People who exercise regularly are better at creative thinking

People who exercise regularly are better at creative thinking. This is the outcome of research by Leiden cognitive psychologist Lorenza Colato. She published an article on this subject in the scientific magazine Frontiers in Human Neuroscience.

Taking a stroll

We know that authors like Søren Kierkegaard, Henry James en Thomas Mann used to take a stroll before they sat down behind their writing desk. Apparently, this helped them to get new ideas and insights. But is it possible to prove scientifically that physical exercise makes creative thinking easier?

Divergent and convergent

To find this out, Colzato investigated whether regular exercise may promote the two main ingredients of creativity: divergent thinking and convergent thinking. Divergent thinking means to think up as many solutions as possible for a certain problem. Convergent thinking leads to one single correct solution for a given problem.

Thinking tasks

The psychologist gave thinking tasks to two groups of test persons: people who do physical exercise at least four times a week -- i.e. cycling -- and people who do not exercise on a regular basis. The first assignment was a so-called alternate uses test, in which the participants had to note down all the possible uses for a pen. This was followed by a remote associates task: the test persons were presented with three non-related words, like time, hair and stretch, and had to come up with the common link, which in this case was long.

Healthy body = sound mind

On the remote associates task, people from the group of frequent exercisers appeared to outperform those who did not exercise regularly. Colzato: We think that phsysical movement is good for the ability to think flexibly, but only if the body is used to being active. Otherwise a large part of the energy intended for creative thinking goes to the movement itself. Colzato believes that these results support the famous classical idea of a sound mind in a healthy body: Exercising on a regular basis may thus act as a cognitive enhancer promoting creativity in inexpensive and healthy ways.

The Best Everyday Cookbooks

(Sweet readers! I was all set to discuss Nutritionism and Your Money today, but the response to yesterday’s Ask the Internet question was so solid, Imma gonna postpone the Pollan discussion until next week.)

When it comes to eating healthfully and frugally, one of the very best things you can do for you and your family is to cook at home. Serving meals from your own kitchen not only allows you to control ingredients and portion sizes, but keeps household expenditures way down.

Of course, if you endeavor to cook, it helps to know how. And that’s where cookbooks come in.

The internet is helpful for research and recipes and such, but there’s nothing quite like holding a well-loved cookbook in your hands; gazing at the pretty pictures and flipping through food-stained pages for a favorite dish.

Yesterday, we asked CHG readers to name their favorite everyday cookbooks, and then describe why each was so useful. Certain titles (revealed below) were name-checked over and over again, largely for the following reasons: they were well written, easy to understand, good for general erence, and included tons of never-fail recipes. Vegetarians and vegans were well represented, as were the classics, PBS, and Mark Bittman.

So, whether you’re just starting out in your kitchen, looking to give a cookbook as a gift, or searching for the ultimate in food tomes, this list will give you a kick in the right direction.

[And hey! It’s an obligatory plug! You can buy all of these through mah Amazon store! (But you don’t have to. But you can. But you don’t have to.) Incidentally, all photos are from Amazon.]

1) Joy of Cooking by Irma S. Rombauer, Marion Rombauer Becker, and Ethan Becker (7 mentions)
Seventy-nine years old and still going strong, Joy of Cooking is full of fail-proof recipes to satisfy folks across the generations. Can a book actually teach you to cook? In this case, yes.

• Jennifer: It is the only one I own.
• Denise: I still have my 20 year old copy of The Joy of Cooking which I still er to.
• K. Tree: When I need information about anything, I go with my Joy of Cooking.
• c.r.a.: Its got a good recipe for most anything you might want to cook.

2) How to Cook Everything by Mark Bittman (6 mentions)
A relatively new entry, at least in terms of the other veterans on the list, Bittmans massive, exhaustive, award-winning book could have been called Everything You Always Wanted to Know About Food (But Were Afraid to Research). Containing literally thousands of recipes, it has a place in every kitchen.

• Debbie Koenig: I dont necessarily cook from it directly, but I consult it practically every day.
• MS: [It] makes so many appearances that I might as well just leave it out.
• Leigh: I have the cookbook and then I got the $5 app for my iPhone which is the ENTIRE BOOK. ON MY iPHONE. It has repeatedly saved dinner.

3) Better Homes and Gardens New Cook Book (5 mentions)
We own this one at home, and Im consistently wowed by the breadth of recipes. While the paperback version could use a few more pictures (IMHO), BH&G has been indispensable for decades.

• Myrnie: For basics like canning, breads, breakfast, "base" recipes like frosting and whipped cream and eggs ... its always Better Homes and Gardens.
• drphibes: I was in a bookstore once and a Czech couple approached me and asked what would be a good source of American recipes. Without hesitation I pulled down a copy of BH&G.
• Anon: The three ring binder set up is great, and all the ingredient info and substitution suggestions make it handy even when Im winging it... Which is most of the time.

4) Moosewood Cookbooks - various, but mostly Moosewood Cooks at Home (5 mentions)
I think every vegetarian I know owns at least one Moosewood book. The Ithaca, New York, collective seems to publish them by the boatload, and Simple Suppers is a personal favorite.

• Charlie: The Moosewoods! I have the original, plus New Classics, Cooks at Home and Low Fat Feasts. I think I probably use Cooks at Home the most but they are all great.
• Anna N: I have fierce love for all the Moosewood cookbooks, especially Sundays at Moosewood, Moosewood Cooks at Home, and New Recipes from Moosewood.

5) Vegetarian Cooking for Everyone by Deborah Madison (4 mentions)
Another vegetarian standard, VCfE is practically a produce encyclopedia, as valuable as a erence guide as it is a cookbook. 

• Kristin: It has great general info on how to cook every possible vegetable or grain.
• Diane: Ive never made a dud recipe from it - ever.
• Anna N.: Apple upside down cake, I love you 

6) America’s Test Kitchen Family Cookbook (3 mentions)
Really, you could stick about anything from the Americas Test Kitchen or Cooks Illustrated crews in this list, but a few readers mentioned this one as the best all-around book.

• Suzanne: I rarely cooked American food until I found this book.
• Peggy: [It has] everything I need: tips, techniques (with pictures of same) product testing results and recommendations.

7) Betty Crocker Cookbook: Everything You Need to Know to Cook Today (3 mentions)
Ive owned this since I was 17, and life would be weird without it. Someday, it will have to be replaced, and Im not looking forward to that day.

• K. Tree: I still have my very first cookbook which is the 1976 version of the Betty Crockers Cookbook

8) Vegan with a Vengeance by Isa Chandra Moskowitz (3 mentions)
Moskowitz has become a veritable vegan guru the last few years, between this 2005 cookbook and 2007s Veganomicon. Whether youre interested in or already neck-deep in non-animal foods, this is the place to be.

• Leslie: Lots of delicious recipes, especially the tofu scramble.

9) How to Cook Everything Vegetarian by Mark Bittman (2 mentions)
Its like How to Cook Everything (meaning: huge, helpful, heavy), but without the meat.


HONORABLE MENTIONS

These cookbooks all received one vote, and could be worth checking out, especially if you’re interested in a particular kind of cuisine.

1000 Vegetarian Recipes by Carol Gells
660 Curries by Raghavan Iyer
America’s Test Kitchen Family Baking Book
Betty Crocker’s Big Book of Baking
Clueless in the Kitchen
Complete Vegetarian Kitchen by Lorna Sass
Cook with Jamie: My Guide to Making You a Better Cook by Jamie Oliver
Cook’s Illustrated Best 30-Minute Recipes
Desperation Dinners by Beverly Mills and Alicia Ross
Essential Dinner Tonight by the editors of Cooking Light
Fannie Farmer Cookbook
Farm Journal cookbooks
Good Food Book by Jane Brody
Good Housekeeping cookbook
Great American Favorite Brand Name Cookbook
How to Cook Without a Book by Pam Anderson
How to Eat by Nigella Lawson
Jamie’s Food Revolution by Jamie Oliver
More with Less and Extending the Table by Doris Janzen Longacre
Not Just Beans
Real Thai by Nancy McDermott
Tassajara Bread Book
The Clueless Vegetarian by Evelyn Raab
The Complete Family Cookbook
The MediterrAsian Way by Ric Watson and Trudy Thelander
The Silver Palate Cookbook
The Victory Garden Cookbook by Marian Morash
Victoria Boutenko’s books

And that’s it. Readers, any other cookbooks you’d like to add? What do you think of this list? Would you start your own collection with any of these? Do tell.

~~~

If you like this article, you might also enjoy:

• Cooking for Small Children: 15 Hows, Whens, and … Honey, Please Put That Cleaver Down
• The Dos and Don’ts of Buying a Cookbook
• Saturday Throwback: Frugal Food Hacks - 10 Tricks to Simplifying Online Recipe Searches

Bittergourd Urad Dal Pappu

Bittergourds are wonderful vegetables and its one the most hated vegetable in the world especially by kids, even i dont like this better bittergourd before,but after going through its nutritional value and health benefits, i started adding them in different dishes. Am trying my best to feed this bittergourds to feed my entrie family eventhough they hate it to the core. Coming to this dish, its one of my recent invention, as dals are our family comforting food.Watever cooked with vegetables and dals or with simply dals goes directly to our comforting food list.

Bittergourd cooked with urad dal and moongdal makes seriously a wonderful dal dish and eventhough this dal have a slight bitter taste its doesnt matter, however i tried my best to feed my family with this healthy vegetable.Served with simple potato fry, we had this bitter dal for our lunch. You can feed easily this dal to diabetic peoples who lives around you and am sure this dish will definitely makes a difference when compared to other dishes prepared with bittergourd.Sending to my own event CWS-Urad Dal guest hosted by Sowmya of Nivedhanam and to my event Healthy Diet-Diabetic Friendly Recipes.

1/4cup Urad dal (deskinned & split)
1/4cup Yellow Moongdal
2nos Bittergourd (chopped)
1no Onion(chopped)
1no Tomato (chopped)
2nos Green Chillies (slit opened)
1tsp Mustard seeds
1/2tspUrad dal
1/2tsp Cumin seeds
2nos Dry red chillies
1/4tsp Asafoetida powder
1/4tsp Turmeric powder
Few curry leaves
Salt
Oil
Chopped coriander leaves

Pressure cook the urad dal,moong dal,chopped bittergourd with turmeric powder and salt with enough water upto 3 hisses.

Keep aside until the steam gets released

Heat enough oil, lets splutters the mustard seeds,urad dal,cumin seeds,asafoetida powder, add the red chillies and fry until they turns brown.

Now add the onions,chopped tomatoes,slit opened green chillies,curry leaves and saute until the veggies gets well cooked.

Add the cooked dal-bittergourd mixture to the tempered spices,cook everything for few minutes,put off the stove.

Add the chopped coriander leaves to dal,give a stir.

Serve hot with papads along with rice or simply with rotis.

The Sweet Stuff A New Color in the Packet Rainbow

Part 1 in a 2-part series about sugar and sugar substitutes. (And sorry about the technical glitch we had this morning. Eegods!)

Hey y’all! It’s me, Leigh. On a Wednesday. I know, it feels a little weird to me too. But not to fear, we’re going to have a blast.

The great wide InterWeb is bursting with noise about sugar substitutes, particularly the artificial kind, and now a new color has jumped into the sky and affixed itself to the rainbow between yellow and blue.

How do we sort through all the shouting? Does Equal really cause cancer? Does Splenda really have chlorine in it? Is Sweet ‘N Low as deadly as Skinny n Sweet? And what in the name of Sweet Angela Lansbury is stevia?

Well, depending on which sources you trust, the answers questions one through three are Yes and No. Four, well get to in a bit. For the love of Angela.

The Skinny on Artificial Sweetners
Medical regulating and reporting agencies like the FDA, the Department of Health and Human Services, and the Mayo Clinic tout artificial sweeteners as safe and promote their use with little reservation. The Mayo Clinic does remind folks that “The FDA has established an ‘acceptable daily intake’ (ADI) for each sweetener,” and provides a handy chart for determining just how much fake sugar is acceptable to ingest in a day.

A lot, it turns out: 18-19 cans of aspartame-sweetened soda, 6 cans of sucralose-sweetened soda, or 9-12 packets of saccharine. Makes the 2-liter-a-day Diet Coke habit I kicked a few years ago seem minor.

But organic healthy practitioners are less confident in chemical sweetners. Natural News reports on an 11-year study conducted by doctors at Boston’s Brigham and Women’s Hospital which found that that beverages containing aspartame reduce kidney function. The same article sited a 2008 Journal of Toxicology and Environmental Health study which indicated that sucralose messes with the flora in the gastro-intestinal tract “and inhibits the assimilation of dietary nutrients.”

Okay, not so good news for my Diet Coke habit. The rumors of cancer, chlorine, and death by rat poison are still volleyed back and forth so often, it’s hard to know who or what to believe. Im going to keep picking on aspartame, because its so easy.

In 2005, Environmental Health Perspectives, a journal of the National Institute of Environmental Health Sciences (a division of the Department of Health and Human Services), published a study linking aspartame to lymphoma and leukemia in rats. Five minutes later, in 2006, the National Cancer Institute, also a branch of DHHS, published findings debunking that very study.

Then, in 2007, EHP produced yet another study demonstrating the link between aspartame and cancer. Your ball, NutraSweet.

Time for a breakdown
Aspartame aka Nutrasweet, Equal
Aspartame is widely used as a beverage sweetener, but because of its instability when heated, it is not recommended for baking or cooking. Aspartic acid and phenylalanine, both amino acids, are combined with methanol to give us that one-of-a kind flavor. Mmm...acidy.

Sucralose aka Splenda
Sucralose (aka Splenda), used in beverages and baked goods because of its heat stability, is marketed as “made from sugar.” Yes, that’s true. Chemists take sugar and add chlorine until its a completely different substance. So, yes, the natural foodies (like me) are right -- it does have chlorine in it. However, because of the way the body metabolizes sucralose, it pretty much scoots right out. But, um, its not sugar...not even close.

Saccharin aka Sweet ‘n’ Low
Saccharin, a delicious extract of antranilic acid, nitrous acid, sulfur dioxide, and ammonia, has been around since the late 19th century. But a series of questionable lab tests in the 1970s put a blight on its chemical-aftertasty name. Testify if you grew up on Tab. In the late 1990s, the methodology of the earlier studies was called into question, and now saccharin is back in action, or in the pink, or yeah.

Acesulfame potassium aka ACK, SweetOne, Sunsett
Usually blended with other sweeteners, acesulfame-K is heat stable and highly controversial. Its primarily used in gum and baked goods in the U.S., but questions about the rigor of its testing remain.

Sugar Alcohols
Isomalt, xylitol, mannitol, sorbitol, lactitol, and maltitol are the most common sugar alcohols found in sugar-free gum and candies, as well as toothpaste and mouthwash. Xylitol is often found the sweetener aisle in granulated form for use as a beverage additive/food topping. Sugar alcohols are often marketed to people with diabetes, as the sweeteners require little to no insulin to be metabolized. However, consumed in large quantities, sugar alcohols can have a laxative effect. Technically, sugar alcohols are natural sweeteners, but they require futzing.

Stevia: The “New” Color in the Rainbow
Truth is, stevia, a Paraguayan herb from the chrysanthemum family, is not new. It has been used in Japan since 1971,  available in the U.S. since 1995, and was kicking around South America for centuries before that. I’ve been using the sweet leaf in my tea for at least 12 years. Until 2008, however, Stevia rebaudiana was only available as a “dietary supplement” in health food stores, not approved by the FDA as a food additive.

But with a little push from Cargill and Whole Earth Sweeteners (a subsidary of Mericant, of Equal fame), the FDA has finally allowed a stevia derivative, Rebaudioside A into the sweetener game, dominated by aspartame and sucralose. Brands like Truvia (Cargill), PureVia (Merisant), and Stevia in the Raw (Cumberland Packaging, makers of Sweet N Low) combine Rebaudioside A with other sugars, bulking agents, and “natural flavors.”

Truvias first ingredient is erythitol, a sugar alcohol, followed by Rebiana, their trade name for Rebaudioside A, and "natural flavors," which can be "...flavoring constituents derived from a spice, fruit or fruit juice, vegetable or vegetable juice, edible yeast, herb, bark, bud, root, leaf or similar plant material, meat, seafood, poultry, eggs, dairy products, or fermentation products thereof, whose significant function in food is flavoring rather than nutritional." (FDA: 21CFR501.22). So anything!

The first ingredient of PureVia is dextrose--a corn sugar--then "Reb A," cellulose powder--a perfectly respectable bulking agent--and once again, those pesky natural flavors. Stevia in the Raw is somewhat closer to the real thing: dextrose and stevia extract in their packet version, and maltodextrin plus stevia extract in their cup-for-cup baking product. Maltodextrin is a grain-sugar bulking agent which could come from any number of grains, but most likely wheat in the U.S. Bulking agents are what fill out the packet. Its all about consumer comfort.

The dietary supplement version of stevia is less likely to contain fillers, and is most commonly found in powdered and liquid forms at the health food store or natural market. Just a pinch or a drop sweetens as much as a teaspoon of sugar. And because it’s not heat-reactive, it’s recommended for sugar-free baking.

While some still have their reservations about the safety of stevia, Mother Earth News is convinced, citing several studies that show stevias health benefits, in particular a Danish study indicating that "stevia may be advantageous in the treatment of type-2 diabetes."

But what does stevia taste like? Well, it is very sweet, but like anything else that isnt sugar, it doesnt taste like sugar. There is a bit of an aftertaste that some equate with licorice, especially if you use too much. Me, I love it. I dont even notice the aftertaste, though I find other artificial sweeteners to be just awful-tasting. Everyones taste buds have a learning curve. Its a matter if you want them to learn.

We love our unprocessed, whole foods around these parts. But what about you, dear readers? Do you use artificial sweeteners or their delivery vehicles? Have you tried stevia or the new stevia products? What do you think? Have you tried baking or cooking with sucralose or stevia? Check back tomorrow for Veggie Might: Baking with Stevia.

Sources/Further Reading:
CSPI, Chemical Cuisine
NY Times, Artificial Sweeteners
NY Times, Graphic: How the Sugar Substitutes Stack Up
Yale New Haven Hospital Nutrition Advisor, Sugar Alcohol
Harvard Healthbeat, Are Artificial Sweeteners Safe?
Health.com, Stevia rebaudiana
Mother Earth News, Stevia: This Sugar Substitute Is Sweet and Healthy

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If you took a shine to this article, sidle on up to
The Problem with Diet Foods
When to Splurge on Organic
Reader Replies: Healthy Defined

Couple of weekly portions of oily fish can help ward off stroke

But fish oil supplements dont have the same effect

Eating at least two servings of oily fish a week is moderately but significantly associated with a reduced risk of stroke, finds a study published on bmj.com today.

But taking fish oil supplements doesnt seem to have the same effect, say the researchers.

Regular consumption of fish and long chain omega 3 fatty acids has been linked with a reduced risk of coronary heart disease and current guidelines recommend eating at least two portions of fish a week, perably oily fish like mackerel and sardines. But evidence supporting a similar benefit for stroke remains unclear.

So an international team of researchers, led by Dr. Rajiv Chowdhury at Cambridge University and Professor Oscar H. Franco at Erasmus MC Rotterdam, analysed the results of 38 studies to help clarify the association between fish consumption and risk of stroke or mini-stroke (transient ischaemic attack or TIA). Collectively, these conditions are known as cerebrovascular disease.

The 38 studies involved nearly 800,000 individuals in 15 countries and included patients with established cardiovascular disease (secondary prevention studies) as well as lower risk people without the disease (primary prevention studies). Differences in study quality were taken into account to identify and minimise bias.

Fish and long chain omega 3 fatty acid consumption was assessed using dietary questionnaires, identifying markers of omega 3 fats in the blood, and recording use of fish oil supplements. A total of 34,817 cerebrovascular events were recorded during the studies.

After adjusting for several risk factors, participants eating two to four servings a week had a moderate but significant 6% lower risk of cerebrovascular disease compared with those eating one or fewer servings of fish a week, while participants eating five or more servings a week had a 12% lower risk.

An increment of two servings per week of any fish was associated with a 4% reduced risk of cerebrovascular disease. In contrast, levels of omega 3 fats in the blood and fish oil supplements were not significantly associated with a reduced risk.

Several reasons could explain the beneficial impact of eating fish on vascular health, say the authors. For example, it may be due to interactions between a wide range of nutrients, like vitamins and essential amino acids, commonly found in fish. Alternatively, eating more fish may lead to a reduction in other foods, like red meat, that are detrimental to vascular health. Or higher fish intake may simply be an indicator of a generally healthier diet or higher socioeconomic status, both associated with better vascular health.

The differences seen between white and oily fish may be explained by the way they are typically cooked (white fish is generally battered and deep fried, adding potentially damaging fats).

Although theres a possibility that some other unmeasured (confounding) factor may explain their results, the authors conclude that "they reinforce a potentially modest beneficial role of fish intake in the cause of cerebrovascular disease."

In addition, they say their findings are in line with current dietary guidelines that encourage fish consumption for all; and intake of fish oils to people with pre-existing or at high risk of heart disease. They also support the view that future nutritional guidelines should be principally "food based."

In an accompanying editorial, authors from the Division of Human Nutrition at Wageningen University suggest that although it is "reasonable" to advise patients that eating one or two portions of fish per week could reduce the risk of coronary heart disease and stroke, any benefit of long chain omega 3 fatty acid supplementation is likely to be small. They say it is possible, however, that patients with additional risk factors such as diabetes may benefit.

Top Natural Weight Loss Supplements

As children and adults continue to wage a losing battle against excessive weight and obesity, the impact to health and longevity is beginning to take its toll.  Dietary excess, lack of exercise and stress are contributing to skyrocketing levels of the major killers.  

Heart disease, diabetes, cancer, stroke and Alzheimers account for over 60% of deaths annually.  Children and teens are the largest growing segment of this epidemic, as they are increasingly raised on a processed diet of sugar, ined carbohydrates and trans fats which have been stripped of essential nutrients and are directly linked to disease when consumed for extended periods.  Targeted supplementation has been shown to be effective as a compliment to a healthy diet and can fuel weight loss through unique metabolic mechanisms.

Green Tea Steps Up Metabolism

Green tea is packed with natural antioxidant and anti-inflammatory compounds known as polyphenol catechins.  EGCG is a catechin which combines with caffeine in the minimally processed green tea and is effective in increasing the Base Metabolic Rate in the body.  This means that calories are continually being burned at a higher rate resulting in reduced fat storage and weight loss.  

Green Tea has the added advantage of modulating the effect of insulin which determines whether carbohydrate calories are stored as fat or burned for fuel.  This is especially important for diabetics as the disorder is characterized by insulin resistance and improper uptake of glucose by the cells. 

Green Tea has been shown to assist in weight loss when combined with a regular fitness program and a diet which drastically restricts ined carbohydrates and highly processed manufactured foods in favor of plenty of raw vegetables, nuts, seeds, lean protein and healthy fats.

Resveratrol Mimics Calorie Restriction

Calorie Restriction has long been known as an effective means to extend lifespan in animals and can also lead to healthy weight loss as a result.  By reducing calories consumed by 25%, certain genetic survival mechanisms are triggered in the body.  Specifically, a group of genes called SIRT1 are sensitive to how much food we are eating, and can slow down or speed up our longevity genetics to ensure reproduction during times of famine.  

Most people today eat enough calories to prevent SIRT1 from activating, but studies are demonstrating that we can mimic Calorie Restriction by taking a powerful grape skin extract called Resveratrol.  Resveratrol works best as an adjunct to continued weight loss after calorie intake has been reduced, as it activates the SIRT1 genes to fuel fat metabolism.

 

DHA From Fish Oil Supports Weight Loss

Omega-3 fats from fish and fish oil have been credited with supporting heart and brain health, and now natural weight loss can be added to the impressive list of benefits.  The DHA component of fish oil is used by the body to construct the outer membrane of each cell, and when this fat is available from diet or supplementation, it creates a healthy cell wall which allows the proper influx of oxygen and nutrients.  

This permits the cell to operate efficiently, and in addition to helping prevent potentially serious diseases such as cancer and Alzheimers, DHA increases the metabolic rate of the cell which burns additional calories.  DHA directly influences how fat stores are released for use as energy and the regulation of blood sugar by the body.  Proper diet and exercise are essential to maximize the effectiveness of DHA.

A solid weight loss strategy is essential for every health conscious child and adult.  Hundreds of thousands of unnecessary deaths are recorded each year from the major killers, and lives can be spared by a sensible approach to diet and exercise.  Additionally, targeted powerhouse dietary supplements help to fuel fat burn and weight loss naturally, while providing major health benefits.  As with any health regime, supplements are only a part of the overall program, but they can provide key support toward an extended, disease-free life.

B Vitamins and Omega 3 Fats Slow Alzheimer’s Disease Progression

Proper nutritional status attained by consuming a healthy diet teaming with natural vitamins and minerals along with optimization of omega fat lipid ratios can help to prevent cognitive decline associated with Alzheimer’s disease (AD) pathology. Researchers studying the effects of nutrition at Oxford University in England found that daily supplementation with folic acid and vitamins B6 and B12 lowered levels of homocysteine, a known risk factor leading to decline in cognition and memory.

Further evidence published in the journalMolecular Nutrition & Food Researchexplains that a disproportionate ratio of omega-6 to omega-3 fatty acids plays a crucial role in the development of AD in later life. Cellular nutritional saturation from diet and appropriate supplementation with B vitamins and omega-3 fats may provide the cornerstone to prevent this most feared memory-robbing disease.

B Vitamin Supplementation Shown to Lower Homocysteine by 30% and Slow Brain Atrophy

Reporting in theInternational Journal of Geriatric Psychiatry, scientists examined the proposed link between elevated homocysteine levels and cognitive decline. Homocysteine has already been shown to dramatically increase the risk of heart disease and heart attack in prior studies. Researchers examined 266 people over the age of 70 with established mild cognitive impairment, and broke them into two groups. One group was supplemented with folic acid, vitamin B6 and B12, vitamin cofactors that lower homocysteine levels, while the second group received a placebo.

Brain wasting or atrophy is a common sign of cognitive impairment and is closely associated with Alzheimer’s dementia. The rate of brain atrophy is increased by higher concentrations of homocysteine in the blood and brain tissue. Researchers examining the results of this study found that the group supplemented with B vitamins for a period of two years experienced a 30% reduction in homocysteine levels. They found dramatic improvements in mental tests including global cognition and episodic memory (69% improvement in word recall memory) compared to the control group.

Omega-6 to Omega-3 Fat Ratio in Diet Creates an Imbalance in the Brain

The standard American diet (SAD) includes large quantities of oxidized omega-6 fats from fried and processed foods when compared to omega-3 fat consumption (from fish, nuts and seeds). The ratio of omega-6 to omega-3 fatty acids ranges from 20:1 to as high as 50:1 (ideal range is no more than 4:1), creating a perpetual degree of inflammation throughout the body. Researchers have determined that this imbalancecreates a disturbance in brain chemistry affecting neurotransmitter balance and electrical firing in the brain that sets the stage for amyloid tangles and cognitive decline.

Reestablishing omega fat homeostasis by balancing toward a 1:1 intake ratio and correcting B vitamin nutritional deficiencies provide deep insight toward understanding and controlling risk factors for the development of many forms of dementia including Alzheimer’s disease. Most middle aged adults will want to include a high potency B vitamin supplement (perably formulated from natural food sources) and include omega-3 fats from diet or fish oil consumption to lower dementia risk factors.

Food is a powerful deterrent prostate cancer

Food is a powerful deterrent prostate cancer - For the first time, researchers have shown that healthy foods such as pomegranate, green tea, and broccoli able to fight prostate cancer.

During the six-month clinical trial at Bedford Hospital, researchers worked with 203 patients with prostate cancer. Researchers then divided the patients into two groups, the first is given healthy meals and two capsules were given a placebo drug.

After the study ended, proved that the group of patients taking the capsules are made ​​of pomegranate extract, green tea, turmeric, broccoli and experience levels of the protein antigens of cancer cells indicates 63 percent lower.

"Eating a healthy diet and lifestyle is keeping the main way to combat prostate cancer. Yet we also prove that any food supplement in the form of a powerful ward off prostate cancer," said Professor Robert Thomas, as quoted from Red Orbit.

Meanwhile, earlier there is also research that says that fried foods proven to increase the risk for prostate cancer in men.

Researchers also hope their findings could be used to help millions of men who suffer from prostate cancer.

Strength Exercises For Thighs

Purpose of the exercise
This training exercise engages and develops the entire body but is especially the thigh muscles and glutes. This is the king of bodybuilding exercise: "Those who do not are not Squat Strength" is a phrase we often hear from the mouths of bodybuilders.

Muscles targeted
The gluteus maximus, quadriceps (rectus femoris, biceps femoris, vastus lateralis and internal), rear thighs (half membranous, semitendinosus), soleus calf, abdominal muscles fixers, small and medium glutes, adductors, back (spinal, lumbar ) and to a lesser extent, the muscles of the shoulder girdle (shoulder, trapezius) to hold the bar.

Execution of the exercise
Standing, based on the trapeze bar, hands spaced shoulder width or more, duck feet ten hours ten, slightly wider apart than shoulder width apart and placed in the axis of the knee. Bend your knees and push your buttocks backward, right chest. Theoretically down until your thighs are parallel to the ground, but it is best to limit the amplitude if you feel you round the back or take off your heels off the ground. The bar goes up and down vertically without stops in the up position and rebounds in the down position. The balance is difficult at first, it takes time to master the exercise.

Breathing
Inhale when lowering the bar and exhale as you go back to the starting position keeping your abs tight.
It is advisable not to hold your breath during the ascent, however this maneuver minimizes the risk of lumbar injury when the load is heavy. The blocked breathing and abs in the critical part of the movement sleeve trunk and protect the spinal condition of course keep your back straight.

Safety
Work safely with a footrest bar or squat rack. This serves to rest the bar between sets but also to raise the bar on media (candles) in case you stay stuck in the load lowered.
Beginners in bodybuilding must learn this movement using a light bar and increase the load once controlled exercise. It is better to learn in a room with professional state certified.
Check the items fitness section, including the dedicated Squat page. It contains many tips on this exercise.

Variants
Variations are possible by varying the position of the feet and the distance between the thighs.
If the legs are wide apart and feet placed duck ten ten hours will result in more work for the inner thighs (adductors).
If the legs are tight with straight legs seeking more vastus lateralis located on the side outside of the thighs.

Retail Clinics for Chronic Conditions Like Asthma Hypertension Lipids and Diabetes Mellitus A Look At the Value Proposition

Is there a business model in there?

To the delight of skeptics, pundits and bloggers everywhere, U.S. health orm continues to follow its predicted trajectory: fiscal shortfalls are now biting the nominally "wealthy," the Feds arent about to admit that theyre in over their head on implementing their health insurance exchanges, opportunities for cronyism are increasing and the DMCB spouse is wondering why her supposedly expert-husband cant find health insurance for less than a thousand a month.

In the meantime, theres no sign that Washington DC will ease up on the "accomodative" money-printing presses that are feeding "QE Infinity."  Thats no problem, though, because Europe is reminding us that once the paper currency is undermined, selling gold is a handy way to quell grumpy voters and prop up the welfare state.

Yet, Clayton Christensen tells us a fix is at hand: much of health cares quality and costs travails, he says, can be solved by embracing the disruptive innovation of non-physician treatment of acute and chronic conditions.  His supporters are undoubtedly cheering Walgreens recent decision to to have its 330 Take Care Clinics add hypertension, diabetes, high cholesterol and asthma care to its portfolio of nurse practitioner services.

After reading the usual retail clinic policy tomes both for ("access to care") and against ("health care balkanization" plus "missed diagnoses"), the Disease Management Care Blog isnt convinced that Walgreens decision is such a slam dunk.

Thats because these clinics business proposition is less about innovation and more about being a loss leader that increases retail pharmacy foot-traffic. In fact, offering free retail clinic services has been tried. The premise is that the retail customer-patients will stop by the pharmacy window for new drugs and, while theyre at it, renew those other high margin prescriptions.  If they pick up some diapers and nail polish while making their way to the front of the store, all the better.

While that certainly sounds good, retail clinics are not a build-it-and-they-will-come cash machine.  Recall that CVS had to pull the plug on its retail clinics several years ago.  Foot traffic didnt materialize and the supposed loss leader turned into a money pit. 

The good news for Walgreens is that they have Jeffrey Kang in their corner.  Prior to this, he led health insurer CIGNAs disease management initiatives. He undoubtedly understands retail, population-based outcomes and care coordination. If anyone can pull this off, he can.

The DMCBs conclusions?

It wont be easy. While Walgreens we-accept-all-insurance plans-VISA-Mastercard-and-American Express foray into primary care might work, it could also fail. Large health care systems use their primary care providers to feed their high margin and still-profitable specialty care services.  On the other side, small physician-owned practices are learning that hustling, high service standards, attention to overhead, accurate billing, patient mix and ancillaries can be profitable. Walgreens has neither. It remains to be seen whether this publicly owned companys bottom line will be aided by salaried NPs chasing pharmaceuticals narrowing margins.

Speaking of margins, the DMCB wonders if Walgreens will use its clinics to steer patients toward favored formularies or aid rebate and market share agreements. Could they also use and eventually monetize the Big Data like Target to further the companys business interests? If any one knows, please contact the DMCB.

Commoditization?  The DMCB thinks so and its not alone. Over time, the professionals staffing these clinics may find primary care is more complex and that they and their patients deserve better.

Ease of Exit? For who? Given that this is ultimately a business, it would be corporate malfeasance if Walgreens didnt have an exit strategy. Unfortunately, one companys exit could be another patients abandonment. Thats a real risk for the patients who come to count on Walgreens for their longitudinal care.

Patient Centered Medical Home Threat... or Friend?  The DMCB doesnt think so. If the medical home offers the value that its advocates say, savvy health care consumers will be able to vote with their feet. If the PCMH falters, it wont be because of Walgreens; in fact, the threat of competition may force help medical homes be more efficient.  In the meantime, medical homes should treat retail clinics like a community resource and er (or outsource) appropriate patients for routine health care. Why not?

Brain Tumor Symptoms and How They Lead to Brain Cancer Diagnosis

Brain Tumor Symptoms and How They Lead to Brain Cancer Diagnosis

There are a lot of possible brain tumors symptoms, and most of them can also be found in people who do not have this ailment. Thus, some people tend to dismiss the signs they experience without knowing that they can lead to a cancer diagnosis. Knowing the common symptoms of brain cancer can help by alerting patients who experience these so that they would undergo a brain scan to determine whether a cancer is present.

Brain Tumors Symptoms

Headaches. The most common symptom is a persistent headache. Over 46% of patients with brain cancer experience headaches, although they usually experience them differently and with no defined pattern. Headache that may be due to a tumor is usually accompanied by nausea and vomiting, and can get worse when you bend over.

Seizures. Seizures are the second most common among all brain tumors symptoms, with 33% of patients reporting a seizure prior to a diagnosis. Seizures are also linked to other diseases such as stroke or epilepsy. If a person is diagnosed with epilepsy or hypertension, seizures should still be brought to the attention of a doctor. However, if it is a persons first time to have a seizure, it is usually indicative of a new illness that he might not be aware of. One of the possible illnesses this may point to is a brain cancer. Thus, a person should get a brain scan immediately after the incident.

Vision or Hearing Problems. A person with a brain cancer will also most likely experience some problems or abnormalities in vision or hearing. Around 25% of patients experience vision problems. These problems occur when a tumor is causing an increased intracranial pressure on the areas of the brain that control hearing and vision.

Behavioral and Cognitive Abnormalities. Some changes in behavior and cognitive ability have been reported among patients with brain tumors. These include problems in short-term memory, inability to concentrate, inability to find the right words to use, and abnormal behavior such as uncharacteristic lack of patience or loss of inhibitions.

Strange Sensations. Since the brain controls much of the body, a tumor can also cause some problems with any body part. Usually, these manifest in strange sensations or a weakening feeling in the legs, arms, facial muscles, head, or hands. These symptoms have been reported in 25% of patients. However, these are also signs of a stroke. When these suddenly occur, the patient must be brought to the doctor. If a stroke is ruled out, then the patient will be advised to get a brain scan to check for tumors.

Brain tumors symptoms and diagnosis can be tricky. When doctors are faced with these, they usually consider the more common causes first before they consider brain cancer. However, some doctors tend to take too long testing different diagnoses, and this may lead to a delay in treatment. Thus, trust only a cancer specialist experienced in dealing with the symptoms.

Article Source: http://EzineArticles.com/7224864

A Money Back Guarantee in Health Care You Bet!

Who cares about the color, so
long as it catches mice?

Talk about disruptive.

While an unholy alliance of CMS mandarins, fawning think-tank supporters and earnest academics continue to promote their top-down "mainframe" health care ideology, along comes AMCHealth and their money back guarantee.

While the Disease Management Care Blog can only speculate on the how the contracting details would work, AMCs fundamental value proposition is pretty compelling: it promises it will reduce a clients hospital readmissions by "at least 10% within 90 days of deployment" or your money back. AMC is confident it can use interactive voice response (IVR) technology and nurse case managers to identify and then help at-risk patients who might otherwise have to be rehospitalized when things are not going well.

In the meantime, the prevailing Washington DC health orm ideology is that hospitals, doctors, nursing homes and community organizations large and small should pool and sort existing resources under the twin banners of integration and coordination. Mix the solar power of CMS innovations, the fiscal wisdom of the White Houses insurance experts, the academispheres eternally funded prospective research studies and politically targeted community grants and, if the Feds have their way, the nations health care non-system will morph into large regional and regulated utilities. Twenty percent of the national GDP will be under the firm control of CMS.

Maybe the DMCB is being overly suspicious. That being said, many of the academics, regulators and government long-timers who are presiding over the medical-industrial complex have made no secret of their disdain of outsider-run care management to the DMCB in meetings and conversations. Using Deng Xiaopings famous observation, they want their cats to be only one color.

The entrepreneurial AMCs of the health care world are a threat to that vision.  Not only are they a viable business option for impressive organizations like this, theyve backed up their claims in the peer-reviewed literature.

If these for-profits succeed, the mainframe healthcare ideology could go the way of dinosaurs, FEMA and Amtrak. By offering solutions that are faster, cheaper and guaranteed, the ultimate success for health care institutions wont lay securing local monopolies but the decentralized and organic business approaches with a mix of build or buy being used in other sectors of the economy.

Image from Wikipedia

Regular Exercise and Active Lifestyle Lower Risk of Developing Alzheimer’s Disease

Scientific studies have previously demonstrated that many lifestyle factors as well as diet can have a major impact on genetic expression that either promotes of inhibits the development of Alzheimer’s dementia. Recent studies have demonstrated that insulin signaling and resistance in the brain result in the formation of amyloid protein tangles that are a hallmark of disease progression.

A new study by neurological researchers from Rush University Medical Center that will be published in the online journalof Neurology demonstrates that daily physical activity may reduce the risk of Alzheimers disease and cognitive decline, even in people over the age of 80. Integrating a healthy diet including foods known to suppress sharp insulin and glucose spikes along with sensible supplementation (curcumin, resveratrol, grape seed extract and omega-3 fatty acids) and regular physical activity may be sufficient to halt Alzheimer’s progression as we age.

All Types of Physical Activity Found to Dramatically Lower Alzheimer’s Disease Risk

Lead author of the study, Dr. Aron S. Buchman noted “The results of our study indicate that all physical activities including exercise as well as other activities such as cooking, washing the dishes, and cleaning are associated with a reduced risk of Alzheimers disease.” The study reinforced the concept of remaining physically active each day to ward off this devastating form of dementia.

Strenuous exercise is not essential and may hold potential health risks for the aging population. The key is to avoid becoming confined to a chair: keeping the muscles and brain active can dramatically alter brain chemistry and metabolism to prevent Alzheimer’s.

Lack of Physical Activity Nearly Triples the Risk of Developing Alzheimer’s Disease

To determine daily physical activity levels, researchers asked 716 older individuals without dementia and an average age of 82 to wear a device called an actigraph, a device attached to the wrist that monitors activity levels, for a period of ten days. Additionally, participants were given annual cognitive tests during this ongoing study to measure memory and thinking abilities. All types of physical activity from structured exercise sessions to common everyday tasks were recorded for analysis.

Over a three and a half year follow up period, 71 participants developed Alzheimer’s disease. Researchers determined that those individuals in the bottom ten percent of daily physical activity were more than twice as likely to develop Alzheimers disease compared to those in the top ten percent. Further, the scientists found that those in the top ten percent as rated by physical intensity were nearly three times as likely to develop Alzheimer’s dementia, as compared to the lowest intensity group.

Dr. Buchman concluded“Our study shows that physical activity, which is an easily modifiable risk factor, is associated with cognitive decline and Alzheimers disease.” This study adds to the mounting evidence that Alzheimer’s disease can be prevented by adopting a lifestyle of healthy eating, stress-reduction, minimized exposure to pesticides and toxins and engaging in daily physical activity.

Want to loose weight try some Yogurt

Researchers found that obese adults who ate three servings of fat-free yogurt a day as part of a reduced-calorie diet lost 22% more weight and 61% more body fat than those who simply cut calories and didnt bone up on calcium. Yogurt eaters also lost 81% more fat in the stomach area than non-yogurt eaters.

Scientists studying the power of probiotics yogurt ( a special kind of yogurt that has beneficial bacteria) to fight obesity got more than they expected for, they not only found that yogurt made the subject slimmer, it also makes them sexier.

Studies in humans suggest eating yogurt may help stave off age-related weight gain. Some researchers in Us wanted to know how and why?  Maybe it has to do with the healthy bacteria that live in our guts, Experts say there are 10 times more bacteria in the body than human cells. “Maybe probiotics in the yogurt have something to do with the effects on weight.”

To test the theory, researchers fed one group of mice a normal mouse diet and another group the same diet with a mouse-sized serving of vanilla yogurt. One of the first thing they noticed was their fur coat, It was so thick and shiny, shockingly shiny.

But shiny fur wasn’t the only thing that set the yogurt-eating mice apart from their siblings, They were also slimmer and sexier actually the males had “swagger.”

“We knew there was something different in the males, but we weren’t sure what it was at first, you know when someone’s at the top of their game, how they carry themselves differently? Well, imagine that in a mouse.” scientist said.

They noticed their testicles were protruding out really far, It turns out their testicles were 5 percent bigger than those of their non-yogurt eating counterparts, and 15 percent bigger than those of mice on a diet designed to mimic “junk food” in humans. And in this case, bigger was better.

“Almost everything about the fertility of those males is enhanced,”  said a scientist, explaining how yogurt-eating males mated faster and produced more offspring. “There were legitimate physiological differences in males fed probiotics, not just the extra sexiness.” And let’s not forget the ladies. Female mice that ate yogurt were even shinier than the males, and tended to be better moms to their larger litters.

“scientists think it’s the probiotics in the yogurt, those organisms are somehow directly interacting with the mice to produce these effects.” Although the study is ongoing, the fluky findings could have implications for human fertility and weight control, not to mention hair health.

“When I saw those fur coats, I thought about adding more yogurt to my diet,” a scientist said

Diet may not impact certain health outcomes in older persons

Eating diets high in sugar and fat may not affect the health outcomes of older adults ages 75 and up, suggesting that placing people of such advanced age on overly restrictive diets to treat their excess weight or other conditions may have little benefit, according to researchers at Penn State and Geisinger Healthcare System.

"Historically people thought of older persons as tiny and frail," said Gordon Jensen, head of the Department of Nutritional Sciences at Penn State, "but that paradigm has changed for many older persons. Currently, 30 percent or more may be overweight, and by 2030, almost 30 percent are projected to be obese, not just overweight. Recent reports even suggest that there may be survival benefits associated with overweight and mild obesity status among the elderly."

"We all know that adverse dietary patterns, such as a Western diet containing high amounts of fat or a diet containing high amounts of ined sugar, both of which may contribute to obesity, are associated with adverse medical conditions and health outcomes for many people, but until now, the health effects of these types of poor diets have not been characterized for people who live to 75 years of age and older," said Pao Ying Hsao, postdoctoral fellow at Penn State.

The teams research is part of a decades-long collaborative study between Penn State and the Geisinger Healthcare System on the effects of nutritional status and diet on the health of more than 20,000 older people living in Pennsylvania. In the current study, the team followed 449 individuals for five years who were on average 76.5 years old at the beginning of the study.

"This is one of the first studies to examine obesity-related health outcomes and dietary patterns in such aged persons," Jensen said.

At study baseline, the team assessed the participants dietary patterns by calling each of them by telephone four or five times during a 10-month period and asking them about their diets over the previous 24 hours. The participants were categorized as adhering to one of three different dietary patterns. The "sweets and dairy" pattern was characterized by the largest proportions of energy from baked goods, milk, sweetened coffee and tea and dairy-based desserts, and the lowest intakes of poultry. The "health-conscious" pattern was characterized by relatively higher intakes of pasta, noodles, rice, whole fruit, poultry, nuts, fish and vegetables, and lower intakes of fried vegetables, processed meats and soft drinks. The "Western" pattern was characterized by higher intakes of bread, eggs, fats, fried vegetables, alcohol and soft drinks, and the lowest intakes of milk and whole fruit.

Using outpatient electronic medical records, the researchers identified whether the participants developed cardiovascular disease, diabetes mellitus, hypertension (high blood pressure) and metabolic syndrome during the five-year period. They found no relationship between dietary pattern and prevalence of cardiovascular disease, diabetes, metabolic syndrome or mortality in the participants; however, they did find an increased risk of hypertension in people who followed the "sweets and dairy" pattern.

The results appeared in this months issue of the Journal of Nutrition Health and Aging.

"We dont know if the participants had been following these dietary patterns their entire adult lives, but we suspect they had been because people dont usually change dietary practices all that much," Jensen said. "The results suggest that if you live to be this old, then there may be little to support the use of overly restrictive dietary prescriptions, especially where food intake may already be inadequate. However, people who live on prudent diets all their lives are likely to have better health outcomes."

Triglycerides and cholesterol whats the difference

Triglycerides and cholesterol, whats the difference? - Heart health depends on cholesterol levels. While in addition to keeping cholesterol, you also need to control triglyceride levels. Then what is the difference between triglycerides and cholesterol? Check out more as reported by the Health Me Up below.

Definition

Triglycerides are compounds present in foods and blood plasma. Triglycerides are a source of energy and as triglycerides into the body through food, the shape can turn into fat cells if it is not transferred into energy. So basically, the body needs triglycerides to produce energy.

Difference

As already mentioned, triglycerides are a source for protein. While cholesterol is needed to form a cell. Both are equally important for the body, as long as the amount is not excessive. Someone had normal cholesterol levels should be no more than 150 mg / dL, especially for people with heart disease.

Excess

If excessive amount of triglycerides, the fat cells can clog blood vessels and increase the risk of cardiovascular disease (including heart disease and stroke). Excess triglycerides also affect the performance of the pancreas.

Control

So how to keep your triglyceride levels remain balanced? From now on, less fatty foods, stop consuming alcohol, lose weight, exercise diligently, and avoid sugary products that have high or purified.

Thus explanation of triglycerides. In addition to cholesterol, a compound that also need to be monitored to maintain overall body health.

Eating more legumes lower heart disease risk

CEating more legumes (such as beans, chickpeas or lentils) as part of a low-glycemic index diet appears to improve glycemic control and reduce estimated coronary heart disease (CHD) risk in patients with type 2 diabetes mellitus (DM), according to a report of a randomized controlled trial published Online First by Archives of Internal Medicine, a JAMA Network publication.

Low glycemic index (GI) foods have been associated with improvement in glycemic control in patients with type 2 (DM) and have been recommended in many national DM guidelines, the authors write in the study background.

David J.A. Jenkins, M.D., of the University of Toronto and St. Michaels Hospital, Toronto, Canada, and colleagues conducted a randomized controlled trial of 121 patients with type 2 DM to test the effect of eating more legumes on glycemic control, serum (blood) lipid levels and blood pressure (BP).

Patients were randomized to either a low-GI legume diet that encouraged patients to increase eating legumes by at least one cup a day or to increase insoluble fiber by eating whole wheat products for three months. Changes in hemoglobin A1c (HbA1c) values were the primary outcome measure and calculated CHD risk score was the secondary outcome.

"In conclusion, legume consumption of approximately 190 g per day (1 cup) seems to contribute usefully to a low-GI diet and reduce CHD risk through a reduction in BP," the authors note.

The low-GI legume diet reduced HbA1c values by -0.5 percent and the high wheat fiber diet reduced HbA1c values by -0.3 percent. The respective CHD risk reduction on the low-GI legume diet was -0.8 percent, largely because of a greater relative reduction in systolic blood pressure on the low-GI legume diet compared with the high wheat fiber diet (-4.5 mm Hg), the study results indicate.

"These findings linking legume consumption to both improved glycemic control and reduced CHD risk are particularly important because type 2 DM is increasing most rapidly in the urban environments of populations in which bean intake has traditionally been high (e.g. India, Latin America, the Pima Indians of Arizona)," the authors conclude. "Support for the continued use of such foods in traditional bean-eating communities, together with their reintroduction into the Western diet, could theore be justified even if the effect on glycemia is relatively small, given the magnitude of the problem and the need for acceptable dietary options, especially those options that may also have a BP and cardiovascular advantage."

How About Team Based Care AND Experts

Disease Management Care Blog readers may recall this snarky "Its Team Based Care, Not More Experts" speechifying that challenged a John A Hartford Foundation report on the growing need for expert geriatric care.  The Foundations Program Director Christopher Langston responded and, rather than let it languish as a bottom-of-the-page-comment, the DMCB thought it warranted its own separate posting. Dr. Langston makes some good points:

The John A. Hartford Foundation has long recognized (heres an example) that there are only 24 hours in the day and that teams are critical to delivering quality care in a cost-effective way.

So when we reported the results of our recent poll showing that despite the existence of the new Medicare Annual Wellness Visit benefit, older adults still aren’t getting important assessments (like fall risk, mood screening, or medication review) at adequate rates, we weren’t trying to doctor bash or even suggest that MDs should work harder. They just need to be sure that the work gets done by someone.

We are in favor of organized, team-based systems of care and the poll results should include services delivered by non physician-providers.   The cognitive interviewing that the survey firm did as part of question development assured us that respondents were saying "yes" when they got services/assessments from a practice regardless of who exactly delivered them (MD, RN, MA, or ??).

So, I dont think we have a real disagreement on this team/delegation issue.

I also tend to agree with the Disease Management Care Blog that we cant really tell from the poll if MORE geriatrics expertise would help or not -- BECAUSE we arent really using even the limited expertise we have. Models like IMPACT or Guided Care mostly use generalists and incorporate "expertise" in the team model and the protocols they use. Unfortunately, these models are underused.

Perhaps the role of geriatrics expertise is to help practice leaders redesign their work? Respondents on the poll did endorse items  that more health professional education would help and even improve their care, but any one perspective, even patients’, on this issue is limited. It was also very interesting that in question development, our polling firm kept trying to focus on the work of the MD. Perhaps the public needs some education too before it buys into the team concept?

Regardless, the Foundation supports more education in geriatric care that can at least teach providers take this part of their work more seriously.  I don’t think that we really need to teach MDs HOW in a mechanical sense to do a “get up and go” test of mobility and balance, but we do seem to need to teach WHY they should do one as well as find ways to incorporate such assessments into the work of the team.  Ageist attitudes seem to stand in the way of many providers understanding that their care of older adults makes an even bigger and more immediate difference in outcomes than the care of younger adults.

Diabetes And Life Expectancy

According to the CDC, people in the US who were born in 1950 (all races combined) are estimated to live about 68.2 years (men 65.6, women 71.1). People born in 1960 are estimated to live about 69.7 years (men 66.6, women 73.1).
(See CDC: Health, United States 2006, Table 27 for more information.)

Those are averages. The course of your life and the choices you make can affect how long you live. A recent study suggests that having diabetes can shave off quite a few years from those averages.
________
We know that people with diabetes have an increased risk for heart disease and that most will die from a heart attack.

Researchers reporting in the Archives of Internal Medicine last month reinforced this knowledge in their analysis of participants of the Framingham Heart Study.¹ They found that men and women in this population who had diabetes more than doubled their risk for developing cardiovascular disease (CVD).

However, the leading cause of death in this country for all people is heart disease. And these researchers found that both diabetics and nondiabetics live about the same number of years with heart disease.

So, does having diabetes cause people to die any sooner than if they didnt have the disease? These researchers say yes, an average of 8 years sooner:

"Diabetic men and women 50 years and older lived on average 7.5 and 8.2 years less than their nondiabetic equivalents."

Also,

"The differences in life expectancy free of CVD [for diabetic men and women 50 years and older] were 7.8 and 8.4 years, respectively."

This is because people with diabetes get CVD earlier than those without diabetes.

A few more findings (keep in mind that people with diabetes in this group tended to be older than those without diabetes):

• There were more men with diabetes than women.
  
• There were fewer smokers among diabetics. (If smoking increases the risk for developing diabetes, can you speculate why this was found?)
  
• Among those with diabetes, twice as many had a family history of the disease.
  
• Systolic blood pressure was higher among diabetics (149 mm Hg vs. 137 mm Hg).
  
• Body Mass Index (BMI) was higher among diabetics (27.5 vs. 26.0).

The authors concluded, not surprisingly:

"These findings underscore the importance of diabetes prevention for the promotion of health aging."

________¹ Associations Of Diabetes Mellitus With Total Life Expectancy And Life Expectancy With And Without Cardiovascular Disease

Fruit and vegetable intake is associated with lower risk of ER breast cancer

There is no association between total fruit and vegetable intake and risk of overall breast cancer, but vegetable consumption is associated with a lower risk of estrogen receptor-negative (ER-) breast cancer, according to a study published January 24 in the Journal of the National Cancer Institute.

The intake of fruits and vegetables has been hypothesized to lower breast cancer risk, however the existing evidence is inconclusive. There are many subtypes of breast cancer including ER- and ER positive (ER+) tumors and each may have distinct etiologies. Since ER- tumors, which have lower survival rates and are less dependent on estrogen levels than ER+ tumors, account for only 15-20% of breast cancers, large pooled analyses are needed to determine the suspected link to lower ER- breast cancer risk and the consumption of fruits and vegetables.

In order to determine if there is a link between the lowered risk of ER- breast cancers and the intake of fruits and vegetables, Seungyoun Jung, Sc.D., formerly from the Department of Nutrition, Harvard School of Public Health, and currently at the Channing Division of Network Medicine, Brigham and Womens Hospital, and colleagues analyzed data from 20 cohort studies of women who were followed for a maximum of 11-20 years. They investigated the association of high compared to low intake of fruit and vegetables and risk of developing breast cancer in each study and then combined the study-specific estimates to generate summary estimates for all studies combined.

The researchers found that total fruit and vegetable intake was statistically significantly linked to a lower risk of ER- breast cancer, but not with risk of overall breast cancer or risk of ER+ breast tumors. The results showed that the lower risk was mostly associated with higher vegetable consumption. "These findings support the value of examining etiologic factors in relation to breast cancer characterized by hormone receptor status in large pooled analyses because modest associations with less common breast cancer subtypes may have been missed in smaller studies," the authors write.

In an accompanying editorial, Cynthia A. Thomson, Ph.D., and Patricia A. Thompson, Ph.D., both of the University of Arizona Cancer Center, write that the findings of the study support the emphasis on greater intake for vegetables (and to a lesser extent fruit) to lower the risk of ER- breast cancer. However, they also write that, "interpretation of these findings may also be challenged by the known effects of other potential confounders, including the aggregation of health behaviors."

Strawberries Increase Antioxidant Levels to Lower Chronic Disease Risks

Strawberries are shown to be a potent source of antioxidants in a body of research published in the journal Food Chemistry. In vivo studies confirm that regular consumption of the flavorful fruit raise antioxidant blood saturation levels.

This can help to lower the risk of chronic diseases ranging from heart disease and cancer to metabolic disorders including diabetes. The study, conducted by Italian and Spanish researchers demonstrated that eating two cups of strawberries daily for two weeks boosted the antioxidant status of red blood cells and improved the body`s immune response reaction to oxidative stress to lower disease risk.

Strawberries Shown to Significantly Increase Disease-Fighting Antioxidants in Blood

European researchers have demonstrated the antioxidant capacity of strawberries on human health using volunteers at the Marche Polytechnic University in Italy. Twelve healthy adults were fed the equivalent of two cups of strawberries over the course of a day for a period of two weeks.

Blood samples were taken after four, eight, twelve and sixteen days and then again after a month. Live blood analysis showed that regular consumption of this super fruit significantly increases the antioxidant capacity of blood plasma as well as the resistance of red blood cells to oxidative haemolysis in a process known as fragmentation.

Lead author and researcher, Dr. Maurizio Battino commented on the initial results “We have shown that some varieties of strawberries make erythrocytes more resistant to oxidative stress. This could be of great significance if you take into account that this phenomenon can lead to serious diseases.”

Strawberries Lower Risk of Developing Heart Disease, Cancer and Dementia

Researchers are continuing to test a variety of strawberry strains and different consumption levels to determine optimal antioxidant levels. They note that strawberries should form part of a healthy, balanced diet and be included as a daily serving of fruits and vegetables necessary to lower disease risk.

Strawberries contain a large concentration of phenolic compounds, such as flavonoids known to exert potent antioxidant properties. Flavonoid consumption triggers an extensive arsenal of antioxidant mechanisms that function at the cellular level to fight free radical production and lower the risk from heart disease, cancer, diabetes and dementia. Antioxidants promote normal cellular function and are either manufactured by the body or consumed through diet in the form of natural foods such as strawberries.

When the blood antioxidant capacity is lowered by stress, physical exertion or normal metabolic function, oxidative stress occurs and the risk of chronic disease increases exponentially. Many forward-thinking scientists posit that oxidative stress is a key factor determining how quickly we age, and foods such as strawberries hold the answer to slow this process and prevent a host of deadly illnesses.

Some Raffle Ideas for the Obama Campaign

Who wants a raffle ticket?

President Obamas reelection campaign is continuing with its hallmark electoral innovation, including entering small dollar donors into "Dinner With The President" raffles like this and this. 

Thinking that this novel approach could become a important means of leveraging the Administrations policy agenda in Americas body politic, the Disease Management Care Blog proposes that the White House offer a suite of raffles for other prizes, like:

1. A front row seat at one of HHS Secretary Sebelius upcoming speeches on the merits of Affordable Care Act.  Sit through 5 or more of these tedious speeches and CMS will und the raffle price; sit through 10 and youll get a Medicaid coverage for a much needed visit with a mental health provider (with the disclaimer that finding a provider who will accept Medicaid is up to you).

2. A free and thorough "Welcome to Medicare" physical examination by a gloved TSA employee.  At the end of it, you may not feel too safe, but the rest of us will.

3. Accompanying Treasury Secretary Geithner on an all expense-paid tour of Beijing (with the disclaimer that that the trip will be generously supported through a loan provided by the Peoples Republic of China). A potential bonus: make it one way!

4. If you would rather not donate at this time, the President could offer a raffle to help change your mind: a "couples massage" at the resort of your choice with Department of Homeland Security Secretary Janet Napolitano

5. For those who care or dare to annoyingly donate to the Republican ticket anyway, the Obama-Biden campaign could have a separate raffle: a drawing for a prominent mention on a Obama campaign web site or the chance at being the subject of opposition research.

6.  Not to be outdone, the Romney camp could also respond with a meal-with-the-candidate raffle.  The DMCB recommends that the dinner be modelled after the Ryan "premium support" approach where the prize is a meal "voucher" that does not include beverage, appetizer, salad, main course or dessert and the winner would need to bring his or her own utensils.

Image from the White House web site

Social Media Does It Really Change Patient Behavior

Thanks to the technologic allure of iPhones replacing stethoscopes, apps substituting for doctors and electronic information substituting for having to actually talk to patients, the thoroughly modern Disease Management Care Blog is all about medical-social media. 

Think Facebook for the flu.  Twitter for tinnitus. Egads, listen to the typical consultant, pundit or futurist and its easy to believe that were on the verge of a silicon-based health care revolution

But then reality intrudes and some skeptic somewhere always asks about the bang for the buck, the juice for the squeeze, the return for the investment. Its a good question.

For something of an answer, consider the results appearing in a recently published randomized clinical trial.  The actual condition in question is going unmentioned for now, so that the DMCB can better focus on the issue of patient engagement

Over a 4 month period, "at risk persons" were recruited for a clinical research trial with on-line ads (Facebook banners, Craigslist, for example) as well as announcements in community settings and venues.  Once persons met the usual inclusion criteria and had a unique Facebook account, they were randomly assigned to one of two treatment arms.

One treatment arm used a closed Facebook group to coach persons about their at risk condition.  The other treatment arm similarly used Facebook to coach persons about general health improvement.  Lay "Peer Leaders," who were given a three hour training session on "epidemiology of the condition or general health subjects and ways of using Facebook to discuss health and stigmatizing topics," were assigned to lead the groups.

Peer Leaders attempted to reach out to their assigned group persons with messaging, chats and wall posts.  Once the link was established, the relationship in the intervention group included communication about prevention and treatment of the condition. At the end of 1, 2 and three months of the study, participants completed a variety of surveys.

Results?

57 individuals were in the control general health group and 55 were in the condition coaching group.  According to the surveys, intervention patients were ultimately statistically significantly more likely to agree to condition testing (44%) than the control patients (20%).  Because there were few participants, the modest decrease in actual tests or risk behaviors were not statistically meaningful.

The DMCBs take:

While this was a small study, this is the first time that the DMCB has seen reasonable proof that social media by itself can move the behavior needle.  On the other hand, this did not result in a patient engagement stampede toward better care or hard clinical outcomes.  A majority of participants (56%) did not appear to benefit.  Nonetheless, the results do support the inclusion of Facebook-style closed group social media in the suite of population health management services.

That being said, the condition at risk was HIV and study population was men who have sex with men ("MSMs").  It doesnt necessarily follow that what would work in this community of persons would necessarily be transferrable to other conditions, such as diabetes.  The DMCB doesnt think thats really true and finds it credible that 112 persons with diabetes or hypertension would probably achieve the same kind of results (A1c testing or home blood pressure monitoring) in a similarly tailored Facebook closed group.

Heres the study.

Let the research continue!

Ivygourd Peanut Rice

A quick, simple and highly flavourful one pot meal with ivygourds aka Kovakkai. Peanuts plays an important role in the spice mix i used to flavour this rice. Sorry guys i couldnt stop myself posting dishes with peanuts coz am hosting this months cooking with seeds event with peanuts as star ingredient. Thanks to each and everyone for their contribution for this months CWS event, since am bit hooked with few stuffs at home,i couldnt able to visit  all the linked posts till today for this event.

Coming to this quick rice, if you have cooked leftover rice and peanut spice mix i used in this rice already aside, you can very well finish preparing this rice within less than 15minutes, obviously you can also go for your choice of veggies somehow i felt saying that ivygourd, brinjal and bottlegourd works wonder for making this podi rice.You can carry very well this rice in your lunch box and dont forget to serve this delicious,flavourful rice simply with chips or fryums.Sending to my event CWS-Peanuts hosted by me.

2cups Cooked rice
1/4kg Ivygourd (chopped lengthwise)
1no Onion (chopped)
1/4tsp Turmeric powder
Salt
Oil
1tsp Mustard seeds+urad dal
Few curry leaves

To roast & grind:
1tbsp Coriander seeds
1/4cup Raw peanuts
1tsp Peppercorns
1tsp Cumin seeds
2tbsp Dessicated coconut
5nos Dry red chillies

Roast and grind as fine powder all the ingredients given under the list to grind and keep aside..

Heat enough oil in a pan, let splutters the mustard seeds,urad dal and curry leaves, add the chopped onions,saute until they turns transculent.

 add the chopped ivygourd,salt,turmeric powder and cook in simmer until the veggies turns soft.

Now add the grounded spice powder as per need(sprinkle water if needed), cook again for few minutes..

Finally add the cooked rice, toss everything gently until the rice get well mixed.

Serve it with chips,papads or any spicy side dish..

Metabolic factors may increase mens risk of dying from prostate cancer

High blood pressure, blood sugar, blood lipids, and body mass index—characteristics that are often lumped together as the metabolic syndrome—are jointly linked with an increased risk of dying from prostate cancer. That is the conclusion of a new study published early online in CANCER, a peer-reviewed journal of the American Cancer Society. The studys results suggest that public health recommendations regarding diet and lifestyle to prevent heart disease and diabetes may also decrease a mans likelihood of dying from prostate cancer.

Researchers have little knowledge about possible links between metabolic factors, separately and combined, and mens risk of being diagnosed with or dying from prostate cancer. To investigate, Christel Häggström, MSc, Tanja Stocks, PhD, both of the Umeå University in Sweden, and their colleagues analyzed information from 289,866 men enrolled in a study called the Metabolic syndrome and Cancer project. The analysis was completed under the leadership of Pär Stattin, MD, PhD, a visiting scientist at Memorial Sloan-Kettering Cancer Center in New York City.

During an average follow-up time of 12 years, 6,673 men were diagnosed with prostate cancer and 961 died from the disease. Men in the highest categories of body mass index and blood pressure had a 36 percent and 62 percent increased risk of dying from prostate cancer, respectively. Also, when comparing a composite score of all metabolic factors, men with a high score were more likely to die from prostate cancer.

The study found no evidence for a link between high levels of metabolic factors and a mans risk of developing prostate cancer but revealed a link between these factors and his risk of dying from the disease. This suggests that while men with the metabolic syndrome are not more likely than others to develop prostate cancer, if they do develop it, they are more likely than other men to die from the malignancy. "These observations suggest that cardiovascular risk factors such as overweight and hypertension are involved in stimulating the progression of prostate cancer," said Dr. Stattin.

Sitting for hours increase the risk of colon cancer in men

Man sitting too long can increase the risk of developing polyps in the colon, according to new research.

The polyps can be benign or malignant eventually leading to colon cancer. Although it can be removed medically, the presence of polyps is still regarded as one of the health threat.

As quoted from the Health , found similar risk does not seem likely in women who also sit for hours.

"Men who sit 11 hours or more a day had a 45 percent greater risk of suffering from polyps," said researcher Christine Sardo Molmenti of Columbia University Mailman School of Public Health.

Although active in sports, the researchers added that the habit of sitting for hours still have a bad effect on health.

Researchers also suggest that everyone sit down for hours activities should stand up and stretch every half hour. This is done to improve blood circulation and prevent a variety of other health problems.

The results are reported later in the meeting of the American Association for Cancer Research in Oxon Hill, Maryland.