Pasteurization: What It Does And Doesn’t Do

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Pasteurization’s Effect On Risks & Nutrients

In Wednesday’s newsletter, we asked you for your health-related opinions of raw (cow’s) milk, and got the above-depicted, below-described, set of responses:

  • About 47% said “raw milk is dangerous to consume, whereas pasteurization makes it safer”
  • About 31% said “raw milk is a good source of vital nutrients which pasteurization would destroy”
  • About 14% said “both raw milk and pasteurized milk are equally unhealthy”
  • About 9% said “both raw milk and pasteurized milk are equally healthy”

Quite polarizing! So, what does the science say?

“Raw milk is dangerous to consume, whereas pasteurization makes it safer: True or False?”

True! Coincidentally, the 47% who voted for this are mirrored by the 47% of the general US population in a similar poll, deciding between the options of whether raw milk is less safe to drink (47%), just as safe to drink (15%), safer to drink (9%), or not sure (30%):

Public Fails to Appreciate Risk of Consuming Raw Milk, Survey Finds

As for what those risks are, by the way, unpasteurized dairy products are estimated to cause 840x more illness and 45x more hospitalizations than pasteurized products.

This is because unpasteurized milk can (and often does) contain E. coli, Listeria, Salmonella, Cryptosporidium, and other such unpleasantries, which pasteurization kills.

Source for both of the above claims:

Characteristics of U.S. Consumers Reporting Past Year Intake of Raw (Unpasteurized) Milk: Results from the 2016 Food Safety Survey and 2019 Food Safety and Nutrition Survey

(we know the title sounds vague, but all this information is easily visible in the abstract, specifically, the first two paragraphs)

Raw milk is a good source of vital nutrients which pasteurization would destroy: True or False?

False! Whether it’s a “good” source can be debated depending on other factors (e.g., if we considered milk’s inflammatory qualities against its positive nutritional content), but it’s undeniably a rich source. However, pasteurization doesn’t destroy or damage those nutrients.

Incidentally, in the same survey we linked up top, 16% of the general US public believed that pasteurization destroys nutrients, while 41% were not sure (and 43% knew that it doesn’t).

Note: for our confidence here, we are skipping over studies published by, for example, dairy farming lobbies and so forth. Those do agree, by the way, but nevertheless we like sources to be as unbiased as possible. The FDA, which is not completely unbiased, has produced a good list of references for this, about half of which we would consider biased, and half unbiased; the clue is generally in the journal names. For example, Food Chemistry and the Journal of Food Science and Journal of Nutrition are probably less biased than the International Dairy Association and the Journal of Dairy Science:

FDA | Raw Milk Misconceptions and the Danger of Raw Milk Consumption

this page covers a lot of other myths too, more than we have room to “bust” here, but it’s very interesting reading and we recommend to check it out!

Notably, we also weren’t able to find any refutation by counterexample on PubMed, with the very slight exception that some studies sometimes found that in the case of milks that were of low quality, pasteurization can reduce the vitamin E content while increasing the vitamin A content. For most milks however, no significant change was found, and in all cases we looked at, B-vitamins were comparable and vitamin D, popularly touted as a benefit of cow’s milk, is actually added later in any case. And, importantly, because this is a common argument, no change in lipid profiles appears to be findable either.

In science, when something has been well-studied and there aren’t clear refutations by counterexample, and the weight of evidence is clearly very much tipped into one camp, that usually means that camp has it right.

Milk generally is good/bad for the health: True or False?

True or False, depending on what we want to look at. It’s definitely not good for inflammation, but the whole it seems to be cancer-neutral and only increases heart disease risk very slightly:

  • Keep Inflammation At Bay ← short version is milk is bad, fermented milk products are fine in moderation
  • Is Dairy Scary? ← short version is that milk is neither good nor terrible; fermented dairy products however are health-positive in numerous ways when consumed in moderation

You may be wondering…

…how this goes for the safety of dairy products when it comes to the bird flu currently affecting dairy cows, and the good news is, the heat of pasteurization kills it:

With all this bird flu around, how safe are eggs, chicken or milk?

Take care!

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  • Test For Whether You Will Be Able To Achieve The Splits

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Some people stretch for years without being able to do the splits; others do it easily after a short while. Are there people for whom it is impossible, and is there a way to know in advance whether our efforts will be fruitful? Liv (of “LivInLeggings” fame) has the answer:

    One side of the story

    There are several factors that affect whether we can do the splits, including:

    • arrangement of the joint itself
    • length of tendons and muscles
    • “stretchiness” of tendons and muscles

    The latter two things, we can readily train to improve. Yes, even the basic length can be changed over time, because the body adapts.

    The former thing, however (arrangement of the joint itself) is near-impossible, because skeletal changes happen more slowly than any other changes in the body. In a battle of muscle vs bone, muscle will always win eventually, and even the bone itself can be rebuilt (as the body fixes itself, or in the case of some diseases, messes itself up). However, changing the arrangement of your joint itself is far beyond the auspices of “do some stretches each day”. So, for practical purposes, without making it the single most important thing in your life, it’s impossible.

    How do we know if the arrangement of our hip joint will accommodate the splits? We can test it, one side at a time. Liv uses the middle splits, also called the side splits or box splits, as an example, but the same science and the same method goes for the front splits.

    Stand next to a stable elevated-to-hip-height surface. You want to be able to raise your near-side leg laterally, and rest it on the surface, such that your raised leg is now perfectly perpendicular to your body.

    There’s a catch: not only do you need to still be stood straight while your leg is elevated 90° to the side, but also, your hips still need to remain parallel to the floor—not tilted up to one side.

    If you can do this (on both sides, even if not both simultaneously right now), then your hip joint itself definitely has the range of motion to allow you to do the side splits; you just need to work up to it. Technically, you could do it right now: if you can do this on both sides, then since there’s no tendon or similar running between your two legs to make it impossible to do both at once, you could do that. But, without training, your nerves will stop you; it’s an in-built self-defense mechanism that’s just firing unnecessarily in this case, and needs training to get past.

    If you can’t do this, then there are two main possibilities:

    • Your joint is not arranged in a way that facilitates this range of motion, and you will not achieve this without devoting your life to it and still taking a very long time.
    • Your tendons and muscles are simply too tight at the moment to allow you even the half-split, so you are getting a false negative.

    This means that, despite the slightly clickbaity title on YouTube, this test cannot actually confirm that you can never do the middle splits; it can only confirm that you can. In other words, this test gives two possible results:

    • “Yes, you can do it!”
    • “We don’t know whether you can do it”

    For more on the anatomy of this plus a visual demonstration of the test, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Stretching Scientifically – by Thomas Kurz ← this is our review of the book she’s working from in this video; this book has this test!

    Take care!

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  • The Checklist Manifesto – by Dr. Atul Gawande

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Gawande, himself a general surgeon, uses checklists a lot. He is, unequivocally, an expert in his field. He “shouldn’t” need a checklist to tell him to do such things as “Check you have the correct patient”. But checklists are there as a safety net. And, famously, “safety regulations are written in blood”, after all.

    And, who amongst us has never made such a “silly” error? From forgetting to turn the oven on, to forgetting to take the handbrake off, it takes only a momentary distraction to think we’ve done something we haven’t.

    You may be wondering: why a whole book on this? Is it just many examples of the usefulness of checklists? Because I’m already sold on that, so, what else am I going to get out of it?

    Dr. Gawande also explains in clear terms:

    • How to optimize “all necessary steps” with “as few steps as possible”
    • The important difference between read-do checklists and do-confirm checklists
    • To what extent we should try to account for the unexpected
    • How to improve compliance (i.e., making sure you actually use it, no matter how tempting it will be to go “yeah this is automatic for me now” and gloss over it)
    • The role of checklists in teams, and in passing on knowledge

    …and more.

    Bottom line: if you’ve ever tried to make tea without putting the tea-leaves in the pot, this is the book that will help you avoid making more costly mistakes—whatever your area of activity or interest.

    Click here to check out the Checklist Manifesto, and make fewer mistakes!

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  • What happens when I stop taking a drug like Ozempic or Mounjaro?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.

    Drugs like Ozempic are very effective at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger.

    But does weight come back when you stop using it?

    The short answer is yes. Stopping tirzepatide and semaglutide will result in weight regain in most people.

    So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far.

    It’s a long-term treatment, not a short course

    If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone.

    For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns.

    Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.)

    Wegovy injections
    Obesity drugs only work while you’re taking them. KK Stock/Shutterstock

    Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less.

    Why do people stop?

    Research trials show anywhere from 6% to 13.5% of participants stop taking these drugs, primarily because of side effects.

    But these studies don’t account for those forced to stop because of cost or widespread supply issues. We don’t know how many people have needed to stop this medication over the past few years for these reasons.

    Understanding what stopping does to the body is therefore important.

    So what happens when you stop?

    When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to move out of your system. As it does, a number of things happen:

    • you start feeling hungry again, because both your brain and your gut no longer have the medication working to make you feel full
    CAPTION.
    When you stop taking it, you feel hungry again. Stock-Asso/Shutterstock
    • blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a low glycemic index to stabilise your blood sugars
    • over the longer term, most people experience a return to their previous blood pressure and cholesterol levels, as the weight comes back
    • weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle.

    While you were on the medication, you will have lost proportionally less skeletal muscle than fat, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat.

    Is stopping and starting the medications a problem?

    People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of yo-yo dieting.

    When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to deal with spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can stress your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual.

    Interestingly, the risk to the body from weight fluctuations is greater for people who are not obese. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight.

    How can you avoid gaining weight when you stop?

    Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include:

    • getting quality sleep
    • exercising in a way that builds and maintains muscle. While on the medication, you will likely have lost muscle as well as fat, although this is not inevitable, especially if you exercise regularly while taking it
    Man walks on treadmill
    Prioritise building and maintaining muscle. EvMedvedeva/Shutterstock
    • addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is fat-phobic and discriminates against people in larger bodies
    • eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes.

    Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important.

    Read the other articles in The Conversation’s Ozempic series here.

    Natasha Yates, General Practitioner, PhD Candidate, Bond University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • What causes food cravings? And what can we do about them?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard?

    High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods activate the brain’s reward system because in the past they were rare.

    Now, they’re all around us. In wealthy modern societies we are bombarded by advertising which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering an intense urge to eat them.

    Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods.

    Fascinadora/Shutterstock

    What causes cravings?

    A food craving is an intense desire or urge to eat something, often focused on a particular food.

    We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt.

    Something that reminds us of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to crave it.

    Three people holding a cone of french fries.
    Our brains learn to crave foods based on what we’ve enjoyed before. fon thachakul/Shutterstock

    The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control.

    What else influences our choices?

    While the effect of cues on our physical response is relatively automatic, what we do next is influenced by complex factors.
    Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals.

    But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the pleasure of eating, over one that’s delayed or abstract – including health goals that will make us feel good in the long term.

    Stress can also make us eat more. When hungry, we choose larger portions, underestimate calories and find eating more rewarding.

    Looking for something salty or sweet

    So what if a cue prompts us to look for a certain food, but it’s not available?

    Previous research suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol.

    But our new research has confirmed something you probably knew: it’s more specific than that.

    If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy.

    Food cues and mindless eating

    Your eating history and genetics can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is hard for almost everyone.

    Food cues are so powerful they can prompt us to seek out a certain food, even if we’re not overcome by a particularly strong urge to eat it. The effect is more intense if the food is easily available.

    This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we eat. Sometimes we use finishing the packet as the signal to stop eating rather than hunger or desire.

    Is there anything I can do to resist cravings?

    We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in.

    • Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit.
    • Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle.
    • At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment.
    • Make sure your goals for eating are SMART. This means they are specific, measurable, achievable, relevant and time-bound.
    • Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.

    Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University and Justin Mahlberg, Research Fellow, Pyschology, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • How they did it: STAT reporters expose how ailing seniors suffer when Medicare Advantage plans use algorithms to deny care

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In a call with a long-time source, what stood out most to STAT reporters Bob Herman and Casey Ross was just how viscerally frustrated and angry the source was about an algorithm used by insurance companies to decide how long patients should stay in a nursing home or rehab facility before being sent home.­

    The STAT stories had a far-reaching impact:

    • The U.S. Senate Committee on Homeland Security and Government Affairs took a rare step of launching a formal investigation into the use of algorithms by the country’s three largest Medicare Advantage insurers.
    • Thirty-two House members urged the Centers for Medicare and Medicaid Services to increase the oversight of algorithms that health insurers use to make coverage decisions.
    • In a rare step, CMS launched its own investigation into UnitedHealth. It also stiffened its regulations on the use of proprietary algorithms and introduced plans to audit denials across Medicare Advantage plans in 2024.
    • Based on STAT’s reporting, Medicare Advantage beneficiaries filed two class-action lawsuits against UnitedHealth and its NaviHealth subsidiary, the maker of the algorithm, and against Humana, another major health insurance company that was also using the algorithm. 
    • Amid scrutiny, UnitedHealth renamed NaviHealth.

    The companies never allowed an on-the-record interview with their executives, but they acknowledged that STAT’s reporting was true, according to the news organization.

    Ross and Herman spoke with The Journalist’s Resource about their project and shared the following eight tips.

    1. Search public comments on proposed federal rules to find sources.

    Herman and Ross knew that the Centers for Medicare and Medicaid Services had put out a request for public comments, asking stakeholders within the Medicare Advantage industry how the system could improve.

    There are two main ways to get Medicare coverage: original Medicare, which is a fee-for-service health plan, and Medicare Advantage, which is a type of Medicare health plan offered by private insurance companies that contract with Medicare. Medicare Advantage plans have increasingly become popular in recent years.

    Under the Social Security Act, the public has the opportunity to submit comments on Medicare’s proposed national coverage determinations. CMS uses public comments to inform its proposed and final decisions. It responds in detail to all public comments when issuing a final decision.

    The reporters began combing through hundreds of public comments attached to a proposed Medicare Advantage rule that was undergoing federal review. NaviHealth, the UnitedHealth subsidiary and the maker of the algorithm, came up in many of the comments, which include the submitters’ information.

    “These are screaming all-caps comments to federal regulators about YOU NEED TO SOMETHING ABOUT THIS BECAUSE IT’S DISGUSTING,” Ross says.

    “The federal government is proposing rules and regulations all the time,” adds Herman, STAT’s business of health care reporter. “If someone’s going to take the time and effort to comment on them, they must have at least some knowledge of what’s going on. It’s just a great tool for any journalist to use to figure out more and who to contact.”

    The reporters also found several attorneys who had complained in the comments. They began reaching out to them, eventually gaining access to confidential documents and intermediaries who put them in touch with patients to show the human impact of the algorithm.

    2. Harness the power of the reader submission box.

    At the suggestion of an editor, the reporters added a reader submission box at the bottom of their first story, asking them to share their own experiences with Medicare Advantage denials.

    The floodgates opened. Hundreds of submissions arrived.

    By the end of their first story, Herman and Ross had confidential records and some patients, but they had no internal sources in the companies they were investigating, including Navihealth. The submission box led them to their first internal source.

    (Screenshot of STAT’s submission box.)

    The journalists also combed through LinkedIn and reached out to former and current employees, but the response rate was much lower than what they received via the submission box.

    The submission box “is just right there,” Herman says. “People who would want to reach out to us can do it right then and there after they read the story and it’s fresh in their minds.”

    3. Mine podcasts relevant to your story.

    The reporters weren’t sure if they could get interviews with some of the key figures in the story, including Tom Scully, the former head of the Centers for Medicare and Medicaid Services who drew up the initial plans for NaviHealth years before UnitedHealth acquired it.

    But Herman and another colleague had written previously about Scully’s private equity firm and they had found a podcast where he talked about his work. So Herman went back to the podcast — where he discovered Scully had also discussed NaviHealth.

    The reporters also used the podcast to get Scully on the phone for an interview.

    “So we knew we had a good jumping off point there to be like, ‘OK, you’ve talked about NaviHealth on a podcast, let’s talk about this,’” Herman says. “I think that helped make him more willing to speak with us.”

    4. When covering AI initiatives, proceed with caution.

    “A source of mine once said to me, ‘AI is not magic,’” Ross says. “People need to just ask questions about it because AI has this aura about it that it’s objective, that it’s accurate, that it’s unquestionable, that it never fails. And that is not true.”

    AI is not a neutral, objective machine, Ross says. “It’s based on data that’s fed into it and people need to ask questions about that data.”

    He suggests several questions to ask about the data behind AI tools:

    • Where does the data come from?
    • Who does it represent?
    • How is this tool being applied?
    • Do the people to whom the tool is being applied match the data on which it was trained? “If racial groups or genders or age of economic situations are not adequately represented in the training set, then there can be an awful lot of bias in the output of the tool and how it’s applied,” Ross says.
    • How is the tool applied within the institution? Are people being forced to forsake their judgment and their own ability to do their jobs to follow the algorithm?

    5. Localize the story.

    More than half of all Medicare beneficiaries have Medicare Advantage and there’s a high likelihood that there are multiple Medicare Advantage plans in every county across the nation.

    “So it’s worth looking to see how Medicare Advantage plans are growing in your area,” Herman says.

    Finding out about AI use will most likely rely on shoe-leather reporting of speaking with providers, nursing homes and rehab facilities, attorneys and patients in your community, he says. Another source is home health agencies, which may be caring for patients who were kicked out of nursing homes and rehab facilities too soon because of a decision by an algorithm.

    The anecdote that opens their first story involves a small regional health insurer in Wisconsin, which was using NaviHealth and a contractor to manage post-acute care services, Ross says.

    “It’s happening to people in small communities who have no idea that this insurer they’ve signed up with is using this tool made by this other company that operates nationally,” Ross says.

    There are also plenty of other companies like NaviHealth that are being used by Medicare Advantage plans, Herman says. “So it’s understanding which Medicare Advantage plans are being sold in your area and then which post-acute management companies they’re using,” he adds.

    Some regional insurers have online documents that show which contractors they use to evaluate post-acute care services.

    6. Get familiar with Medicare’s appeals databases

    Medicare beneficiaries can contest Medicare Advantage denials through a five-stage process, which can last months to years. The appeals can be filed via the Office of Medicare Hearings and Appeals.

    “Between 2020 and 2022, the number of appeals filed to contest Medicare Advantage denials shot up 58%, with nearly 150,000 requests to review a denial filed in 2022, according to a federal database,” Ross and Herman write in their first story. “Federal records show most denials for skilled nursing care are eventually overturned, either by the plan itself or an independent body that adjudicates Medicare appeals.”

    There are several sources to find appeals data. Be mindful that the cases themselves are not public to protect patient privacy, but you can find the number of appeals filed and the rationale for decisions.

    CMS has two quality improvement organizations, or QIOs, Livanta and Kepro, which are required to file free, publicly-available annual reports, about the cases they handle, Ross says.

    Another company, Maximus, a Quality Improvement Contractor, also files reports on prior authorization cases it adjudicates for Medicare. The free annual reports include data on raw numbers of cases and basic information about the percentage denials either overturned or upheld on appeal, Ross explains.

    CMS also maintains its own database on appeals for Medicare Part C (Medicare Advantage plans) and Part D, which covers prescription drugs, although the data is not complete, Ross explains.

    7. Give your editor regular updates.

    “Sprinkle the breadcrumbs in front of your editors,” Ross says.

    “If you wrap your editors in the process, you’re more likely to be able to get to the end of [the story] before they say, ‘That’s it! Give me your copy,’” Ross says.

    8. Get that first story out.

    “You don’t have to know everything before you write that first story,” Ross says. “Because with that first story, if it has credibility and it resonates with people, sources will come forward and sources will continue to come forward.”

    Read the stories

    Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need

    How UnitedHealth’s acquisition of a popular Medicare Advantage algorithm sparked internal dissent over denied care

    UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care

    UnitedHealth used secret rules to restrict rehab care for seriously ill Medicare Advantage patients

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • Healthy Kids, Happy Kids – by Dr. Elisa Song

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    If you have young children or perhaps grandchildren, you probably care deeply about those children and their wellbeing, but there can often be a lot more guesswork than would be ideal, when it comes to ensuring they be and remain healthy.

    Nevertheless, a lot of common treatments for children are based (whether parents know it or not—and often they dont) on what is most convenient for the parent, not necessarily what is best for the child. Dr. Song looks to correct that.

    Rather than dosing kids with acetaminophen or even antibiotics, assuming eczema can be best fixed with a topical cream (treating the symptom rather than the cause, much?), and that some things like asthma “just are”, and “that’s unfortunate”, Dr. Song takes us on a tour of pediatric health, centered around the gut.

    Why the gut? Well, it’s pretty central to us as adults, and it’s the same for kids, except one difference: their gut microbiome is changing even more quickly than ours (along with the rest of their body), and as such, is even more susceptible to little nudges for better or for worse, having a big impact in either direction. So, might as well make it a good one!

    After an explanatory overview, most of the book is given over to recognizing and correcting what things can go wrong, including the top 25 acute childhood conditions, and the most critical chronic ones, and how to keep things on-track as a team (the child is part of the team! An important part!).

    The style of the book is very direct and instructional; easy to understand throughout. It’s a lot like being in a room with a very competent pediatrician who knows her stuff and explains it well, thus neither patronizing nor mystifying.

    Bottom line: if there are kids in your life, be they yours or your grandkids or someone else, this is a fine book for giving them the best foundational health.

    Click here to check out Healthy Kids, Happy Kids, and take care of yours!

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