Severe Complications for Pregnant Veterans Nearly Doubled in the Last Decade, a GAO Report Finds
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Over the past decade, the rate of veterans suffering severe pregnancy complications has risen dramatically, a new federal report found.
Veterans have raced to the hospital with dangerous infections, kidney failure, aneurysms or blood loss. They’ve required hysterectomies, breathing machines and blood transfusions to save their lives. Between 2011 and 2020, 13 veterans died after such complications.
The report found that among people getting health care benefits through the Department of Veterans Affairs, the rate of severe complications nearly doubled during that time, from about 93 per 10,000 hospitalizations in 2011 to just over 184 per 10,000 hospitalizations in 2020. Black veterans had the highest rates.
The report, which was put together by the Government Accountability Office, also made recommendations for reducing the problem, which focus on conducting more routine screenings throughout pregnancy and in the postpartum period.
“It is imperative that the VA help ensure veterans have the healthiest pregnancy outcomes possible,” the report said, highlighting the increasing number of veterans using the agency’s maternity benefits as well as the troublesome complication rates faced by Black women.
The report’s findings are an unfortunate trend, said Alyssa Hundrup, director of health care at the GAO. The office analyzed data on 40,000 hospitalizations related to deliveries paid for by the VA. It captures a time period before 21 states banned or greatly restricted abortion and the military was thrust into a political battle over whether it would pay for active service members to travel for abortion care if a pregnancy was a risk to their health.
Hundrup, who led the review, said the analysis included hospital records from days after delivery to a year postpartum. The report was mandated after Congress passed a law in 2021 that aimed to address the maternal health crisis among veterans. The law led to a $15 million investment in maternity care coordination programs for veterans.
The report recommended that the VA analyze and collect more data on severe complications as well as data on the mental health, race and ethnicity of veterans who experience complications to understand the causes behind the increase and the reasons for the disparity. The report also states that oversight is needed to ensure screenings are being completed.
Studies show there’s a connection between mental health conditions and pregnancy-related complications, VA officials said.
The report recommended expanding the screening questions that providers ask patients at appointments to glean more information about their mental health, including anxiety and PTSD symptoms. It urged the VA to review the data more regularly.
“You don’t know what you don’t measure,” Hundrup said in an interview with ProPublica.
The VA health system, which historically served a male population, does not provide maternity care at its facilities. Instead, the agency has outsourced maternity care. But when patients were treated by those providers, the VA failed to track whether they were getting screened for other health issues and mental health problems.
Officials hope the improved data collection will help the VA study underlying issues that may lead to complications. For example, do higher rates of anxiety have a connection to rates of high blood pressure in pregnant people?
VA officials are working with a maternal health review committee to monitor the data as it is gathered. The agency recently conducted its first review of data going back five years about pregnancy-related complications, said Dr. Amanda Johnson, acting head of the VA’s Office of Women’s Health, who is overseeing the implementation of the report’s recommendations.
The VA has created a dashboard to monitor pregnant veterans’ health outcomes. The VA’s data analysis team will also examine the impact of veterans’ ages on complications and whether they differ for people who live in urban and rural areas.
VA officials will begin to review mental health screenings conducted by maternal care coordinators in March. The coordinators advocate for veterans, helping them between health care visits, whether their providers are inside or outside the VA.
Johnson said that reducing racial and ethnic disparities is a priority for the agency. In 2018, ProPublica published “Lost Mothers,” a series that shed light on the country’s maternal health crisis. Studies have shown that in the general population, Black women are three times more likely than white women to die from pregnancy-related complications. While deaths made up only a small portion of the bad outcomes for Black veterans cited in the report, VA care could not spare them from elevated rates of severe complications. Johnson said the maternal health crisis also persists within the VA.
“There is a disparity,” Johnson said. “We are not immune to that.”
Research shows pregnant people who have used the VA’s coverage have higher rates of trauma and mental conditions that can increase their risks of complications and bad outcomes.
This may be because many people who join the military enter it having already faced trauma, said Dr. Laura Miller, a psychiatrist and the medical director of reproductive mental health at the VA.
She said veterans with PTSD have higher rates of complications such as preeclampsia, a potentially fatal condition related to high blood pressure, gestational diabetes and postpartum depression. If untreated during pregnancy, depression also increases the likelihood of preterm birth and lingering problems for babies.
Hundrup said she hopes this proactive work will improve maternal health.
“We want these numbers trending in the other direction,” Hundrup said.
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4 Critical Things Female Runners Should Know
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When it comes to keeping up performance in the face of menopause, Shona Hendricks has advice:
Don’t let menopause run you down
- Prioritize recovery! Overtraining without adequate recovery just leads to decreased performance in the long term, and remember, you may not recover as quickly as you used to. If you’re still achey from your previous run, give it another day, or at least make it a lighter run.
- Slow down in easy and long runs! This isn’t “taking the easy way out”; it will improve your overall performance, reducing muscle damage, allowing for quicker recovery and ultimately better fitness gains.
- Focus on nutrition! And that means carbs too. A lot of people fighting menopausal weight gain reduce their intake of food, but without sufficient energy availability, you will not be able to run well. In particular, carbohydrates are vital for energy. Consume them sensibly and with fiber and proteins and fats rather than alone, but do consume them.
- Incorporate strength training! Your run is not “leg day” by itself. Furthermore, do whole-body strength training, to prevent injuries and improve overall performance. A strong core is particularly important.
For more on each of these (and some bonus comments about mobility training for runners), enjoy:
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You can thaw and refreeze meat: five food safety myths busted
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This time of year, most fridges are stocked up with food and drinks to share with family and friends. Let’s not make ourselves and our guests sick by getting things wrong when preparing and serving food.
As the weather warms up, so does the environment for micro-organisms in foods, potentially allowing them to multiply faster to hazardous levels. So put the drinks on ice and keep the fridge for the food.
But what are some of those food safety myths we’ve long come to believe that aren’t actually true?
Myth 1: if you’ve defrosted frozen meat or chicken you can’t refreeze it
From a safety point of view, it is fine to refreeze defrosted meat or chicken or any frozen food as long as it was defrosted in a fridge running at 5°C or below. Some quality may be lost by defrosting then refreezing foods as the cells break down a little and the food can become slightly watery.
Another option is to cook the defrosted food and then divide into small portions and refreeze once it has stopped steaming. Steam in a closed container leads to condensation, which can result in pools of water forming. This, combined with the nutrients in the food, creates the perfect environment for microbial growth. So it’s always best to wait about 30 minutes before refrigerating or freezing hot food.
Plan ahead so food can be defrosted in the fridge, especially with large items such as a frozen turkey or roll of meat. If left on the bench, the external surface could be at room temperature and micro-organisms could be growing rapidly while the centre of the piece is still frozen!
Myth 2: Wash meat before you prepare and/or cook it
It is not a good idea to wash meats and poultry when preparing for cooking. Splashing water that might contain potentially hazardous bacteria around the kitchen can create more of a hazard if those bacteria are splashed onto ready-to-eat foods or food preparation surfaces.
It is, however, a good idea to wash fruits and vegetables before preparing and serving, especially if they’re grown near or in the ground as they may carry some dirt and therefore micro-organisms.
This applies particularly to foods that will be prepared and eaten without further cooking. Consuming foods raw that traditionally have been eaten cooked or otherwise processed to kill pathogenic micro-organisms (potentially deadly to humans) might increase the risk of food poisoning.
Fruit, salad, vegetables and other ready-to-eat foods should be prepared separately, away from raw meat, chicken, seafood and other foods that need cooking.
Myth 3: Hot food should be left out to cool completely before putting it in the fridge
It’s not OK to leave perishable food out for an extended time or overnight before putting it in the fridge.
Micro-organisms can grow rapidly in food at temperatures between 5° and 60°C. Temperature control is the simplest and most effective way of controlling the growth of bacteria. Perishable food should spend as little time as possible in the 5-60°C danger zone. If food is left in the danger zone, be aware it is potentially unsafe to eat.
Hot leftovers, and any other leftovers for that matter, should go into the fridge once they have stopped steaming to reduce condensation, within about 30 minutes.
Large portions of hot food will cool faster if broken down into smaller amounts in shallow containers. It is possible that hot food such as stews or soup left in a bulky container, say a two-litre mixing bowl (versus a shallow tray), in the fridge can take nearly 24 hours to cool to the safe zone of less than 5°C.
Myth 4: If it smells OK, then it’s OK to eat
This is definitely not always true. Spoilage bacteria, yeasts and moulds are the usual culprits for making food smell off or go slimy and these may not make you sick, although it is always advisable not to consume spoiled food.
Pathogenic bacteria can grow in food and not cause any obvious changes to the food, so the best option is to inhibit pathogen growth by refrigerating foods.
Myth 5: Oil preserves food so it can be left at room temperature
Adding oil to foods will not necessarily kill bugs lurking in your food. The opposite is true for many products in oil if anaerobic micro-organisms, such as Clostridium botulinum (botulism), are present in the food. A lack of oxygen provides perfect conditions for their growth.
Outbreaks of botulism arising from consumption of vegetables in oil – including garlic, olives, mushrooms, beans and hot peppers – have mostly been attributed to the products not being properly prepared.
Vegetables in oil can be made safely. In 1991, Australian regulations stipulated that this class of product (vegetables in oil) can be safely made if the pH (a measure of acid) is less than 4.6. Foods with a pH below 4.6 do not in general support the growth of food-poisoning bacteria including botulism.
So keep food out of the danger zone to reduce your guests’ risk of getting food poisoning this summer. Check out other food safety tips and resources from CSIRO and the Food Safety Information Council, including testing your food safety knowledge.
Cathy Moir, Team leader, Microbial and chemical sciences, Food microbiologist and food safety specialist, CSIRO
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Eat to Beat Disease – by Dr. William Li
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Dr. William Li asks the important question:is your diet feeding disease, or defeating it?
Because everything we put in our bodies makes our health just a little better—or just a little worse. Ok, sometimes a lot worse.
But for most people, when it comes to diet, it’s a death of a thousand cuts of unhealthy food. And that’s what he looks to fix with this book.
The good news: Dr. Li (while not advocating for unhealthy eating, of course), focuses less on what to restrict, and more on what to include. This book covers hundreds of such healthy foods, and ideas (practical, useful ones!) on incorporating them daily, including dozens of recipes.
He mainly looks at five ways our food can help us with…
- Angiogenesis (blood vessel replacement)
- Regeneration (of various bodily organs and systems)
- Microbiome health (and all of its knock-on effects)
- DNA protection (and thus slower cellular aging)
- Immunity (defending the body while also reducing autoimmune problems)
The style is simple and explanatory; Dr. Li is a great educator. Reading this isn’t a difficult read, but you’ll come out of it feeling like you just did a short course in health science.
Bottom line: if you’d like an easy way to improve your health in an ongoing and sustainable way, then this book can help you do just that.
Click here to check out Eat To Beat Disease, and eat to beat disease!
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Macadamia Nuts vs Brazil Nuts – Which is Healthier?
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Our Verdict
When comparing macadamia nuts to Brazil nuts, we picked the Brazil nuts.
Why?
They’re a lot more nutrient dense! But watch out…
First, to do due diligence in terms of macros: Brazil nuts have twice as much protein and less fat, as well as being a little higher in fiber and slightly lower in carbs.
In terms of vitamins, Brazil nuts are about 10x higher in vitamin E, while macadamias are somewhat higher in several B-vitamins.
The category of minerals is where it gets interesting. Macadamia nuts are a little higher in iron and considerably higher in Manganese. But… Brazil nuts are a lot higher in calcium, copper, magnesium, phosphorus, potassium, selenium, and zinc.
About that selenium… Specifically, it’s more than 5,000x higher, and a cup of Brazil nuts would give nearly 10,000x the recommended daily amount of selenium. Now, selenium is an essential mineral (needed for thyroid hormone production, for example), and at the RDA it’s good for good health. Your hair will be luscious and shiny. However, go much above that, and selenium toxicity becomes a thing, you may get sick, and it can cause your (luscious and shiny) hair to fall out. For this reason, it’s recommended to eat no more than 3–4 Brazil nuts per day.
In short… Brazil nuts are much more nutrient dense in general, and thus come out on top here. But, they’re so nutrient dense in the case of selenium, that careful moderation is advised.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
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Capsaicin For Weight Loss And Against Inflammation
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Capsaicin’s Hot Benefits
Capsaicin, the compound in hot peppers that makes them spicy, is a chemical irritant and a neurotoxin. However, humans being humans, we decided to eat them for fun.
In contrast to many other ways in which humans recreationally enjoy things that are objectively poisonous, consuming capsaicin (in moderation) is considered to have health benefits, such as aiding weight loss (by boosting metabolism) and reducing inflammation.
Let’s see what the science says…
First: is it safe?
Capsaicin is classified as “Generally Recognized As Safe”. That said, the same mechanism that causes them to boost metabolism, does increase blood pressure:
Mechanisms underlying the hypertensive response induced by capsaicin
If you are in good cardiovascular health, this increase should be slight and not pose any threat, unless for example you enter a chili-eating contest when not acclimated to such:
Capsaicin and arterial hypertensive crisis
As ever, if unsure, do check with your doctor first, especially if you are taking any blood pressure medications, or otherwise have known blood pressure issues.
Does it really boost metabolism?
It certainly does; it works by increasing oxygen consumption and raising body temperature, both of which mean more calories will be burned for the same amount of work:
Dietary capsaicin and its anti-obesity potency: from mechanism to clinical implications
This means, of course, that chili peppers enjoy the status of being functionally a “negative calorie” food, and a top-tier one at that:
Chili pepper as a body weight-loss food
Here’s a good quality study that showed a statistically significant* fat loss improvement over placebo:
*To put it in numbers, the benefit was:
- 5.91 percentage points lower body fat percentage than placebo
- 6.68 percentage points greater change in body fat mass than placebo
See also: Difference between percentages and percentage points
For those who prefer big reviews than single studies, we’ve got you covered:
Does it really reduce inflammation?
Counterintuitive as it may seem, yes. By means of reducing oxidative stress. Given that things that reduce oxidative stress tend to reduce inflammation, and in turn tend to reduce assorted disease risks (from diabetes to cancer to Alzheimer’s), this probably has more knock-on benefits too, but we don’t have room to explore all of those today.
Fresh peppers are best for this, but dried peppers (such as when purchased as a ground spice in the supermarket, or when purchased as a capsule-based supplement) still have a very respectable anti-inflammatory effect:
- Capsaicinoids, Polyphenols and Antioxidant Activities of Capsicum annuum: Comparative Study of the Effect of Ripening Stage and Cooking Methods
- A Review on the Effect of Drying on Antioxidant Potential of Fruits and Vegetables
How much should we take?
It’s recommended to start at a low dose and gradually increase it, but 2–6mg of capsaicin per day is the standard range used in studies.
If you’re getting this from peppers, then for example cayenne pepper (a good source of capsaicin) contains around 2.5mg of capsaicin per 1 gram of cayenne.
In the case of capsules, if for example you don’t like eating hot pepper, this will usually mean taking 2–6 capsules per day, depending on dosage.
Make sure to take it with plenty of water!
Where can we get it?
Fresh peppers or ground spice from your local grocery store is fine. Your local health food store probably sells the supplements, too.
If you’d like to buy it online, here is an example product on Amazon.
Note: options on Amazon were more limited than usual, so this product is not vegan, and probably not halal or kosher, as the capsule contains an unspecified gelatin.
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13 Things Mentally Strong Couples Don’t Do – by Dr. Amy Morin
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The saying “happy wife; happy life” indeed goes regardless of gender. One can have every other happiness, but if there’s relational trouble, it brings everything else down.
This book is not intended, however, only for people whose relationships are one couple’s therapy session away from divorce. Rather, it’s intended as a preventative. Because, in this as in every other aspect of health, prevention is better than cure!
It is the sign of a strong couple to be proactive about the health of the relationship, and work together to build and reinforce things along the way.
The style of this book is very accessible pop-science, but the author speaks from a strong professional background in social work, psychology, and psychotherapy, and it shows.
Bottom line: if you’d like to strengthen your relationship skills, this book gives 13 great ways to do that.
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