Health news headlines this week

Heres a quick roundup from the news headlines in the health pages this week.

Baldness cure on the cards? The Telegraph reports that a treatment could be available within a couple of years. This will no doubt arouse a great amount of interest - well follow the story as it happens.

Rise in diabetes. Its being reported this week that Scotlands diabetes rates continue to increase, with nearly quarter of a million people suffering from the condition - or 4.7% of the population.

The effect of sickness absence from work has also been making the news, with a recent survey indicating that only just over half of employers believing theyre "well equipped" to deal with the problem. Being well equipped isnt defined in this context but presumably the better equipped employers will have a health and wellbeing strategy, provide group medical insurance, EAPs and so on.

The Guardian posits an interesting theory today regarding Obamacare - namely that the Presidents affordable care act will mean the US being short of doctors - tens of thousands of them. This is because so many currently uninsured Americans will have access to healthcare. So the possibility, according to the story, is that the US shortfall could be made up in part by UK doctors leaving for jobs across the pond. Which could then cause a shortage here.

And thats all from us just now. If you have any comments on the above stories, then please leave us a comment - wes love to hear from you!

10 Benefits of magical strawberry for health

10 Benefits of magical strawberry for health - Who does not know the strawberry? Cute pieces that look beautiful and make saliva dripping. Although small, this fruit is called as Queen of fruits you know! The reason is because strawberries contain many nutrients and health benefits.

What are the benefits of magic strawberries for health? Heres the list, as reported by Best Health.

1. Boost immunity

Strawberry is the best source of vitamin C. Two bowls of strawberries a day alone can satisfy the bodys vitamin C requirement. Vitamin C is known as an immune system enhancer and antioxidant good for fighting disease. Plus, the antioxidants in strawberry fruit is different from others because the antioxidants work more quickly and be ready in the bloodstream.

2. Maintaining eye health

Antioxidants in strawberries are also effective to prevent cataracts can lead to blindness in old age. Eyes need vitamin C to keep them from free radical sun. In addition, strawberries can also strengthen the cornea and the retina of the eye. Although the study never reveal that excess vitamin C actually increase the risk of cataracts in the elderly, but this does not apply vitamin C in strawberry bag.

3. Ward off cancer
Antioxidants in strawberries also help prevent cancer. Chemical called ellagic acid found in strawberries is erred to as an anti-cancer agent that can suppress the growth of cancer cells. In addition, other antioxidants such as lutein and zeathancins can also ward off free radicals and protect the health of the cell.

4. Preventing wrinkles
Not only good for your health, strawberries are also good for skin health. indirectly, strawberries also make you more beautiful. This fruit helps improve the elasticity of the skin so that it can prevent the appearance of wrinkles and make you look younger. Ellagic acid in strawberries can protect the collagen in mind that is not easily damaged and prevents inflammation of the skin.

5. Fight bad cholesterol

Based on the Heart and Stroke Foundation, heart disease is one of the most deadly diseases for women. Fortunately strawberries also contain substances that can improve heart health and lowering cholesterol. In addition, strawberry also prevent inflammation which indirectly also protect the heart. To that end, strawberries fit for consumption and included in the diet if you have problems with cholesterol.

6. Reducing inflammation

Antioxidants and chemical found in strawberries may reduce inflammation in the joints that can lead to arthritis and can lead to heart disease. A study at the Harvard School of Public Health showed that women who ate at least 16 strawberries per week had a 14 percent lower likelihood becomes inflamed.

7. Keeping blood pressure

Potassium in strawberries are known to maintain blood pressure levels, and even lower high blood pressure. If you have a problem with high blood pressure, there is no harm in eating strawberries regularly. One bowl of strawberry can contain 134 milligrams of potassium to keep blood pressure.

8. Digestion

Strawberry also contains fiber which is good for smooth digestion. Strawberry contains at least two grams of fiber per dose. Eating strawberries can prevent constipation and inflammation of the intestine. In addition, as well as the strawberry can also prevent type 2 diabetes because it slows the digestive process and absorption of sugar in the blood.

9. Keeping weight

m Trying to keep the weight off? Strawberry can be your best friend. Strawberry has a fairly low calories, no fat, sodium or sugar. Carbohydrates contained in it even only half a loaf of bread. Nothing wrong with inserting a strawberry in a part of your diet.

10. Maintaining health during pregnancy

Folate and B vitamins are recommended for women who are pregnant or give birth. Strawberry contains lots of folate and B vitamins that can help you. This substance is very good for babys brain development and skull early in pregnancy. In addition, folic acid in strawberries are also good for preventing birth defects.

That many wonders of strawberry for health. Nothing wrong with this fruit is called as one of the healthiest fruit because of the many benefits contained therein. So, do not hesitate to eat strawberries on a regular basis.

Apple Health Benefits

Health Benefits of Apple

Apples have many health benefits thus its well said an Apple a day keeps the doctor away! Have you ever thought if this phrase is practically true or it is just a trick to make us eat it. So my dear let me just tell you that this wonderful fruit is packed up with a lot of good things that will help you stay healthy and will try its best to keep the doctor away. Apple is low in calories and is notably good source of antioxidants.

Health Benefits of Apple Pectin

Apple is contained with high concentration of a compound called Pectin. Pectin is useful in many ways for maintaining a healthy body.

Apple health benefits due to the presence of pectin are:

1. Pectin present in apple helps in the treatment of disorders related to digestion.

2. Pectin regularizes the bowel movements and it also helps in treating and controlling irritable bowel problems.

3. As apple pectin is soluble fiber it helps in maintaining good health by keeping low cholesterol levels and managing intestinal disorders
Pectin is found under apple peel in higher amount and is also present in the flesh of an apple. Pectin also used in making jams and jellies.

Apple Health Benefits for Weight Loss

Among various health benefits of apples is  high fiber content of apple, which makes an apple a  good weight loss food. Eat three apples a day and you shall be able to get rid of those extra bulges here and there. Each apple contains about 4.5 gms of fiber whereas the calories count is only 70 which is much less than the calorie present in 1 cup of chocolate ice-cream. 

Also Read : Apple detox diet at home

You can eat an apple before each meal. It is very filling and eating before meal will fill your stomach and will help you to cut down all the excess that you eat to please your taste buds.

Not only its filling but it will also give a boost to your digestive system, so that what ever you eat flushes out quick. The fiber in apples ensures that the nutrition is absorbed and the waste is driven out of your body soon. This will also make you feel fresh and energetic.
There are various Apple Diet programs available which primarily involves eating apple before meals and between meals. If followed properly both will show good results on scale.

Health Benefit of Apples for Healthy Teeth

Natures Toothbrush Apple : Have you ever heard of Natures Toothbrush Apple, this another praise that apple has in its credits.The qualities that makes an apple a good teeth cleanser and brighter are its acidic nature, its astringents properties and its fiber rich flesh.This crunchy fruit along with it juices will cleanse your teeth if taken after snacks. However you should not forget to rinse your mouth after eating an apple for removing the sugar and acids from your mouth.

Apples health benefits and Antioxidant

A lot of health benefits of apples are due to the presence of antioxidants in Apples 

Our body needs antioxidants to defend itself from various diseases, antioxidants keeps the harmful free radical in check. Free radicals are naturally produced in our body and are also derived from external agents like cigarette smoking, highly ined and processed food and from environment pollution as well.Among the various health benefits of apples is its capacity to keep the defense mechanism of our body intact. The presence of compounds called Antioxidants prevents damage of cells and tissues.

Apples have rich content of minerals. Boron is a mineral which is present in good amount in Apple. Boron keep the brain alert. It has got the ability to reduce the risk of pain in the joints as it tends to prevent osteoarthritis.

Apples are rich in Fibre

Another benefit of apple is its properties that help in reducing bad cholesterol and increasing good cholesterol levels in the body which is due to the presence of fiber in apple.

Benefits of Eating Apples During Pregnancy

Many pregnant women have craving for apples. Studies have proved that  eating apples during pregnancy reduces the risk of developing asthma in the babies. 

These are just a few to name health benefits of apples but this great fruit Apple has a lot more credits to its name.

Health benefits of coconut water

coconut water

Coconut water provides numerous health benefits to us. It could potentially be the greatest energy drink in the world, to top it off, it’s all-natural. Low in calories, naturally fat- and cholesterol free, more potassium than four bananas, and super hydrating - America’s latest health craze: It contains more potassium than the majority of energy drinks. The chloride it holds is at 118g, and it’s natural sugars extent to about 5mg. 

Coconut water is the juice or liquid inside an immature green coconut and it is best to drink when it is more than 5 months as the water will have a bitter tinge if consumed earlier. Its water is one of the nature’s most reshing drinks, consumed worldwide for its nutritious and health benefiting properties.
 
The coconut palms grow abundantly along the coasts of tropical environments.Botanically, coconut plant belongs within the Arecaceae family of palm trees and has the scientific name: Cocos nucifera.

The coconut tree has been called the "Tree of Life" for its uncanny (nearly miraculous) healing properties and usefulness. A study of the coconut tree reveals an almost supernatural evolution to become one of the most useful species of plant life known to man.
 
Coconut palm flourishes well along the costal tropical environments. A coconut tree may yield several hundred tender nuts each season. Different species of coconut palms are grown all over the tropics. Naturally, their taste and flavor of water show variations according to saline content in the soil, distance from sea shore, mainland, etc.

tender coconut

The palm can yield 150 to 200 coconuts a season and each coconut contains 200ml to 1000ml of water depending on its cultivar size and type. This water is rich in vitamins, minerals, electrolytes, enzymes, amino acids and cytokine. This water is now popular all over the world for its reshing nutty taste as well as its health benefits.

Any nuts younger than five months of age tend to be bitter in taste and devoid of nutrients. In contrast, mature nuts contain less water, and their endosperm thickens quickly to white edible meat (kernel). Coconut milk obtained from the meat is theore should not be confused with coconut water. Coconut milk is obtained by grating and grinding this ‘meat’ and passing it through a sieve. It is very high in fat content – a cup of coconut milk has 550 calories whereas coconut water has only 50 calories a cup.

Surprisingly, Coconut water is more nutritious than whole milk. Its crammed with Natural Sugars, Salts, and Vitamins to block out fatigue. Drinking coconut water straight from a green tender coconut in the summer heat is simply divine. Not only is it reshing, it also has a number of health benefits. Most importantly, coconut water contains less sodium than any other energy drink. See the table below for in depth analysis of nutrients:

Nutritional value per 100 g (3.5 oz)
Energy	354 kcal (1,480 kJ)
Carbohydrates	24.23
- Sugars	6.23
- Dietary fiber	9
Fat	33.49
Protein	3.33 g
Water	47
Thiamine (vit. B1)	0.066 mg (6%)
Riboflavin (vit. B2)	0.02 mg (2%)
Niacin (vit. B3)	0.54 mg (4%)
Pantothenic acid (B5)	1.014 mg (20%)
Vitamin B6	0.05 mg (4%)
Vitamin C	3.3 mg (4%)
Calcium	14 mg (1%)
Iron	2.43 mg (19%)
Magnesium	32 mg (9%)
Phosphorus	113 mg (16%)
Potassium	356 mg (8%)
Zinc	1.1 mg (12%)
Percentages are relative to US recommendations for adults. Source: USDA Nutrient Database

Fresh tender coconuts are readily available in the markets in tropical countries year around. However, they require importation into the semitropical and cold regions. Nowadays, ready to use prepared tender coconuts are made available in USA and Canada imported from Thailand and Malaysia.

In the stores, coconut water sold in packets, and bottles. However, their overall nutritional profile may not be up to the mark in terms of vitamins and enzyme levels, since some kind of additives and preservative added in order to enhance shelf life.  

Health benefits of coconut water:
Coconut water is very beneficial after a bout of diarrhoea, as it replaces fluid loss. It is rich in amino acids, enzymes, dietary fibre, vitamin C and minerals such as potassium, magnesium and manganese; at the same time it is low in cholesterol and chlorides. This fluid is ideal to maintain body fluids when a person gets dehydrated. Coconut water contains a good amount of electrolyte potassium, thus it can replenish the electrolyte composition in body fluids. 

Coconut water was used as a “universal donor”, making it identical to human blood plasma. It was used in the Pacific War to save thousands of lives through Coconut IV’s, and emergency plasma transfusions.

A study published in the American Journal of Emergency Medicine suggested that coconut water can be successfully used as a short term intravenous hydration fluid for hydration and resuscitation of critically ill patients in the remote regions of the world where medical resources are not available. Other health benefits are as under.

Quick energy boost
Abundant in vitamins, minerals and other nutrients, Coconut Water makes a wonderful energy drink. In particular, coconut water has less sugar and sodium content compared to most sports drinks, while packing more Potassium, Calcium, and Chloride, which makes it a better choice to rehydrate, replenish and boost the bodys energy levels after any strenuous activity or workout. 

Weight Loss
Coconut water is a natural electrolyte and isotonic beverage which help increase the bodys metabolism. Theore, it can greatly benefit people who are struggling with weight issues. Drinking coconut water helps a person to lose weight as it is low in fat and it keeps a person feeling full. It also reduces food cravings.

Useful in aging spots, wrinkles, and other skin problems
Researchers have found that Cytokinins help regulate the cell growth and their divisions. Coconut Water contains these cytokinins and lauric acid which can minimize the aging of skin cells, balance PH levels, and keep the connective tissues strong and hydrated. Theore, simply applying ccoconut water onto affected skin areas every night before going to bed may help with acne, age spots, wrinkles, stretch marks, cellulite, and eczema. Within two to three weeks, it clears up the skin.

Cardiovascular health
Coconut water promotes health as it is rich in potassium and it also helps to reduce the risk of hypertension and strokes. According to researchers, individuals with high blood pressure usually have low potassium levels. Theore, drinking coconut water on a regular basis can be quite effective at regulating blood pressure. 

There are several animal studies suggesting coconut water can lower cholesterol and blood pressure, but this research is too preliminary to make claims about it’. But they do agree that coconut water may be a healthier option as compared with other beverages. Similarly, some recent studies have found that coconut water can help increase HDL (good) cholesterol, which makes it a wonderful natural treatment for maintaining good cardiovascular health.

Dehydration
Rich in Potassium and other minerals, Coconut Water helps to regulate our internal fluids and replenish and rehydrate the body. It has been used to treat dehydration caused by dysentery, cholera, diarrhea and stomach flu, and the electrolyte balance and plasma in coconut water has been found to be similar to that of human blood. 

Theore, drinking one cup of Coconut Water twice daily during digestive tract abnormalities, hot temperatures, and after strenuous workouts can help rehydrate the body quickly.

Good in diabetes 
It is good for diabetics as it is good in nutrients required by diabetics to keep their sugar levels in control.

Anti viral
If you are suffering from flu or herpes due to some type of viral attack on your body, drinking coconut water is very beneficial as it has anti viral and anti bacterial properties.

Reduces the risk of kidney stones 
Due to the minerals, potassium and magnesium, present in coconut water the risk of kidney stones is greatly reduced.

What are the side effects of coconut water?
Fresh coconut water is one of the best natural drinks on the face of the earth. It doesnt have any known side effects unless somebody is prone to having allergic reactions or have severe nut allergies. 

It is considered to be safe for children, pregnant, and breastfeeding women. If you are taking potassium supplements it is recommended to regulate your potassium levels since Coconut Water is high in potassium.

NOTE: Once a coconut is cut open the water should be consumed as exposure to air can result in loss of nutrients. It is low in fat though rich in vitamins and the potassium level is twice the amount found in banana.

Better Health Solution Health Tips and Information What Is Heart Disease

Better Health Solution, Health Tips and Information: What Is Heart Disease?: "Bring up heart disease, and most people think of a heart attack. But there are many conditions that can undermine the hearts ability to do ..."

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

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."

Ten Rules for Health System Boards of Directors to Follow to Reduce the Risk of Fraudulent Outcomes Reporting and Scientific Misconduct

Enjoying a good spin

Are you on the Board of Directors for a large health service provider, population health vendor, integrated delivery system, managed care organization or other care corporation? 

If so, your company is likely collecting, analyzing and publicly reporting quality and cost data. Not only do superior results in journals, meetings, splashy web sites and glossy marketing materials present a competitive advantage, achieving superior outcomes is part and parcel of your organizations mission.

The Disease Management Care Blog reminds Board members that intentionally or unintentionally misrepresenting outcomes is an existential threat to health care organizations.  Having to retract a publication, correct a white paper, meet with grumpy regulators, confront claw backs, deal with a whistle-blower, respond to allegations of interpretation spin, uncover suppression of bad results or defend the integrity of your brand is something no Board wants to deal with.

To the DMCBs knowledge, this hasnt happened to any ACOs, risk contracting systems, managed care organizations or population health or wellness vendors.

Yet. 

Its just a matter of time.

While the risk of allegations of scientific misconduct can never be reduced to zero, the DMCB offers up ten best practices for Boards to follow:

Reduce opportunities by:

1. Exhibiting healthy skepticism regarding all outcomes reported by your management team, especially if the results seem to be too good to be true.

2. Insist that your management team has two persons with access to any data base, and that they have separate reporting relationships.

3. Insist that your management team has two persons independently involved in any data analysis, and that they have separate reporting relationships.

4. Be familiar with and insist that the rules on research on human subjects be followed.

5. Maintain a low threshold for conducting internal or external audits of any databases and any interpretations of those data.

Combat any rationalizations that fudging outcomes is OK by:

6. Recruiting Board members with research expertise.

7. Explicitly engage the Audit Committee and any other Board member or committee with oversight of risk to view "outcomes" with the same level of scrutiny as your companys financials.

8. Maintain an ethical "tone at the top" when it comes to research.

9. Have a disaster plan ready to go.  For starters, train your Board on how to deal with hostile media inquiries.

Reduce incentives by:

10.  Asking your CEO if any compensation plans including bonuses or unwittingly promoting unethical or fraudulent behavior.

The Important Look AHEAD Action for Health in Diabetes Study No Benefit from Exercise and Weight Loss in Diabetes

Diabetes? Exercise and then die just as soon.

It makes sense, doesnt it? If persons are overweight and have diabetes, diet and exercise-based "prevention" should translate into fewer heart attacks, strokes and deaths, right?

Wrong.

It turns out that a just-published and high quality research study shows its not so simple.  Whats more, the Disease Management Care Blog brazenly suggests that the disease management/population health vendors discovered this years ago.

The just-published study is here in the prestigious New England Journal of Medicine. The DMCB suspects that, thanks to the mainstream medias fixation on Snowden, SCOTUS, and Shakira possibly hawking Obamacare, this important research may not get the front-page attention it deserves.  Considering that it was ten-year, prospective, randomized multi-center academic study involving over 5000 patients, thatd be a shame.

Heres the DMCBs summary:

Eligibility: Participants had to be between 45 and 75 years of age with adequately controlled (A1c less than 11) "type 2" diabetes, an "overweight" body mass index (BMI) of 25 or more, blood pressure less than 160/100, an ability to exercise and access to a primary care provider. 

Recruitment: This went from August of 2001 through April of 2004. It was also tailored to keep insulin-using participants to less than 30% of the study group.

Interventions That Were Compared: Participants were randomly assigned to an "intensive lifestyle intervention" study arm or a "support and education" study arm.  The intensive group received weekly group and individual counseling for six months that subsequently tapered over the subsequent duration of the study. The counseling included a 1200-1800 calorie diet plus 175 minutes of moderate physical activity per week that was aimed at achieving a weight loss of at least 7% of body weight.  The support group got only three group sessions per year. Medicines and their doses were generally left to the primary care provider.

Outcomes Studied: Participants waist circumference, weight, blood pressure, medications and exercise tolerance were assessed once a year. Hospital and other medical records were reviewed to assess the number of deaths and cardiovascular events, such has heart attack or stroke.

The Study Population: 5,124 persons were enrolled; 2570 were randomly assigned to the intensive group while 2575 were assigned to the support group. The average age was 59 years, 60% were women, the median duration of the diabetes diagnosis was 5 years and the average body mass index was a hefty 36. Only 4% were lost to follow-up.

Outcomes:  After a median of 9.6 years of follow-up......

• patients assigned to the intensive group lost approximately three cm. from their waist and six kg. in weight vs. zero cm. and four kg., respectively, in the support group. This translated to a weight loss of 6% of body weight (vs. the target of 7%) in the intensive group vs. about 3.5% in the support group.

• the A1c, which is a test of overall blood sugar control, was about two tenths of a point (7.4% vs. 7.2%) lower (i.e. better) in the intensive group. LDL cholesterol was also lower. Better control of the diabetes meant that the persons in the intensive group were taking fewer medicines at lower doses.

• But it was all for naught.  During the course of the study, there were 403 cardiovascular deaths, non-fatal heart attacks or heart-related ("angina") hospitalizations in the intensive group, vs. 418 in the support group. The calculated rates of 1.8 vs. 1.9 events per 100 person years was too small to be statistically significant and was more likely the result of chance or randomness.

The Disease Management Care Blogs take?

The early painful lesson of the "disease management" industry was that a broad life-style intervention applied to a large group of diabetics was not going to meaningfully improve outcomes. Critics believed that while the interventions were conceptually sound (diet, exercise, weight loss), the delivery was flawed. 

This just published NEJM study would suggest the intervention itself is futile. If so, that is bad news.

"Not so fast!" says the DMCB.

In addition to renaming itself (now "population health"), the industry responded to the science and the critics by retooling.  It learned to channel tailored interventions at population sub-segments who are most likely to experience a specific benefit. Instead of an "intensive" weight loss intervention for all overweight diabetics, population health can use baseline survey, insurance or clinical data to spot (risk stratify) those diabetics who are most likely to achieve a specific benefit that could range from (for example) a sustained 7% weight loss to reduced readmissions.

This NEJM study tried to benefit all diabetics.  A better approach is to find which diabetics will benefit.

As an aside there were some other issues with the study to bring up when debating the study with colleagues and foes:

The BMI of 36 suggests this was a very obese study population that lost only 6% of their body weight during the course of the study.  Since weight was still a health risk at the end of the study, the DMCB wonders if the intervention would have shown more benefit with a less heavy population.

The support group also lost weight and lowered their A1c, which could have obscured the clinically significant benefit in the intervention group. 

This accompanying editorial points out that lower statin and ACE drug use in the intervention group could have paradoxically increased their risk, since these drugs are known to lower the incidence of stroke and heart attack.

The editorial also points out that spin-off studies have already shown that the intervention group benefitted from higher quality of life.

Resveratrol and Nuts Combine to Improve Brain Health and Boost Cognitive Function

Nuts, especially walnuts, almonds and hazelnuts, combined with the potent polyphenol resveratrol team together to improve mood and protect the aging brain to help maintain memory and cognition. Researchers reportingin the New England Journal of Medicinehave found that nuts consumed over a period of years not only help with weight management issues, but also can reduce systemic inflammation to improve spirits and prevent cognitive decline.

Resveratrol has long been associated with brain health. The Journal of Pineal Research reportsthat resveratrol demonstrates anti-aging properties in the brain necessary for energy production and optimal brain function. Combining these two natural agents together as part of your healthy diet can improve mood, help retain memories and preserve youthful thought patterns.

Nuts Improve Mood, Slash Brain Inflammation and Prevent Cognitive Decline

Researchers determined to validate the health-promoting capacity of nuts provided test participants with a diet of walnuts, almonds and hazelnuts for a period of 12 weeks. The volunteers for this study were sex and age-matched individuals given a control diet, and compared to a group not receiving the nut mixture. All participants exhibited symptoms of metabolic syndrome, increasing risk for developing diabetes, heart disease, mood disorders and loss of cognition.

Individuals receiving the nutshad increased levels of serotonin which will help a person feel better and potentially more satisfied and less likely to suffer from depression and poor mood. Additionally, the nut control group demonstrated reduced inflammatory markers from the high polyphenol content of the nuts. This is an important finding, as individuals exhibiting the signs of metabolic syndrome experience the effects of systemic inflammation leading to accelerated brain aging and cognitive decline.

Resveratrol Positively Influences Gene Expression to Restore Mitochondria Function

Mitochondria are the tiny metabolic engines that are responsible for powering each of our trillion or so cells throughout the body. Over time, mitochondria begin to experience loss of function and cellular decline and aging of the cell begin. Mitochondrial regulation is controlled in large part by the ‘longevity’ gene known as Sirt1. Calorie restriction and potent natural nutrients such as resveratrol are known to alter expression of the Sirt1 gene. Researchers have demonstrated that resveratrolis able to restore neural mitochondria function by reviving Sirt1 gene expression, and provides “a potent anti-aging effect within the brain.”

The human brain is a highly metabolic organ, demanding 20% of the total oxygen supply for the body. As such, it is also susceptible to the effects of oxidative stress and free radical damage that cause brain inflammation and advanced signs of aging. Natural nutrients such as resveratrol (25 – 50 mg per day) that cross the blood-brain barrier and foundation monounsaturated fats supplied by most nuts (1 to 2 ounces each day) and seeds protect the brain from damage and dramatically lower the risk of memory loss and cognitive decline.

Health Benefits of Aspirin Updated

Review of Daily Aspirin Dosage Highlights Concerns About Side Effects

Researchers at Warwick Medical School have published the most comprehensive review of the benefits and risks of a daily dose of prophylactic aspirin and warn that greater understanding of side effects is needed.
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The possible benefits of a daily dose have been promoted as a primary prevention for people who are currently free of, but at risk of developing, cardiovascular disease or colorectal cancer.

However, any such benefit needs to be balanced alongside a fuller understanding of the potentially harmful side effects such as bleeding and gastrointestinal problems.

The paper, published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme, reviews the wealth of available randomised controlled trials (RCTs), systematic reviews and meta-analyses, allowing the team from Warwick Evidence to quantify those relative benefits and risks.

The reported benefits of taking aspirin each day ranged from 10% reduction in major cardiovascular events to a 15% drop in total coronary heart disease. In real terms, that would ultimately mean 33-46 fewer deaths per 100,000 patients taking the treatment.

There was also evidence of a reported reduction in incidents of colorectal cancer, which showed from approximately five years after the start of treatment. This would equate to 34 fewer deaths from colorectal cancer per 100,000 patients.

The adverse effects of aspirin were also noted with a 37% increase in gastrointestinal bleeding (an extra 68-117 occurrences per 100,000 patients) and between a 32%-38% increase in the likelihood of a haemorrhagic stroke (an extra 8-10 occurrences per 100,000 patients).

Aspirin for Primary Prevention in Men When Cancer Mortality Benefit Added

A research team, including UNC scientists, reports that including the positive effect of aspirin on cancer mortality influences the threshold for prescribing aspirin for primary prevention in men. The benefit of aspirin for cancer mortality prevention would help offset the risks and thus lower the age and increase the number of men for whom aspirin is recommended.

Aspirin May Lower Melanoma Risk

Overall, women who used aspirin had a 21 percent lower risk of melanoma relative to non-users. Each incremental increase in duration of aspirin use (less than one year of use, one to four years of use, and five or more years of use) was associated with an 11 percent lower risk of melanoma. Thus, women who used aspirin for five or more years had a 30 percent lower melanoma risk than women who did not use aspirin. The researchers controlled for differences in pigmentation, tanning practices, sunscreen use, and other factors that may affect skin cancer risk.

Aspirin Every Other Day May Lower Womens Colon Cancer Risk

Taking a low-dose aspirin every other day may reduce the risk of colorectal cancer, according to a study that focused on nearly 40,000 women aged 45 and older.

The protection does seem to take some time to surface, said researcher Nancy Cook, a professor of medicine at Brigham and Womens Hospital and Harvard Medical School. "After 10 years, we started to see an effect," she noted.

"After 18 years of follow-up, we saw a 20 percent reduction in colon cancer over the whole time period," she said. When they looked at the 10-to-18 year mark, the reduction was 42 percent, she said.

Aspirin use = lower risk of death from chronic liver disease

Aspirin use is associated with a decreased risk of developing hepatocellular carcinoma and death from chronic liver disease (CLD), according to a study published November 28, 2012 in the Journal of the National Cancer Institute. Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, occurs mainly among patients with CLD.

Study participants who used aspirin had a 41% reduced risk of HCC and a 45% reduced risk of death from CLD, whereas those who used non-aspirin NSAIDs experienced a 26% reduced risk of CLD mortality but no reduced risk of HCC.

Aspirin blocks tumor growth in some colorectal cancer

Aspirin has the potential to block tumor growth in certain patients with colorectal cancer, according to an editorial in the Oct. 25, 2012 issue of the New England Journal of Medicine by a University of Alabama at Birmingham oncologist. In a study that appears in the same issue, researchers examined the use of aspirin in the treatment outcomes of patients with colorectal cancer and a certain gene mutation. The authors found that the use of aspirin after diagnosis in patients with the gene mutation was associated with a 46 percent reduction in overall mortality and an 82 percent reduction in colorectal cancer-specific mortality.

Aspirin may decrease risk of aggressive form of ovarian cancer

Aspirin May Slow Brain Decline

Aspirin use and the risk of prostate cancer mortality

Study: daily aspirin linked to lower cancer mortality

For the current study, American Cancer Society researchers led by Eric J. Jacobs, Ph.D., analyzed information from 100,139 predominantly elderly participants in the Cancer Prevention Study II Nutrition Cohort who reported aspirin use on questionnaires, did not have cancer at the start of the study, and were followed for up to 11 years. They found daily aspirin use was associated with an estimated 16% lower overall risk of cancer mortality, both among people who reported taking aspirin daily for at least five years and among those who reported shorter term daily use. The lower overall cancer mortality was driven by about 40% lower mortality from cancers of the gastrointestinal tract (such as esophageal, stomach, and colorectal cancer) and about 12% lower mortality from cancers outside the gastrointestinal tract.

The reduction in cancer mortality observed in the current study is considerably smaller than the 37% reduction reported in the recent pooled analysis of randomized trials. The authors note that their study was observational, not randomized, and therefore could have underestimated or overestimated potential effects on cancer mortality if participants who took aspirin daily had different underlying risk factors for fatal cancer than those who did not. However, the studys large size is a strength in determining how much daily aspirin use might lower cancer mortality

Aspirin use responsible for a 57 percent reduction in the risk of prostate cancer death

Aspirin and omega-3 fatty acids work together to fight inflammation

Statin and Aspirin Use Linked to Improved Survival in Women with Endometrial Cancer


Regular use of low-dose aspirin may prevent the progression of breast cancer

Aspirin reduces risk of Barretts esophagus & cancer

Aspirin use appears to reduce the risk of Barretts esophagus (BE), the largest known risk factor for esophageal cancer, according to a new study (July, 2012) in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association. Those taking aspirin were 44 percent less likely to have BE.

Aspirin before heart surgery reduces the risk of post-operative acute kidney failure

Aspirin May Guard Against Skin Cancer

Colon Cancer Survival Improves With Aspirin

Colon cancer patients who take aspirin regularly shortly after diagnosis tend to live longer, researchers from Leiden University Medical Centre, the Netherlands, reported in the British Journal of Cancer. (April, 2012) Those taking a daily dose of aspirin for nine months or more after diagnosis had a 30% lower risk of cancer-related death compared to non-users. Even taking aspirin regularly for any length of time reduced the risk of death (by 23%).

Aspirins potential role in reducing the risk of cancer death

A new report by American Cancer Society scientists says new data showing aspirins potential role in reducing the risk of cancer death bring us considerably closer to the time when cancer prevention can be included in clinical guidelines for the use of aspirin in preventive care. The report, published early online in Nature Reviews Clinical Oncology (April, 2012), says even a 10% reduction in overall cancer incidence beginning during the first 10 years of treatment could tip the balance of benefits and risks favorably in average-risk populations.

Current guidelines for the use of aspirin in disease prevention consider only its cardiovascular benefits, weighed against the potential harm from aspirin-induced bleeding. While daily aspirin use has also been convincingly shown to reduce the risk of colorectal cancer and recurrence of adenomatous polyps, these benefits alone do not outweigh harms from aspirin-induced bleeding in average-risk populations. But recently published secondary analyses of cardiovascular trials have provided the first randomized evidence that daily aspirin use may also reduce the incidence of all cancers combined, even at low doses (75-100 mg daily).

The report says recently published meta-analyses of results from randomized trials of daily aspirin treatment to prevent vascular events have provided provocative evidence that daily aspirin at doses of 75 mg and above might lower both overall cancer incidence and overall cancer mortality.

Why Dont More Women Take a Daily Aspirin to Prevent Heart Disease?

Heart disease is the leading cause of death among women, and evidence-based national guidelines promote the use of daily aspirin for women at increased risk for cardiovascular disease. However, less than half of the women who could benefit from aspirin are taking it,.

Aspirin: High or Low Dose? No significant difference.

Aspirin lowers trans fat-related stroke risk in older women

Older women whose diets include a substantial amount of trans fats are more likely than their counterparts to suffer an ischemic stroke, a new study shows.

However, the risk of stroke associated with trans fat intake was lower among women taking aspirin, according to the findings from University of North Carolina at Chapel Hill researchers.

The study of 87,025 generally healthy postmenopausal women aged 50 to 79 found that those whose diets contained the largest amounts of trans fats were 39 percent more likely to have an ischemic stroke (clots in vessels supplying blood to the brain) than women who ate the least amount of trans fat. The risk was even more pronounced among non-users of aspirin: those who ate the most trans fat were 66 percent more likely to have an ischemic stroke than females who ate the least trans fat.

However, among women who took aspirin over an extended period of time, researchers found no association between trans fat consumption and stroke risk – suggesting that regular aspirin use may counteract trans fat intakes adverse effect on stroke risk among women.

Regular aspirin intake halves hereditary cancer risk

Higher daily dose of aspirin prevents heart attacks

Using information from diabetic patients in these studies, Simpson discovered that patients with previous cardiac episodes who were taking a low dose of aspirin daily had very little benefit in terms of prevention of a second heart attack or a decreased risk of mortality. However, in patients taking higher doses of aspirin, the risk of a repeat heart attack and/or death was significantly lower.

Aspirin reduces the risk of cancer recurrence in prostate cancer patients

After 10-years from completion of treatment, 31% of the men who took aspirin developed recurrence compared with 39% of non-aspirin users. There was also a 2% improvement in 10-year prostate cancer related survival associated with aspirin use

Aspirin may lower the risk of pancreatic cancer

Results showed that people who took aspirin at least one day during a month had a 26 percent decreased risk of pancreatic cancer compared to those who did not take aspirin regularly. The effect was also found for those who took low-dose aspirin for heart disease prevention at 35 percent lower risk.

Daily Aspirin at Low Doses Reduces Cancer Deaths

A daily low dose of aspirin significantly reduces the number of deaths from a whole range of common cancers, an Oxford University study has found.

The 20% drop in all cancer deaths seen in the study adds new evidence to the debate about whether otherwise healthy people in their 40s and 50s should consider taking a low dose of aspirin each day.

Aspirin is already known to be beneficial for those at high risk of heart disease. But among healthy people, the benefit in lower chances of heart problems only marginally outweighs the small risk of stomach bleeds.

The large size of the effect now seen in preventing cancer deaths may begin to tip the balance in favour of taking aspirin.

The results, published in the Lancet, showed that aspirin reduced death due to any cancer by around 20% during the trials. But the benefits of aspirin only became apparent after taking the drug for 5 years or more, suggesting aspirin works by slowing or preventing the early stages of the disease so that the effect is only seen much later.

After 5 years of taking aspirin, the data from patients in the trials showed that death rates were 34% less for all cancers and as much as 54% less for gastrointestinal cancers, such as oesophagus, stomach, bowel, pancreas and liver cancers.

The researchers also wanted to determine if the benefits from aspirin continued over time. By using cancer registries and death records, they were able to follow up what had happened to participants in three of the trials.

They showed that risk of cancer death over a period of 20 years remained 20% lower for all solid cancers among those who had taken aspirin (even though they would have been unlikely to have continued taking aspirin after the trials finished), and 35% lower for gastrointestinal cancers.

It took about 5 years to see a benefit in taking aspirin for oesophagus, pancreatic, brain, and lung cancer; about 10 years for stomach and bowel cancer; and about 15 years for prostate cancer. The 20-year risk of death was reduced by about 10% for prostate cancer, 30% for lung cancer, 40% for bowel cancer and 60% for oesophagus cancer.

Low dose of aspirin wards off bowel cancer

Even the lowest possible dose of aspirin (75 mg) can ward off bowel cancer, if taken regularly, finds research published online in the journal Gut.

After a year, taking daily low dose aspirin was associated with a 22% reduced risk of developing bowel cancer, and the magnitude of the reduction in risk was cumulative, rising to 30% after five years.

The benefits of aspirin treatment significantly outweigh the risk of a major hemorrhage

The American Heart Association:

“Background— Low-dose aspirin is an important therapeutic option in the secondary prevention of myocardial infarction (MI) and ischemic stroke, especially in light of its unique cost-effectiveness and widespread availability. In addition, based on the results of a number of large studies, aspirin is also widely used in the primary prevention of MI. This review provides an update of the available data to offer greater clarity regarding the risks of aspirin with respect to hemorrhagic stroke, as well as insights regarding patient selection to minimize the risk of this complication.

Summary of Review— In the secondary prevention of cardiovascular, cerebrovascular, and ischemic events, the evidence supports that the benefits of aspirin treatment significantly outweigh the risk of a major hemorrhage. The evidence from primary prevention of MI studies, including that from the recent Women’s Health Study evaluation of aspirin use in healthy women, demonstrate that the increased risk for hemorrhagic stroke is small, is comparable to the secondary prevention studies, and fails to achieve statistical significance. A reasonable estimate of the risk of hemorrhagic stroke associated with the use of aspirin in primary prevention patients is 0.2 events per 1000 patient-years, which is comparable to estimates of the risk associated with the use of aspirin in secondary prevention patients.

Conclusions— When considering whether aspirin is appropriate, the absolute therapeutic cardiovascular benefits of aspirin must be balanced with the possible risks associated with its use, with the most serious being hemorrhagic stroke.”

Another study (http://www.ynhh.org/healthlink/neurology/neurology_08_06.html ) had revealed that the 100 mg dose of aspirin every other day caused a 24 percent drop in the risk of ischemic stroke, which is the more common kind of stroke, and an insignificant increase in the risk of hemorrhagic stroke, hence the overall reduction in stroke risk of 17 percent. .

Aspirin use lowers breast & ovarian cancer risk

Breast Cancer Patients Who Take Aspirin Reduced Risk of Metastasis and Death by Half

An analysis of data from the Nurse’s Health Study, a large, ongoing prospective observational study, shows that women who have completed treatment for early-stage breast cancer and who take aspirin have a nearly 50 percent reduced risk of breast cancer death and a similar reduction in the risk of metastasis.

Aspirin can reduce risk of Alzheimers disease

Different types of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin, appear to be equally effective in lowering the risk of Alzheimer’s disease, according to the largest study of its kind published in the May 28, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology. Experts have debated whether a certain group of NSAIDs that includes ibuprofen may be more beneficial than another group that includes naproxen and aspirin.

Using information from six different studies, researchers examined data on NSAID use in 13,499 people without dementia. Over the course of these six studies, 820 participants developed Alzheimer’s disease.

Researchers found that people who used NSAIDs had 23 percent lower risk of developing Alzheimer’s disease compared to those who never used NSAIDs. The risk reduction did not appear to depend upon the type of NSAID taken.

Aspirin at night = significant reductions in blood pressure

Data unveiled at the American Society of Hypertensions Twenty Third Annual Scientific Meeting and Exposition (ASH 2008) revealed for the first time that people with prehypertension who are treated with aspirin may experience significant reductions in blood pressure—but only if they take the pill before bedtime, and not when they wake up in the morning.

Aspirin may reduce risk of breast cancer


Aspirin can prevent liver damage that afflicts millions, Yale study finds

Using Aspirin to Prevent Heart Attack Or Stroke - U.S. Preventive Services Task Force Recommendations

Patients and clinicians should consider risk factors-- including age, gender, diabetes, blood pressure, cholesterol levels, smoking and risk of gastrointestinal bleeding-- before deciding whether to use aspirin to prevent heart attacks or strokes, according to new recommendations from the U.S. Preventive Services Task Force. These recommendations do not apply to people who have already had a heart attack or stroke.

• The USPSTF recommends the use of aspirin for men age 45 to 79 years when the potential benefit due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in gastrointestinal hemorrhage.

• The USPSTF recommends the use of aspirin for women age 55 to 79 years when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage.

• The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of aspirin for cardiovascular disease prevention in men and women 80 years or older.

• The USPSTF recommends against the use of aspirin for stroke prevention in women younger than 55 years and for myocardial infarction prevention in men younger than 45 years.

Aspirin Improves Survival in Women with Stable Heart Disease, According to WHI Study

Compared to those who did not report taking aspirin, regular aspirin users had a 25 percent lower risk of death from cardiovascular disease and a 14 percent lower risk of death from any cause. There were no significant differences in death rates or other outcomes between women taking 81 mg of aspirin compared to those taking 325 mg.

Benefits of aspirin for treating osteoporosis


Aspirin reduces the risk of colorectal cancer.

Aspirin Better Heart Treatment for Men than Women

Aspirin therapy is a cornerstone in managing heart disease because it inhibits blood clotting. Aspirin therapy can reduce the risk of a nonfatal heart attack or stroke by about 23 percent, and an estimated 20 million men and women take a low dose of aspirin (81-325 mg daily) to control heart disease.

Aspirin Fights Cancer

A daily dose of adult-strength aspirin may modestly reduce cancer risk in populations with high rates of colorectal, prostate, and breast cancer if taken for at least five years.

Eric Jacobs, Ph.D., of the American Cancer Society in Atlanta, and colleagues looked for associations between long-term daily aspirin use (at least 325mg/day) and cancer incidence in a group of nearly 70,000 men and 76,000 women. Aspirin use was determined by a questionnaire.

During the 12 year follow-up, nearly 18,000 men and women in the study were diagnosed with cancer. The researchers found that daily use of adult-strength aspirin for at least five years was associated with an approximately 15 percent relative reduction in overall cancer risk, though the decrease was not statistically significant in women. Additionally, aspirin use was associated with a 20 percent reduced risk of prostate cancer and a 30 percent reduced risk of colorectal cancer in men and women, compared to people who didnt take aspirin. There was no effect on risk in other cancers examined—lung cancer, bladder cancer, melanoma, leukemia, non-Hodgkins lymphoma, pancreatic cancer, and kidney cancer. Aspirin use for less than five years was not associated with decreased cancer risk.

Long-term aspirin = reduced risk of dying in women

Women who reported using aspirin currently had a 25 percent lower risk of death from any cause than women who never used aspirin regularly. The association was stronger for death from cardiovascular disease (women who used aspirin had a 38 percent lower risk) than for death from cancer (women who used aspirin had a 12 percent lower risk).

"Use of aspirin for one to five years was associated with significant reductions in cardiovascular mortality," the authors write. "In contrast, a significant reduction in risk of cancer deaths was not observed until after 10 years of aspirin use. The benefit associated with aspirin was confined to low and moderate doses and was significantly greater in older participants and those with more cardiac risk factors."

Aspirin saves lives of cancer patients suffering heart attacks, despite fears of bleeding

Heart attack patients with low platelets who did not receive aspirin had a seven-day survival rate of 6 percent, compared with 90 percent survival in those who received aspirin. Dr. Durand notes that there were no severe bleeding complications in patients who used aspirin. Conversely, patients with low platelet counts who formed a blood clot and were not exposed to aspirin died.

The beneficial effect of aspirin also was seen in patients with normal platelet counts. Seven-day survival was 88 percent in aspirin-treated patients as compared to 45 percent in patients who did not receive aspirin, the researchers found.

Durand observed that these deaths rates are abnormally high. "In the non-cancer patient with acute coronary syndrome anywhere in the United States, an expected seven-day mortality is less than 1 percent," he says.

Low-dose aspirin offers lower chance of asthma

In a large, randomized, placebo-controlled study of 22,071 healthy male physicians, taking a low-dose of aspirin every other day lowered the risk of receiving an initial asthma diagnosis by 22 percent.