Increase in online ADHD diagnoses for kids poses ethical questions
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In 2020, in the midst of a pandemic, clinical protocols were altered for Ontario health clinics, allowing them to perform more types of care virtually. This included ADHD assessments and ADHD prescriptions for children – services that previously had been restricted to in-person appointments. But while other restrictions on virtual care are back, clinics are still allowed to virtually assess children for ADHD.
This shift has allowed for more and quicker diagnoses – though not covered by provincial insurance (OHIP) – via a host of newly emerging private, for-profit clinics. However, it also has raised significant ethical questions.
It solves an equity issue in terms of rural access to timely assessments, but does it also create new equity issues as a privatized service?
Is it even feasible to diagnose a child for a condition like ADHD without meeting that child in person?
And as rates of ADHD diagnosis continue to rise, should health regulators re-examine the virtual care approach?
Ontario: More prescriptions, less regulation
There are numerous for-profit clinics offering virtual diagnoses and prescriptions for childhood ADHD in Ontario. These include KixCare, which does not offer the option of an in-person assessment. Another clinic, Springboard, makes virtual appointments available within days, charging around $2,600 for assessments, which take three to four hours. The clinic offers coaching and therapy at an additional cost, also not covered by OHIP. Families can choose to continue to visit the clinic virtually during a trial stage with medications, prescribed by a doctor in the clinic who then sends prescribing information back to the child’s primary care provider.
For-profit clinics like these are departing from Canada’s traditional single-payer health care model. By charging patients out-of-pocket fees for services, the clinics are able to generate more revenue because they are working outside of the billing standards for OHIP, standards that set limits on the maximum amount doctors can earn for providing specific services. Instead many services are provided by non-physician providers, who are not limited by OHIP in the same way.
Need for safeguards
ADHD prescriptions rose during the pandemic in Ontario, with women, people of higher income and those aged 20 to 24 receiving the most new diagnoses, according to research published in January 2024 by a team including researchers from the Centre for Addictions and Mental Health and Holland Bloorview Children’s Hospital. There may be numerous reasons for this increase but could the move to virtual care have been a factor?
Ontario psychiatrist Javeed Sukhera, who treats both children and adults in Canada and the U.S., says virtual assessments can work for youth with ADHD, who may receive treatment quicker if they live in remote areas. However, he is concerned that as health care becomes more privatized, it will lead to exploitation and over-diagnosis of certain conditions.
“There have been a lot of profiteers who have tried to capitalize on people’s needs and I think this is very dangerous,” he said. “In some settings, profiteering companies have set up systems to offer ADHD assessments that are almost always substandard. This is different from not-for-profit setups that adhere to quality standards and regulatory mechanisms.”
Sukhera’s concerns recall the case of Cerebral Inc., a New York state-based virtual care company founded in 2020 that marketed on social media platforms including Instagram and TikTok. Cerebral offered online prescriptions for ADHD drugs among other services and boasted more than 200,000 patients. But as Dani Blum reported in the New York Times, Cerebral was accused in 2023 of pressuring doctors on staff to prescribe stimulants and faced an investigation by state prosecutors into whether it violated the U.S. Controlled Substances Act.
“At the start of the pandemic, regulators relaxed rules around medical prescription of controlled substances,” wrote Blum. “Those changes opened the door for companies to prescribe and market drugs without the protocols that can accompany an in-person visit.”
Access increased – but is it equitable?
Virtual care has been a necessity in rural areas in Ontario since well before the pandemic, although ADHD assessments for children were restricted to in-person appointments prior to 2020.
But ADHD assessment clinics that charge families out-of-pocket for services are only accessible to people with higher incomes. Rural families, many of whom are low income, are unable to afford thousands for private assessments, let alone the other services upsold by providers. If the private clinic/virtual care trend continues to grow unchecked, it may also attract doctors away from the public model of care since they can bill more for services. This could further aggravate the gap in care that lower income people already experience.
This could further aggravate the gap in care that lower income people already experience.
Sukhera says some risks could be addressed by instituting OHIP coverage for services at private clinics (similar to private surgical facilities that offer mixed private/public coverage), but also with safeguards to ensure that profits are reinvested back into the health-care system.
“This would be especially useful for folks who do not have the income, the means to pay out of pocket,” he said.
Concerns of misdiagnosis and over-prescription
Some for-profit companies also benefit financially from diagnosing and issuing prescriptions, as has been suggested in the Cerebral case. If it is cheaper for a clinic to do shorter, virtual appointments and they are also motivated to diagnose and prescribe more, then controls need to be put in place to prevent misdiagnosis.
The problem of misdiagnosis may also be related to the nature of ADHD assessments themselves. University of Strathclyde professor Matthew Smith, author of Hyperactive: The Controversial History of ADHD, notes that since the publication of Diagnostic and Statistical Manual of Mental Disorders in 1980, assessment has typically involved a few hours of parents and patients providing their subjective perspectives on how they experience time, tasks and the world around them.
“It’s often a box-ticking exercise, rather than really learning about the context in which these behaviours exist,” Smith said. “The tendency has been to use a list of yes/no questions which – if enough are answered in the affirmative – lead to a diagnosis. When this is done online or via Zoom, there is even less opportunity to understand the context surrounding behaviour.”
Smith cited a 2023 BBC investigation in which reporter Rory Carson booked an in-person ADHD assessment at a clinic and was found not to have the condition, then had a private online assessment – from a provider on her couch in a tracksuit – and was diagnosed with ADHD after just 45 minutes, for a fee of £685.
What do patients want?
If Canadian regulators can effectively tackle the issue of privatization and the risk of misdiagnosis, there is still another hurdle: not every youth is willing to take part in virtual care.
Jennifer Reesman, a therapist and Training Director for Neuropsychology at the Chesapeake Center for ADHD, Learning & Behavioural Health in Maryland, echoed Sukhera’s concerns about substandard care, cautioning that virtual care is not suitable for some of her young clients who had poor experiences with online education and resist online health care. It can be an emotional issue for pediatric patients who are managing their feelings about the pandemic experience.
“We need to respect what their needs are, not just the needs of the provider,” says Reesman.
In 2020, Ontario opted for virtual care based on the capacity of our health system in a pandemic. Today, with a shortage of doctors, we are still in a crisis of capacity. The success of virtual care may rest on how engaged regulators are with equity issues, such as waitlists and access to care for rural dwellers, and how they resolve ethical problems around standards of care.
Children and youth are a distinct category, which is why we had restrictions on virtual ADHD diagnosis prior to the pandemic. A question remains, then: If we could snap our fingers and have the capacity to provide in-person ADHD care for all children, would we? If the answer to that question is yes, then how can we begin to build our capacity?
This article is republished from healthydebate under a Creative Commons license. Read the original article.
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Why Going Gluten-Free Could Be A Bad Idea
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Is A Gluten-Free Diet Right For You?
This is Rachel Begun, MS, RD. She’s a nutritionist who, since her own diagnosis with Celiac disease, has shifted her career into a position of educating the public (and correcting misconceptions) about gluten sensitivity, wheat allergy, and Celiac disease. In short, the whole “gluten-free” field.
First, a quick recap
We’ve written on this topic ourselves before; here’s what we had to say:
On “Everyone should go gluten-free”
Some people who have gone gluten-free are very evangelical about the lifestyle change, and will advise everyone that it will make them lose weight, have clearer skin, more energy, and sing well, too. Ok, maybe not the last one, but you get the idea—a dietary change gets seen as a cure-all.
And for some people, it can indeed make a huge difference!
Begun urges us to have a dose of level-headedness in our approach, though.
Specifically, she advises:
- Don’t ignore symptoms, and/but…
- Don’t self-diagnose
- Don’t just quit gluten
One problem with self-diagnosis is that we can easily be wrong:
But why is that a problem? Surely there’s not a health risk in skipping the gluten just to be on the safe side? As it turns out, there actually is:
If we self-diagnose incorrectly, Begun points out, we can miss the actual cause of the symptoms, and by cheerfully proclaiming “I’m allergic to gluten” or such, a case of endometriosis, or Hashimoto’s, or something else entirely, might go undiagnosed and thus untreated.
“Oh, I feel terrible today, there must have been some cross-contamination in my food” when in fact, it’s an undiagnosed lupus flare-up, that kind of thing.
Similarly, just quitting gluten “to be on the safe side” can mask a different problem, if wheat consumption (for example) contributed to, but did not cause, some ailment.
In other words: it could reduce your undesired symptoms, but in so doing, leave a more serious problem unknown.
Instead…
If you suspect you might have a gluten sensitivity, a wheat allergy, or even Celiac disease, get yourself tested, and take professional advice on proceeding from there.
How? Your physician should be able to order the tests for you.
You can also check out resources available here:
Celiac Disease Foundation | How do I get tested?
Or for at-home gluten intolerance tests, here are some options weighed against each other:
MNT | 5 gluten intolerance tests and considerations
Want to learn more?
Begun has a blog:
Rachel Begun | More than just recipes
(it is, in fact, just recipes—but they are very simple ones!)
You also might enjoy this interview, in which she talks about gluten sensitivity, celiac disease, and bio-individuality:
Want to watch it, but not right now? Bookmark it for later
Take care!
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10 Ways To Balance Blood Sugars
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.
“Let Them Eat Cake”, She Said…
This is Jessie Inchauspé, a French biochemist and author. She’s most known for her best-selling “Glucose Revolution: The Life-Changing Power Of Balancing Your Blood Sugar”.
It’s a great book (which we reviewed recently) and you absolutely should read it, but meanwhile, we’re going to distill at least the most critical core ideas, 10almonds style. In this case, her “ten hacks”:
Eat foods in the right order
The order is:
- Fiber first
- Protein and fat second
- Starches and sugars last
What happens here is… the fiber perks up the gut bacteria, the protein and fat will then be better-digested next, and the starches and sugars will try to jump the line, but they can’t because the fiber is a physical speedbump and the proteins and fats are taking the prime place for being digested. So instead, the starches and sugars—usually responsible for blood sugar spikes—get processed much more gradually, resulting in a nice even curve.
Add a green starter to all your meals
We know what you’re thinking: “that’s just the first one again”, but no. This is an extra starter, before you get to that. If you’re the cook of the household, this can absolutely simply mean snacking on green ingredients while cooking.
Stop counting calories
Especially, she advises: stop worrying about extra calories from fats, such as if doing an oil-and-vinegar dressing for salad—which she also recommends, because all three components (the oil, the vinegar, and the salad) help even out blood sugar levels.
Flatten your breakfast curve
For many, breakfast is the starchiest meal of the day, if not the sugariest. Inchauspé recommends flipping this (ideally) or softening it (if you really must have a carb-based breakfast):
- Top choices include: a warm vegetable salad, fish, or eggs (or tofu if you don’t do animal products).
- Next-best include: if you must have toast, make sure to have butter (and/or the aforementioned egg/tofu, for example) to give your digestion an extra thing to do.
- Also: she recommends skipping the juice in favour of home-made breakfast smoothies. That way, instead of basically just sugar with some vitamins, you’re getting a range of nutrients that, if you stack it right, can constitute a balanced meal itself, with fiber + protein + fat + carbs.
As an extra note from the 10almonds team: come to think of it, today’s sponsor’s product would be a great choice for this “mixed nutrient breakfast” idea! But more on that later
Have any type of sugar—they’re all the same
They’re technically not, but the point is that your body will immediately take them apart and then they will be just the same. Whether it’s the cheapest white sugar or the most expensive organic lovingly hand-reared free-range agave nectar, your body is going to immediately give it the chop-shop treatment (a process so quick as to be practically instantaneous) and say “this is now glucose”.
Pick a dessert over a sweet snack
Remember that about the right order for foods? A dessert, when your body is already digesting dinner, is going to make much less of a glucose spike than, say, a blueberry muffin when all you’ve had this morning is coffee and juice.
Reach for the vinegar before you eat
We recently did a whole main feature about this, so we’ll not double up today!
After you eat, move
The glucose you eat will be used to replace lost muscle glycogen, before any left over is stored as fat… and, while it’s waiting to be stored as fat, just sitting in your bloodstream being high blood sugars. So, this whole thing will go a lot better if you are actively using muscle glycogen (by moving your body).
Inchauspé gives a metaphor: imagine a steam train worker, shoveling coal into the furnace. Meanwhile, other workers are bringing more coal. If the train is moving quickly, the coal can be shoveled into the furnace and burned and won’t build up so quickly. But if the train is moving slowly or not at all, that coal is just going to build up and build up, until the worker can shovel no more because of being neck-deep in coal.
Same with your blood sugars!
If you want to snack, go low-sugar
In the category of advice that will shock nobody: sugary snacks aren’t good for avoiding blood sugar spikes! This one probably didn’t need a chapter devoted to it, but anyway: low sugar is indeed the way to go for snacks.
Put some clothes on your carbs
This is about olive oil on pasta, butter on potatoes, and so forth. Basically, anything starchy is going to be broken down quickly to sugar and sent straight into the bloodstream, if there’s nothing to slow it down. If you’re wondering what to do with rice: adding a tablespoon of chia seeds to the rice while cooking (so they’re cooked together) will add very healthy fats to your rice, and (because they’ve been cooked) will not seem like eating seeds, by the way. In terms of texture and appearance, it’ll be as though you threw some black pepper in*
*which you should also do for many reasons, but that’s beyond the scope of this “about blood sugars” feature!
Wanting to know more about the science of this?
We’ve done all we have room for here today, but Inchauspé is, as ever, happy to explain it herself:
Prefer text? Check out:
The Science Behind Glucose GoddessShare This Post
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They Were Injured at the Super Bowl Parade. A Month Later, They Feel Forgotten.
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KFF Health News and KCUR are following the stories of people injured during the Feb. 14 mass shooting at the Kansas City Chiefs Super Bowl celebration. Listen to how one Kansas family is coping with the trauma.
Jason Barton didn’t want to attend the Super Bowl parade this year. He told a co-worker the night before that he worried about a mass shooting. But it was Valentine’s Day, his wife is a Kansas City Chiefs superfan, and he couldn’t afford to take her to games since ticket prices soared after the team won the championship in 2020.
So Barton drove 50 miles from Osawatomie, Kansas, to downtown Kansas City, Missouri, with his wife, Bridget, her 13-year-old daughter, Gabriella, and Gabriella’s school friend. When they finally arrived home that night, they cleaned blood from Gabriella’s sneakers and found a bullet in Bridget’s backpack.
Gabriella’s legs were burned by sparks from a ricocheted bullet, Bridget was trampled while shielding Gabriella in the chaos, and Jason gave chest compressions to a man injured by gunfire. He believes it was Lyndell Mays, one of two men charged with second-degree felony murder.
“There’s never going to be a Valentine’s Day where I look back and I don’t think about it,” Gabriella said, “because that’s a day where we’re supposed to have fun and appreciate the people that we have.”
One month after the parade in which the U.S. public health crisis that is gun violence played out on live television, the Bartons are reeling from their role at its epicenter. They were just feet from 43-year-old Lisa Lopez-Galvan, who was killed. Twenty-four other people were injured. Although the Bartons aren’t included in that official victim number, they were traumatized, physically and emotionally, and pain permeates their lives: Bridget and Jason keep canceling plans to go out, opting instead to stay home together; Gabriella plans to join a boxing club instead of the dance team.
During this first month, Kansas City community leaders have weighed how to care for people caught in the bloody crossfire and how to divide more than $2 million donated to public funds for victims in the initial outpouring of grief.
The questions are far-reaching: How does a city compensate people for medical bills, recovery treatments, counseling, and lost wages? And what about those who have PTSD-like symptoms that could last years? How does a community identify and care for victims often overlooked in the first flush of reporting on a mass shooting: the injured?
The injured list could grow. Prosecutors and Kansas City police are mounting a legal case against four of the shooting suspects, and are encouraging additional victims to come forward.
“Specifically, we’re looking for individuals who suffered wounds from their trying to escape. A stampede occurred while people were trying to flee,” said Jackson County Prosecutor Jean Peters Baker. Anyone who “in the fleeing of this event that maybe fell down, you were trampled, you sprained an ankle, you broke a bone.”
Meanwhile, people who took charge of raising money and providing services to care for the injured are wrestling with who gets the money — and who doesn’t. Due to large donations from celebrities like Taylor Swift and Travis Kelce, some victims or their families will have access to hundreds of thousands of dollars for medical expenses. Other victims may simply have their counseling covered.
The overall economic cost of U.S. firearm injuries is estimated by a recent Harvard Medical School study at $557 billion annually. Most of that — 88% — represented quality-of-life losses among those injured by firearms and their families. The JAMA-published study found that each nonfatal firearm injury leads to roughly $30,000 in direct health care spending per survivor in the first year alone.
In the immediate aftermath of the shootings, as well-intentioned GoFundMe pages popped up to help victims, executives at United Way of Greater Kansas City gathered to devise a collective donation response. They came up with “three concentric circles of victims,” said Jessica Blubaugh, the United Way’s chief philanthropy officer, and launched the #KCStrong campaign.
“There were folks that were obviously directly impacted by gunfire. Then the next circle out is folks that were impacted, not necessarily by gunshots, but by physical impact. So maybe they were trampled and maybe they tore a ligament or something because they were running away,” Blubaugh said. “Then third is folks that were just adjacent and/or bystanders that have a lot of trauma from all of this.”
PTSD, Panic, and the Echo of Gunfire
Bridget Barton returned to Kansas City the day after the shooting to turn in the bullet she found in her backpack and to give a statement at police headquarters. Unbeknownst to her, Mayor Quinton Lucas and the police and fire chiefs had just finished a press conference outside the building. She was mobbed by the media assembled there — interviews that are now a blur.
“I don’t know how you guys do this every day,” she remembered telling a detective once she finally got inside.
The Bartons have been overwhelmed by well wishes from close friends and family as they navigate the trauma, almost to the point of exhaustion. Bridget took to social media to explain she wasn’t ignoring the messages, she’s just responding as she feels able — some days she can hardly look at her phone, she said.
A family friend bought new Barbie blankets for Gabriella and her friend after the ones they brought to the parade were lost or ruined. Bridget tried replacing the blankets herself at her local Walmart, but when she was bumped accidentally, it triggered a panic attack. She abandoned her cart and drove home.
“I’m trying to get my anxiety under control,” Bridget said.
That means therapy. Before the parade, she was already seeing a therapist and planning to begin eye movement desensitization and reprocessing, a form of therapy associated with treating post-traumatic stress disorder. Now the shooting is the first thing she wants to talk about in therapy.
Since Gabriella, an eighth grader, has returned to middle school, she has dealt with the compounding immaturity of adolescence: peers telling her to get over it, pointing finger guns at her, or even saying it should have been her who was shot. But her friends are checking on her and asking how she’s doing. She wishes more people would do the same for her friend, who took off running when the shooting started and avoided injury. Gabriella feels guilty about bringing her to what turned into a horrifying experience.
“We can tell her all day long, ‘It wasn’t your fault. She’s not your responsibility.’ Just like I can tell myself, ‘It wasn’t my fault or my responsibility,’” Bridget said. “But I still bawled on her mom’s shoulder telling her how sorry I was that I grabbed my kid first.”
The two girls have spent a lot of time talking since the shooting, which Gabriella said helps with her own stress. So does spending time with her dog and her lizard, putting on makeup, and listening to music — Tech N9ne’s performance was a highlight of the Super Bowl celebration for her.
In addition to the spark burns on Gabriella’s legs, when she fell to the concrete in the pandemonium she split open a burn wound on her stomach previously caused by a styling iron.
“When I see that, I just picture my mom trying to protect me and seeing everyone run,” Gabriella said of the wound.
It’s hard not to feel forgotten by the public, Bridget said. The shooting, especially its survivors, have largely faded from the headlines aside from court dates. Two additional high-profile shootings have occurred in the area since the parade. Doesn’t the community care, she wonders, that her family is still living with the fallout every day?
“I’m going to put this as plainly as possible. I’m f—ing pissed because my family went through something traumatic,” Bridget vented in a recent social media post. “I don’t really want anything other [than], ‘Your story matters, too, and we want to know how you’re doing.’ Have we gotten that? Abso-f—lutely not.”
‘What Is the Landscape of Need?’
Helped in part by celebrities like Swift and Kelce, donations for the family of Lopez-Galvan, the lone fatality, and other victims poured in immediately after the shootings. Swift and Kelce donated $100,000 each. With the help of an initial $200,000 donation from the Kansas City Chiefs, the United Way’s #KCStrong campaign took off, reaching $1 million in the first two weeks and sitting at $1.2 million now.
Six verified GoFundMe funds were established. One solely for the Lopez-Galvan family has collected over $406,000. Smaller ones were started by a local college student and Swift fans. Churches have also stepped up, and one local coalition had raised $183,000, money set aside for Lopez-Galvan’s funeral, counseling services for five victims, and other medical bills from Children’s Mercy Kansas City hospital, said Ray Jarrett, executive director of Unite KC.
Money for Victims Rolls In
Donations poured in for those injured at the Super Bowl Parade in Kansas City after the Feb. 14 shootings. The largest, starting with a $200,000 donation from the Kansas City Chiefs, is at the United Way of Greater Kansas City. Six GoFundMe sites also popped up, due in part to $100,000 donations each from Taylor Swift and Travis Kelce. Here’s a look at the totals as of March 12.United Way#KCStrong: $1.2 million.Six Verified GoFundMe AccountsLisa Lopez-Galvan GoFundMe (Taylor Swift donated): $406,142Reyes Family GoFundMe (Travis Kelce donated): $207,035Samuel Arellano GoFundMe: $11,896Emily Tavis GoFundMe: $9,518Cristian Martinez’s GoFundMe for United Way: $2,967Swifties’ GoFundMe for Children’s Mercy hospital: $1,060ChurchesResurrection (Methodist) “Victims of Violence Fund”: $53,358‘The Church Loves Kansas City’: $183,000
Meanwhile, those leading the efforts found models in other cities. The United Way’s Blubaugh called counterparts who’d responded to their own mass shootings in Orlando, Florida; Buffalo, New York; and Newtown, Connecticut.
“The unfortunate reality is we have a cadre of communities across the country who have already faced tragedies like this,” Blubaugh said. “So there is an unfortunate protocol that is, sort of, already in place.”
#KCStrong monies could start being paid out by the end of March, Blubaugh said. Hundreds of people called the nonprofit’s 211 line, and the United Way is consulting with hospitals and law enforcement to verify victims and then offer services they may need, she said.
The range of needs is staggering — several people are still recovering at home, some are seeking counseling, and many weren’t even counted in the beginning. For instance, a plainclothes police officer was injured in the melee but is doing fine now, said Police Chief Stacey Graves.
Determining who is eligible for assistance was one of the first conversations United Way officials had when creating the fund. They prioritized three areas of focus: first were the wounded victims and their families, second was collaborating with organizations already helping victims in violence intervention and prevention and mental health services, and third were the first responders.
Specifically, the funds will be steered to cover medical bills, or lost wages for those who haven’t been able to work since the shootings, Blubaugh said. The goal is to work quickly to help people, she said, but also to spend the money in a judicious, strategic way.
“We don’t have a clear sightline of the entire landscape that we’re dealing with,” Blubaugh said. “Not only of how much money do we have to work with, but also, what is the landscape of need? And we need both of those things to be able to make those decisions.”
Firsthand Experience of Daily Kansas City Violence
Jason used his lone remaining sick day to stay home with Bridget and Gabriella. An overnight automation technician, he is the family’s primary breadwinner.
“I can’t take off work, you know?” he said. “It happened. It sucked. But it’s time to move on.”
“He’s a guy’s guy,” Bridget interjected.
On Jason’s first night back at work, the sudden sound of falling dishes startled Bridget and Gabriella, sending them into each other’s arms crying.
“It’s just those moments of flashbacks that are kicking our butts,” Bridget said.
Tell Us About Your Experience
We are continuing to report on the effects of the parade shooting on the people who were injured and the community as a whole. Do you have an experience you want to tell us about, or a question you think we should look into? Message KCUR’s text line at (816) 601-4777. Your information will not be used in an article without your permission.
In a way, the shooting has brought the family closer. They’ve been through a lot recently. Jason survived a heart attack and cancer last year. Raising a teenager is never easy.
Bridget can appreciate that the bullet lodged in her backpack, narrowly missing her, and that Gabriella’s legs were burned by sparks but she wasn’t shot.
Jason is grateful for another reason: It wasn’t a terrorist attack, as he initially feared. Instead, it fits into the type of gun violence he’d become accustomed to growing up in Kansas City, which recorded its deadliest year last year, although he’d never been this close to it before.
“This crap happens every single day,” he said. “The only difference is we were here for it.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Is Air-Fried Food Really Healthier?
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Air-frying has a reputation for being healthy—and it generally is, provided it’s used carefully:
Just one thing to watch out for
An air-fryer is basically a small convection oven that uses circulating air rather than immersion in oil to cook food. The smallness of an air-fryer is a feature not a bug—if you get an air-fryer over a certain size, then congratulations, you just have a convection oven. The small size it what helps it to cook so efficiently. This is one reason that they’re not really used in industrial settings.
The documentary-makers from this video had their food (chicken, fish, and fries) lab-tested (for fat, cholesterol, and acrylamide), and found:
- Air-frying significantly reduced saturated fat (38–53%) and trans fats (up to 55%) in some foods.
- Cholesterol reduction varied depending on the food type.
- Acrylamide levels in air-fried potatoes were much higher due to cooking time and temperature.
About that acrylamide: acrylamide forms in starchy foods at high temperatures and may pose cancer risks (the research is as yet unclear, with conflicting evidence). Air-frying can cause higher acrylamide levels if cooking is prolonged or temperatures are too high.
Recommendations to reduce acrylamide:
- Soak potatoes before cooking.
- Use lower temperatures (e.g. 180℃/350℉) and shorter cooking times.
- Avoid over-browning food.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Unlock Your Air-Fryer’s Potential!
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Give Your Adrenal Glands A Chance
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The Hats Of Wrath
Your adrenal glands are two little hat-shaped glands that sit on top of your kidneys (like your kidneys are wearing them as hats, in fact).
They produce adrenaline, as you might have guessed, and also cortisol and aldosterone, which you might or might not have known, as well as some miscellaneous corticosteroids that are beyond the scope of today’s article.
Fun fact! For a long time, doctors thought adrenal glands were much larger than they usually are, because of learning anatomy from corpses that were dissected, but invariably the corpses were those of poor people, especially criminals, whose adrenal glands were almost always overworked and swollen.
You don’t want yours to be like that.
What goes wrong
Assuming you don’t have a rare disorder like Addison’s disease (in which the adrenal glands don’t produce enough of the hormones they’re supposed to), your adrenal glands will usually not have trouble producing enough adrenaline et al.
However, as we learned from the Victorian vagabonds, they can also have no problems producing too much—much like any organ that gets overworked, however, this has consequences.
Hopefully you’re not living a life of stressful crime on the streets, but maybe you have other reasons your adrenal glands are working overtime, such as any source of chronic stress, bad sleep (can’t recharge without this downtime), overuse of stimulants (including caffeine and/or nicotine), and, counterintuitively, alcohol. All these things can tax the adrenal glands considerably.
When this happens, in the extreme we can get Cushing’s syndrome, characterized by the symptoms: hypertension, cortisol-based fat distribution i.e. especially face and abdomen, weakness, fragile easily irritable skin, hair loss and/or hirsutism, paradoxically, and of course general fatigue.
In the non-extreme, we get all the same symptoms just to a lower level, and experience what the medical profession is begging us not to call “Adrenal Fatigue Syndrome” because that’s not an official diagnosis, whereas if it gets a name then they’ll be expected to treat it.
What keeps things going right
Obviously, the opposite of the above, for a start. Which means:
Manage chronic stress; see: How To Manage Chronic Stress
Get good sleep; see: Why You Probably Need More Sleep
Go easy on the caffeine; see: Caffeine Mythbusting
Skip the nicotine; see: Nicotine Benefits (That We Don’t Recommend)!
Avoid alcohol; see: How To Reduce Or Quit Alcohol
There are specific vitamins and minerals that support adrenal health too; they are: vitamins B5, B6, B12, C, & D, and also magnesium and zinc.
Good dietary sources of the above include green leafy things, cruciferous vegetables*, nuts and seeds, avocados, olive oil, and if you eat fish, then also fatty fish.
In contrast, it is good to cut down (or avoid entirely) red meat and unfermented dairy.
*Unsure how to get cruciferous vegetables in more often? Try today’s featured recipe, superfood broccoli pesto
Want to know more?
A large part of adrenal health is about keeping cortisol levels down generally (except: for most of us, we can have a little hormesis, as a treat), so for the rest of that you might like to read:
Lower Your Cortisol! (Here’s Why & How)
Take care!
Don’t Forget…
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Chili Hot-Bedded Salmon
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This one can be made in less time than it takes to order and receive a Chinese take-out! The principle is simple: it’s a bed of greens giving pride of place to a salmon fillet in a deliciously spicy marinade. So healthwise, we have greens-and-beans, healthy protein and fats, and tasty polyphenols. Experientially, we have food that tastes a lot more decadent than it is!
You will need
- 4 salmon fillets (if vegan, substitute firm tofu; see also how to make this no-salmon salmon)
- 2 bok choy, washed and stems trimmed
- 7 oz green beans, trimmed
- 4 oz sugar snap peas
- 4 spring onions, sliced
- 2 tbsp chili oil*
- 1 tbsp soy sauce
- 1 tsp garlic paste
- 1 tsp ginger paste
- 1 tsp black pepper
*this can be purchased as-is, but if you want to make your own in advance, simply take extra virgin olive oil and infuse it with [finely chopped, red] chili. This is a really good thing to do for commonly-used flavored oils, by the way—chili oil and garlic oil are must-haves in this writer’s opinion; basil oil, sage oil, and rosemary oil, are all excellent things to make and have in, too. Just know, infusing is not quick, so it’s good to do these in batch and make plenty well before you need it. For now, if you don’t have any homemade already, then store-bought is fine 🙂
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 360℉/180℃/gas mark 6
2) Lay out 4 large squares of foil, and put the bok choy, green beans, and sugar snap peas in a little pile in the middle of each one. Put a salmon fillet on top of each (if it has skin, score the skin first, so that juices will be able to penetrate, and put it skin-side down), and then top with the spring onions.
3) Mix the rest of the ingredients in a small bowl, and then spoon this marinade evenly over each of the fillets (alternatively, if you have occasion to marinade the fillets in advance and let them sit in the marinade in the fridge for some hours before, do so, in which case this step will already be done now, because past-you did it. Yay for past-you!)
4) Fold up the edges of the foil, making each one an enclosed parcel, gently sealed at the top by folding it over. Put them on a baking tray and bake for about 20 minutes.
5) Serve! If you’d like some carbs with it, we recommend our tasty versatile rice recipe.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- We Are Such Stuff As Fish Are Made Of
- Farmed Fish vs Wild-Caught ← don’t underestimate the difference this makes!
- Tasty Polyphenols For Your Heart And Brain
- Brain Food? The Eyes Have It!
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
