabetes.
Startup tracker Crunchbase lists about 130 new tech-oriented companies (the number changes constantly) involved in some aspect of diabetes. While many of these startups will fail, its hard to imagine that some wont have a significant impact.
These efforts matter to all of us because diabetes is such an enormous drain on health care resources. Venture capitalist Hemant Taneja, who helped start Livongo, says technology could take $100 billion out of the annual cost of diabetes in the U.S. Imagine if even 20 percent of diabetics could get off medication and have little need for a doctors care. All of those medical resources would get freed up for other patients and other conditions, which should help lower prices of health care for all. If we want to massively lower health care costs, we need to figure out how to address metabolic health issues [like diabetes] at their core, Inkinen says. I would bet my house that in 15 years, the future health care company looks like what were doing todaynot treating diseases at the end of the road but catching them along the way and reversing them.
A user checks blood glucose with the Livongo system. Livongo
Over the past decade, medical records in the U.S.long kept on paper in doctors horrible handwritinghave been digitized and fed into software. That hasnt helped lower health care costs yet, and in fact it is adding to them as systems get installed and medical professionals learn to use software that can be clunky. Epic Systems, the biggest electronic medical records company, handles 54 percent of patients records in the U.S. but gets bad marks for being so hard to use that it eats up doctors and nurses time. One report from Beckers Hospital Review said that almost 30 percent of Epic clients wouldnt recommend it to their peers. A survey by Black Book Market Research found that 30 percent of hospital personnel were dissatisfied with their EMR systems, with Epic getting the strongest dissatisfaction.
But theres a larger gain from the pain of EMRs: Enormous amounts of medical information are now digitized. As more medical interaction happens onlineas with Virta or Livongothe more kinds of data well collect. Internet of Things devices, whether Fitbits or connected glucose meters or potential new devices like Apple AirPods that take biometric readings, will add yet more data. All this data can help AI software learn about diseases in general, and about individual patients, opening up new ways for technology to be applied.
Some of the new applications of AI will simply improve a tragically inefficient health care industry. Qventus is a startup using AI to take all the data flowing through a hospital to learn how to free up doctors and nurses to see more patients and improve outcomes. Were creating efficiency out of seemingly nothing, Qventus CEO Mudit Garg tells me. Two years ago, work like this was so unsexy. But this is where the rubber meets the road.
One of his clients, Mercy Hospital Fort Smith in Fort Smith, Arkansas, has been able to treat 3,000 more patients a year with the same resources, an increase of 18 percent. Here again, technology is increasing the supply of medical services, potentially changing the cost equation that keeps forcing health care prices higher.
AI is also starting to automate some of the work of doctors. IBMs Watson, which uses machine learning and massive computing power to reason its way through questions, is on its way to becoming the best diagnostician on the planet. Its software can soak up all manner of available (and anonymized) patient data, plus the tens of thousands of medical research papers published every year (far more than any human could read). The system can even keep up with the news, learning, for instance, which regions are affected by a certain contagious disease, which might help diagnose someone who recently traveled to one of those areas. By asking patients a series of questions spoken into any kind of computer or connected device, Watson can quickly narrow down the possible causes of a medical problem. Today, IBM works on test projects with major hospitals like the Cleveland Clinic to put Watson in the hands of doctors, who are learning how to use the technology like a brilliant assistant.
But the day will come when Watson or something like it is available to everyone through a smartphone or some other device. Amazon is starting down that path by partnering with HealthTap to offer what it calls Dr. A.I. on Alexa, Amazons voice-activated AI gadget for consumers. Its not nearly as robust as Watson but works on the same idea. Just tell it your medical problem, and it will ask you questions to help narrow down what it might be.
A clerk works in the medical records department at Clinica Sierra Vista's East Bakersfield Community Health Center in Bakersfield, California on October 20, 2009. As medical records increasingly become digitized, their data will help AI learn more about diseases and how to help patients. Phil McCarten/Reuters
As health care AI develops, startups are also creating new kinds of genomics-based medicine. Just 16 years ago, the Human Genome Project and geneticist Craig Venters startup, Celera Genomics, published the results of their human genome sequencing within a day of each other in 2001. Venter said his project took 20,000 hours of processor time on a supercomputer. This year, startup Color Genomics is offering a $249 genetic test that can sequence most of the pertinent genes in the human body. Colors goal is to make genetic sequencing so cheap and easy that every baby born will have it done, and the data will inform his or her health care for life.
Combine genetic data about a person with all the kinds of data Watson can ingest, and were close to being able to build AI software that can at least supplant that first visit to a doctor when youre sickwhich, of course, is when you least want to travel to a doctors office. Instead, people will increasingly speak to a smartphone or to something like Dr. A.I. on Alexa about their health problems and, if necessary, send in photos of that rash or funky toe. If the system has your health care records and genetic data, it can gain more insight into your condition than any doctor operating on an informed hunch.
An early prototype of Watson in Yorktown Heights, NY. The cognitive computing system was originally the size of a master bedroom in 2011. Clockready
On many occasions, the app might tell the user the problem is nothing seriousa robot equivalent of Take two aspirin and call me in the morning. Other times, the app might send the user to a clinic to get a test or X-ray. If thats how it plays out, a large chunk of the traffic into doctors offices and hospitals will fade away.
Add it up, and in these next few years were going to see a parade of tech applications that reduce demand on the health care system while giving all of us more access to care. Doctors should be freed up to do a better job for patients who truly need their attention. Theoretically, all of this will help keep more people healthier. And if were all healthier and using health care less, the laws of supply and demand should kick in, sending the overall cost of health care tumbling.
However, there are bumps ahead because, as our erudite president recently said, nobody knew that health care could be so complicated.
The economics of health care are weird. First of all, the usual forces dont apply to highly regulated industries, and health care is perhaps the most regulated in the U.S. and around the world because lives are at stake. In most countries, regulators prevent AI software from crossing the line into independently offering a diagnosis or clinical advicethats strictly the purview of doctors. New medical devices, like Fractyls, have to get approval from the Food and Drug Administration. Lobbyists often slow regulatory change to maintain the status quo and benefit incumbents charging inflated prices.
Personal health care decisions in the U.S. often get influenced by insurance companies, employers who pay for health benefits, and Medicare. Unlike most industries, consumers in health care dont have much information about pricing or quality, so they cant weigh options and make rational choices. Moreover, we think about health differently from anything else we buy. Many of us are never satiated with health carewe always want more and better health care, if we can afford it. One study published in March showed that telehealth making doctors available by video callprompted people to seek care for minor illnesses they otherwise wouldve ignored. Only 12 percent of telehealth visits replaced in-person visits, and the other 88 percent was new demand.
Until recently, most new medical technology has been high-end products that give doctors and hospitals a reason to charge more for something that couldnt have been done in the past. Think MRI machines or robotic limbs. These improve quality of life but add to costs. In 2008, the Congressional Budget Office concluded, The most important factor driving the long-term growth of health care costs has been the emergence, adoption, and widespread diffusion of new medical technologies and services.
A doctor and patient demonstrate how they use Virta for diabetes monitoring and treatment. Virta Health
The next wave of health care technology is different. The combination of data and AI was not available until the past year or two, and it can lead to the kind of automation that has disrupted so many other industries. Many health care entrepreneurs are focused precisely on the win-win-win prospect of lowering the cost of care while making it better and available to more people. Of course, there will be challenges to address, such as making sure our highly sensitive medical data stays protected and private, even as it flies around various networks and systems.
As startups bring these technologies online, theyre often doing an end run around insurance companies, instead finding demand among consumers or employers who offer health coverage. Livongo, for instance, points out to companies that each diabetic employee costs thousands of dollars a year in care. Pay for the Livongo service, the pitch goes, and your company will save money as those employees better manage their conditions. By last year, Livongo had signed up more than 50 large customers, including Quicken, Office Depot, Office Max and S.C. Johnson & Son.As the thinking goes among health care startups, once employers and consumers embrace new technology, insurance companies, regulators and health care incumbents will have to follow.
As that happens, the technologists promise, economic forces will finally stall or reverse the climbing cost of health care in the U.S. and around the world, a development that would, if were lucky, leave the president and just about every member of Congress speechless.
Jon-Paul Pezzolo
Excerpt from:
How Artificial Intelligence Will Cure America's Sick Health Care System - Newsweek
Posted: May 24, 2017 at 5:42 pm
Every year more money is being spent studying the now-infamous plant protein gluten. The studying raises more questions. That leads to more money being spent. And then more questions.
If there was more than one lecture in medical school where gluten came up, I dont remember it. The one I remember was in 2007, in the context of celiac disease. After the lecturer mentioned gluten, a classmate raised a hand and asked him to repeat himself. People who eat what?
Of course gluten, which comes from wheat, rye, and barley, was all around us then, as it is now. Its a sort of mortar in the walls of the modern food system, in so much of what we eat or otherwise ingest and apply to ourselves. But we were barely, if at all, aware of it.
When someone with celiac disease eats gluten, it causes an immune reaction that destroys the lining of the small intestine. But as long as people with celiac disease avoid gluten, theyre fine. Got it. And like most medical doctors, thats what I remember learning about gluten.
Cut to a decade later, and this month there is a headline that says eating gluten doesnt cause people to develop heart disease.
Heart disease. I dont actually have a no shit folder but my trained impulse was to commandeer a file cabinet and start one. Id also put a study there that said gluten doesnt cause rickets or global warming. Why or how would gluten cause heart disease?
In fact, not only does gluten not cause heart disease in the general population, but people who go gluten-free seem to actually be putting themselves at an increased risk of heart disease, insofar as it means eating fewer whole grains. This discovery is among those slowly painting a picture of a diverse array of harms that come with blindly avoiding gluten. The finding comes from a group of prominent nutrition and gastrointestinal researchers at Harvard and Columbia. In a prospective cohort study in the latest BMJ, they concluded that people without celiac disease should not be encouraged to adopt gluten-free diets.
In the language of academia, thats a stern admonition. Its coming late, though, and its less compelling than the myriad promises in glossy magazines and miracle books and celebrity-endorsed facial creams. The scientists advice is at odds with the fact that gluten-free diets are promoted everywhere and Googled more frequently than any other diet. By my own rough estimate, in April some $700 quadrillion in gluten-free products were sold in California alone.
Still, the new research is among the most meaningful to date on the relationship between gluten intake and health outcomes in people without celiac disease. It is based on data from more than 100,000 people over almost two decades.
Outside of this, the few small trials that have been done to study the effects of gluten intakein which blinded participants are divided into gluten-free and gluten-containing diets and then monitored for symptomshave been short-term and small. A study like this new one can look at dietary patterns in real life and health outcomes over the course of decades. The strongest evidence in glutens favor is that the longest-lived, healthiest populations on Earth have long eaten diets that include grain products. No study has yet suggested that gluten causes heart disease.
So why was this being studied at all?
The lead researcher is Benjamin Lebwohl, a gastroenterologist with the Celiac Disease Center at Columbia University. He has spent more time thinking about the societal role of gluten than anyone Ive met before. If were going to consider science as orthogonal to whatever the public is doing, its just going to worsen polarization, he said. Well just continue to talk past each other.
In talking to patients, he notes an important difference between saying that theres no proof that gluten has health effects in the general population and saying that there is proof that gluten has no health effects in the general population. To a concerned patient, that distinction can be huge.
I talked with Lebwohl one morning recently in the hours before he started scoping, as he put it, or performing endoscopies and colonoscopies, looking through a fiberoptic tube at the parts of us most of us never see. There he has come to understand that celiac diseaseand the effects of glutenare still largely mysterious.
The textbook take on celiac disease is still that its an autoimmune condition. It is usually diagnosed by testing for antibodies called tissue-transglutaminase, and by taking a biopsy of a persons small intestine after the person has eaten gluten. If a person has celiac disease, then Lebwohl expects to see that the finger-like villi of the intestinal wall have been obliterated, flattened like a mowed lawn.
But sometimes things get strange. Some of the people Lebwohl sees who have severe atrophy of their intestinal villi eat gluten and feel totally fine. Its only when they stop eating gluten, and then are exposed to it at some later point, that symptoms arise.
He and the rest of the celiac team at Columbia also see many, many cases of the inverse: people with normal-looking bowel walls who feel horrible when they eat gluten.
Why is gluten making people without celiac disease ill? Lebwohl asks rhetorically. And why is there such variability in symptoms among people with celiac disease when they eat gluten? There are people that appear to have symptoms that are triggered by gluten, but they definitely do not have celiac disease. This is likely because its a new disorder, one for which we dont have good biomarkers [lab tests] and dont have an understanding of its mechanism.
The condition likely involves some degree of placebo and nocebo effects, and variations in intestinal flora probably also play a part. He also notes that symptoms may actually be related to FODMAPsan increasingly popular acronym for a group of carbohydrates that some believe are actually the cause of the symptoms that many people attribute to gluten (or to dairy or soy, et cetera, or simply chalk them up to irritable bowel syndrome). And nothing about these explanations is mutually exclusive.
Theres also a good chance that theres a distinct clinical entity out there we just havent discovered yet, he said. If thats the case, we have a choice. We can roll our eyes and say this isnt in the medical textbooks, which often then drives patients to alternative practitioners, and they start taking multiple supplements, or we can listen and study these patients.
Lebwohl spent his undergraduate years at Harvard studying music. After four years of medical school, four years of residency, and three years of fellowship, he did a masters degree in patient-oriented research at Columbia, and a post-doctoral fellowship in cancer-related population sciences. He came out the other end less developed than he imaginedless prepared to care for people who exist in the real world than he imagined.
After all that, I realized that people were asking me about leaky gut and candida, he said. I had zero exposure to any of these concepts, or how to approach patients who are coming to you with concepts that are totally foreign to medical training.
Ive felt the same, and I know my classmates have. When I write about these things that people ask aboutlike cryotherapy or chelation therapy or lectin-free dietingI inevitably hear from science-minded readers who are concerned that these subjects are not worthy of any coverage at all. The best course is to simply ignore them.
Lebwohls teamwhich includes veteran researchers like Harvards Walter Willettsee it otherwise. They decided to devote their time and money to studying the relationship between gluten and heart disease not because it seemed that they could be plausibly related, but simply because people believe them to be. And they believe this because of a monstrously popular 2011 book called Wheat Belly, which includes the implication that eating gluten has adverse cardiovascular effects.
The book was written by William Davis, who is a cardiologist based in Milwaukee, but whose concern about grains is substantially out of proportion to that of academic medicine on the whole. For example, he has likened eating wheat to smoking. One post on his blog warns: Whole grains are indeed healthier than white flour productsjust as filtered cigarettes are healthier than unfiltered cigarettes.
Though blindly avoiding gluten is not recommended by any body of cardiologists or preventive-medicine experts, the outsider status of Daviss alarmist hypothesis was promoted as the angle that seems to have made his book enormously successful. He promised readers secrets that few others were willing to tell them, and superiority to the sheep who had been played by the system. This narrative tends to sell. Ive previously traced the modern multi-billion-dollar gluten-free obsession to Wheat Belly, which is published by Rodale, along with subsequent spinoff books in the franchise. (Wheat Belly Total Health: The Ultimate Grain-Free Health and Weight-Loss Life Plan; Wheat Belly 30-Minute (Or Less!) Cookbook: 200 Quick and Simple Recipes to Lose the Wheat, Lose the Weight, and Find Your Path Back to Health; Wheat Belly 10-Day Grain Detox: Reprogram your body for rapid Weight Loss and Amazing Health, and Wheat Belly Cookbook: 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health.)
In all, five books to tell people to stop eating grains. The accomplice to Wheat Belly was the comparably fictive 2012 Grain Brain, the author of which has called gluten this generations tobacco, and which also became a number-one bestseller by promising secrets that no one else was willing to tell us, namely that avoiding grains would prevent and reverse dementia. Its also based on the idea that gluten sensitivity causes inflammation throughout a persons body, which has not been shown to be true. The idea has been picked up by theorists and presented as certainty, though, even the founder of The Ultrawellness Center and embattled doctor to the Clintons, Mark Hyman, who has written that even in the absence of celiac disease, gluten creates inflammation throughout the body, with wide-ranging effects across all organ systems including your brain, heart, joints, digestive tract, and more. According to his web site, he has written ten books that were number-one bestsellers.
Daviss publicist said he was unavailable for comment in time for this story, as he was doing a radio interview and then driving to Cleveland as part of a press tour for his new book. This new one is a break from the franchise in name, but not in subversive tone. Its called Undoctored: Why Health Care Has Failed You and How You Can Become Smarter Than Your Doctor. The title is not hyperbolic. The text literally sells superiority: Lets be absolutely clear: I propose that people can manage their own health safely and responsibly and attain results superior to those achieved through conventional health carenot less than, not on par with, but superior.
This is the same anti-establishment, outsider spirit that sent Daviss first book to the number-one spot on The New York Times bestseller list and brought gluten free to such a pitch that it can now be found as one of very few nutritional distinctions on restaurant menus around the world. At a time when some best-selling books sell just a few thousand copies, Wheat Belly has sold more than a million.
In that book, a lot of the science from celiac disease has been sort of co-opted and extrapolated into the general population, said Lebwohl. Like the notion that gluten is intrinsically pro-inflammatory. Thats something for which we have very shaky data.
But since people believe the story, these ideas are now the topics of serious study. They came to popularity among crowds that felt alienated and unheard, and so were susceptible to demagoguery, and now a medical establishment that has long been seen as elitist and closed-minded is paying for the power dynamic it created.
The funding for the new gluten-heart-disease study came from grants from the American Gastroenterological Association, Massachusetts General Hospital, and the National Institutes of Health. Any entrenched system is going to have a backlash; in the case of gluten, the rebellion is now leading the discourse. The team at Columbia is now working on another study looking for any relationship between gluten and cancer. (They have no reason to think that gluten causes cancer. But some people do believe this.)
I believe we need to research and study rigorously the things that patients are interested in, said Lebwohl. This is, in my view, a necessary part of sciences missionto go to where the public is interested and provide sound analysis. If the public is barking up the wrong tree, we shouldnt ignore that.
Some find this concerningthat weve entered a cycle of buying and belief that will require so much research that science will never catch up, but only ever be chasing whatever people have already chosen to believe gluten is doing to them. Others say this is exactly how science is supposed to work.
In the meantime, Lebwohl tells gluten-wary patients to be wary, rather, of any practitioner who is telling people that the problem is that their gut is leaking. And as a general rule, beware of any lab tests that tell you what foods you cant tolerate. If there is a lab that does tests that cant be paid for by conventional meansinsurance companiesmaybe that lab is testing things that are totally unproven. There are countless people who will take advantage of those who are looking for answers right now.
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Science Has Begun Taking Gluten Seriously - The Atlantic
Posted: May 24, 2017 at 5:42 pm
By Serena Gordon
HealthDay Reporter
TUESDAY, May 23, 2017 (HealthDay News) -- Fiber helps lower cholesterol, stabilize blood sugar levels and keep the bowels running smoothly, but a new study suggests it can also reduce knee pain from arthritis.
Researchers found that people who ate the most fiber reported reduced osteoarthritis knee pain by up to 60 percent. However, X-rays did not show any difference in their knees compared to those who consumed less fiber.
A second study looked at the effects of the dietary supplement chondroitin on knee pain. That study -- sponsored by a maker of the supplements -- found that taking chondroitin daily was linked to less knee pain and improved function.
But at least two bone specialists noted that the potent type of chondroitin used in the study probably isn't available in the United States, and the safety of long-term daily use of the supplement is unknown.
Both studies were published online May 23 in the Annals of the Rheumatic Diseases.
"With both of these studies, the danger is that people are thinking they're making a change in their arthritis, but they may only be masking the pain. Neither study has proven a change in the natural history of osteoarthritis," explained Dr. Victor Khabie, who was not involved with the studies. He is co-director of the Orthopedic and Spine Institute at Northern Westchester Hospital, in Mount Kisco, N.Y.
Fiber is found in fruits, vegetables, nuts and whole grains. It helps to make people feel full and reduce calorie intake. Fiber is also believed to reduce inflammation, the researchers said.
The fiber study looked at data from two other studies. One included nearly 5,000 people who had or were at risk of osteoarthritis. Their health has been monitored since at least 2006, when their average age was 61.
The second set of data came from the Framingham Offspring study, and included just over 1,200 people. That study began in 1971, and includes data from 1993 to 1994, when the average age of participants was 54. They were followed until 2002-2005.
In the first group, median fiber intake ranged from 21 grams a day to 9 grams a day. In the Framingham group, the highest group ate a median of 26 grams daily. The lowest group had nearly 14 grams daily.
People who ate the most fiber were at lower risk of developing osteoarthritis knee pain, the study found. For those in the first group who ate the most fiber, the risk went down by 30 percent. For those in the Framingham group who ate the most fiber, the risk was 61 percent less than those who ate the least fiber.
The researchers also found that people who ate more fiber were less likely to have worsening knee pain.
Lead researcher Zhaoli Dai, a postdoctoral researcher at Boston University, said, "There is a strong link among obesity, inflammation and painful knee osteoarthritis. We speculate that eating more fiber increases satiety and therefore reduces total caloric intake and reduces body weight."
But Dai added that because the study is an observational one, it can't prove a cause-and-effect relationship.
Dr. Matthew Hepinstall is associate director of the Lenox Hill Hospital Center for Joint Preservation & Reconstruction in New York City.
He agreed that the study cannot prove a causal relationship.
"Nevertheless, when combined with recently published data suggesting lower rates of osteoarthritis progression in patients who lose weight -- also only an association -- a picture is emerging that healthy lifestyles may have measurable effects on the risk of progressive osteoarthritis pain," Hepinstall said.
But he noted that plenty of people who maintain healthy and active lifestyles also develop painful osteoarthritis. So, Hepinstall added that "a high-fiber diet should not be seen as a proven strategy for preventing arthritis."
Dai said: "As the average intake of fiber is about 15 grams per day among Americans. This amount is way below the recommended nutritional goal according to the Dietary Guidelines for Americans 2015-2020, which recommends 22.4 grams/day for women and 28 grams/day for men aged 51 years and above."
According to the Dietary Guidelines for Americans 2015-2020, a usual serving of high-fiber cereal contains 9 or more grams of fiber. A cup of navy beans provides nearly 10 grams, and an apple has about 5 grams of fiber.
The second study looked at chondroitin sulfate. It's a chemical found naturally in the cartilage of the knee, according to the U.S. National Library of Medicine.
The study included more than 600 people from five European countries who had been diagnosed with knee osteoarthritis. The patients were randomly assigned to one of three treatment groups.
One group was given 800 milligrams (mg) of "pharmaceutical grade" chondroitin daily and one placebo pill to mimic 200 mg of the pain reliever celecoxib (Celebrex). Another group was given a 200-mg celecoxib pill and a placebo to mimic the chondroitin pill. The third group was given two placebo pills.
The study lasted six months. Doctors assessed the study participants at one, three and six months.
Reductions in pain and improvements in joint function were greater in people treated with chondroitin or celecoxib at three and six months. The researchers said that chondroitin provided similar relief to celecoxib.
Khabie said, "It looks like there's an anti-inflammatory or pain-relieving effect when chondroitin is taken in a very purified, very well-controlled state, but that's probably not what's available off-the-shelf [in the United States]." He noted that chondroitin is a supplement, and in the United States supplements aren't regulated in the same way that drugs are.
Khabie also said that the safety of taking chondroitin long-term isn't known.
Hepinstall echoed Khabie's concerns about the chondroitin study, but also said chondroitin might be "particularly well-suited for patients who cannot take NSAID medications." NSAIDs, or non-steroidal anti-inflammatory drugs, include ibuprofen (Motrin, Advil), naproxen (Aleve) and aspirin.
WebMD News from HealthDay
SOURCES: Zhaoli Dai, Ph.D., postdoctoral researcher, Boston University; Victor Khabie, M.D., chief, department of surgery, chief, sports medicine, and co-director of the Orthopedic and Spine Institute, Northern Westchester Hospital, Mount Kisco, N.Y.; Matthew S. Hepinstall, M.D., associate director, Lenox Hill Hospital Center for Joint Preservation and Reconstruction, New York City; May 23, 2017, Annals of the Rheumatic Diseases, online
Originally posted here:
Studies Spotlight Diet, Supplements for Knee Pain - WebMD
Posted: May 24, 2017 at 5:42 pm
Photograph by Ben Watts
Gear up for the homestretch.
At last, after a long and unforgiving winter during which you occasionally wondered if you would ever feel warmth again, Memorial Day is upon us, which means that it's almost time for that pre-summer diet and exercise regimen to which you've adhered with such discipline to pay off. Since this last week is what really separates the Globo Gym physical specimens from the Peter LaFleurs of the world, we asked a couple of registered dietitians for their advice on what you should eat in order to finish on a high note. Whether you choose to celebrate this weekend by launching yourself headlong into a sea of perfectly-grilled hamburgers and sunscreen-laced light beer afterwards, though, is entirely up to you.
Protein and produce. This may come as a shock, but lean proteins are really, really good for you. Maria Bella of Top Balance Nutrition explains that protein produces a hunger hormone called ghrelin and requires a bit more energy to digest than other nutrients, which makes these foods the bedrock of a smart diet. Vegetables should also be a major part of what you eat this weeka good rule of thumb, according to Bella, is that produce should take up about half of your plate's surface area at any given meal.
Cut starches, not carbs. Don't get confused! Carbohydrates are found in pretty much everything that we eat, and cutting them altogether would be both unnecessary and wildly impractical. But you can get all the carbohydrates you need from a few servings of fruit combined with your intake of foods that are sources of lean protein, like beans or dairy. It's the elimination of starchesfoods with high energy density and minimal nutritional value like breads and pastasthat will have the most significant impact on your precise degree of shirtless season-readiness.
Timing matters. You are probably going to feel hungry as you work off those last few pounds, but Pam Nisevich Bede of EAS Sports Nutrition is here to reassure you: It's going to be okay. Most people today prefer to eat frequently and graze throughout the day, but Nisevich Bede urges her dieting clients to reacquaint themselves with their satiety and hunger signals. As a rule of thumb, she suggests scheduling four nibbling-free hours between mealsno matter what the voices in your head say.
Eat things in order. When eating meals this week, Bella offers a simple suggestion for limiting intake of starches: Eat them last. If you've already eaten your servings lean proteins and produce, she points out, you're going to be less likely to go back for those second and third helpings of spaghetti that threaten to torpedo all your best-laid plans.
Size matters, too. You've heard it before, but it's still true: Breakfast and lunch, in that order, should be your largest meals of the day. Nisevich Bedepoints out that eating adequately during those meals will help you to avoid being tempted by myriad mid-afternoon snacks or making poor choices of the all-you-can-eat variety when dinnertime finally rolls around.
Drink water. Not just because it's hot. Nisevich Bede cautions that a principal symptom of dehydration is fatigue, which in turn makes you more likely to resort to sugary drinks or snacks for a pick-me-up. Many people also confuse the sensations of thirst and hunger, and end up eating when all they really need to do is hydrate. Bella recommends starting meals with a water-heavy course, like a broth-based soup or a green salad topped with lemon juice. You probably won't love these dishes, unless you're astoundingly boring and/or a psycho, but they'll help take the edge off of hunger.
Eating out? Don't despair. Just because you're on a mission doesn't mean you have to skip nights out and eat at home alone while contemplating the depths of your loneliness. Simple salads, lean filets, and roasted vegetables are dependable and healthy mainstays that are almost certainly available at your American restaurant of choice. If you're going out for Thai, for example, Bella recommends dishes like chicken satay and spring rolls wrapped in rice paper; if your friends are in the mood for sushi, sashimi is a no-brainer, and most rolls can be wrapped in cucumber instead of rice to save yourself the starch.
Do dessert the smart way. If you absolutely cannot go without a little treat at the end of the meal, Bella suggests that you have three bites of it. Why three? The first and last bites taste the best. Everything in between, though, tastes exactly the same.
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A Last-Minute Summer Diet to Get Your Body Ready(ish) for the Sun - GQ Magazine
