What Your Doctor Wants You to Know to Crush Medical Debt – by Dr. Virgie Ellington
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First things first: this one’s really only of relevance to people living in the US. That’s most of our readership, but if it’s not you, then apologies, this one won’t be of interest.
For the US Americans, though, Dr. Ellington starts strong with “you got a bill—now get the right bill”, and then gives a step-by-step process for finding the mistakes in your medical bills, fixing them, dealing with insurers who do not want to live up to their part of the bargain, and how to minimize what you need to pay, when you actually arrive at your final bill.
The biggest strength of this book is the wealth of insider knowledge (the author has worked as a primary care physician as well as as a health insurance executive), and while this information won’t stay current forever, its relatively recent publication date (2022) means that little has changed since then, and once you’re up to speed with how things are now, it’ll be easy to roll with whatever changes may come in the future.
Bottom line: if you’re living in the US and would like to not be ripped off as badly as possible when it comes to healthcare costs, this book is a very small, very powerful, investment.
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Can you drink your fruit and vegetables? How does juice compare to the whole food?
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Do you struggle to eat your fruits and vegetables? You are not alone. Less than 5% of Australians eat the recommended serves of fresh produce each day (with 44% eating enough fruit but only 6% eating the recommended vegetables).
Adults should aim to eat at least five serves of vegetables (or roughly 375 grams) and two serves of fruit (about 300 grams) each day. Fruits and vegetables help keep us healthy because they have lots of nutrients (vitamins, minerals and fibre) and health-promoting bioactive compounds (substances not technically essential but which have health benefits) without having many calories.
So, if you are having trouble eating the rainbow, you might be wondering – is it OK to drink your fruits and vegetables instead in a juice or smoothie? Like everything in nutrition, the answer is all about context.
Darina Belonogova/Pexels It might help overcome barriers
Common reasons for not eating enough fruits and vegetables are preferences, habits, perishability, cost, availability, time and poor cooking skills. Drinking your fruits and vegetables in juices or smoothies can help overcome some of these barriers.
Juicing or blending can help disguise tastes you don’t like, like bitterness in vegetables. And it can blitz imperfections such as bruises or soft spots. Preparation doesn’t take much skill or time, particularly if you just have to pour store-bought juice from the bottle. Treating for food safety and shipping time does change the make up of juices slightly, but unsweetened juices still remain significant sources of nutrients and beneficial bioactives.
Juicing can extend shelf life and reduce the cost of nutrients. In fact, when researchers looked at the density of nutrients relative to the costs of common foods, fruit juice was the top performer.
So, drinking my fruits and veggies counts as a serve, right?
How juice is positioned in healthy eating recommendations is a bit confusing. The Australian Dietary Guidelines include 100% fruit juice with fruit but vegetable juice isn’t mentioned. This is likely because vegetable juices weren’t as common in 2013 when the guidelines were last revised.
The guidelines also warn against having juice too often or in too high amounts. This appears to be based on the logic that juice is similar, but not quite as good as, whole fruit. Juice has lower levels of fibre compared to fruits, with fibre important for gut health, heart health and promoting feelings of fullness. Juice and smoothies also release the sugar from the fruit’s other structures, making them “free”. The World Health Organization recommends we limit free sugars for good health.
But fruit and vegetables are more than just the sum of their parts. When we take a “reductionist” approach to nutrition, foods and drinks are judged based on assumptions made about limited features such as sugar content or specific vitamins.
But these features might not have the impact we logically assume because of the complexity of foods and people. When humans eat varied and complex diets, we don’t necessarily need to be concerned that some foods are lower in fibre than others. Juice can retain the nutrients and bioactive compounds of fruit and vegetables and even add more because parts of the fruit we don’t normally eat, like the skin, can be included.
Juicing or blending might mean you eat different parts of the fruit or vegetable. flyingv3/Shutterstock So, it is healthy then?
A recent umbrella review of meta-analyses (a type of research that combines data from multiple studies of multiple outcomes into one paper looked at the relationship between 100% juice and a range of health outcomes.
Most of the evidence showed juice had a neutral impact on health (meaning no impact) or a positive one. Pure 100% juice was linked to improved heart health and inflammatory markers and wasn’t clearly linked to weight gain, multiple cancer types or metabolic markers (such as blood sugar levels).
Some health risks linked to drinking juice were reported: death from heart disease, prostate cancer and diabetes risk. But the risks were all reported in observational studies, where researchers look at data from groups of people collected over time. These are not controlled and do not record consumption in the moment. So other drinks people think of as 100% fruit juice (such as sugar-sweetened juices or cordials) might accidentally be counted as 100% fruit juice. These types of studies are not good at showing the direct causes of illness or death.
What about my teeth?
The common belief juice damages teeth might not stack up. Studies that show juice damages teeth often lump 100% juice in with sweetened drinks. Or they use model systems like fake mouths that don’t match how people drinks juice in real life. Some use extreme scenarios like sipping on large volumes of drink frequently over long periods of time.
Juice is acidic and does contain sugars, but it is possible proper oral hygiene, including rinsing, cleaning and using straws can mitigate these risks.
Again, reducing juice to its acid level misses the rest of the story, including the nutrients and bioactives contained in juice that are beneficial to oral health.
Juice might be more convenient and could replace less healthy drinks. PintoArt/Shutterstock So, what should I do?
Comparing whole fruit (a food) to juice (a drink) can be problematic. They serve different culinary purposes, so aren’t really interchangeable.
The Australian Guide to Healthy Eating recommends water as the preferred beverage but this assumes you are getting all your essential nutrients from eating.
Where juice fits in your diet depends on what you are eating and what other drinks it is replacing. Juice might replace water in the context of a “perfect” diet. Or juice might replace alcohol or sugary soft drinks and make the relative benefits look very different.
On balance
Whether you want to eat your fruits and vegetables or drink them comes down to what works for you, how it fits into the context of your diet and your life.
Smoothies and juices aren’t a silver bullet, and there is no evidence they work as a “cleanse” or detox. But, with society’s low levels of fruit and vegetable eating, having the option to access nutrients and bioactives in a cheap, easy and tasty way shouldn’t be discouraged either.
Emma Beckett, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation – School of Health Sciences, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healthiest-Three-Nut Butter
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We’re often telling you to “diversify your nuts”, so here’s a great way to get in three at once with no added sugar, palm oil, or preservatives, and only the salt you choose to put in. We’ve picked three of the healthiest nuts around, but if you happen to be allergic, don’t worry, we’ve got you covered too.
You will need
- 1 cup almonds (if allergic, substitute a seed, e.g. chia, and make it ½ cup)
- 1 cup walnuts (if allergic, substitute a seed, e.g. pumpkin, and make it ½ cup)
- 1 cup pistachios (if allergic, substitute a seed, e.g. poppy, and make it ½ cup)
- 1 tbsp almond oil (if allergic, substitute extra virgin olive oil) (if you prefer sweet nut butter, substitute 1 tbsp maple syrup; the role here is to emulsify the nuts, and this will do the same job)
- Optional: ¼ tsp MSG or ½ tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1a) If using nuts, heat your oven to 350℉ / 180℃. Place the nuts on a baking tray lined with baking paper, and bake/roast for about 10 minutes, but keep an eye on it to ensure the nuts don’t burn, and jiggle them if necessary to ensure they toast evenly. Once done, allow to cool.
1b) If using seeds, you can either omit that step, or do the same for 5 minutes if you want to, but really it’s not necessary.
2) Blend all ingredients (nuts/seeds, oil, MSG/salt) in a high-speed blender. Note: this will take about 10 minutes in total, and we recommend you do it in 30-second bursts so as to not overheat the motor. You also may need to periodically scrape the mixture down the side of the blender, to ensure a smooth consistency.
3) Transfer to a clean jar, and enjoy at your leisure:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Why You Should Diversify Your Nuts!
- Sesame Seeds vs Poppy Seeds – Which is Healthier?
- If You’re Not Taking Chia, You’re Missing Out
- Sea Salt vs MSG – Which is Healthier?
Take care!
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The Whole-Body Approach to Osteoporosis – by Keith McCormick
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You probably already know to get enough calcium and vitamin D, and do some resistance training. What does this book offer beyond that advice?
It’s pretty comprehensive, as it turns out. It covers the above, plus the wide range of medications available, what supplements help or harm or just don’t have enough evidence either way yet, things like that.
Amongst the most important offerings are the signs and symptoms that can help monitor your bone health (things you can do at home! Like examinations of your fingernails, hair, skin, tongue, and so forth, that will reveal information about your internal biochemical make-up), as well as what lab tests to ask for. Which is important, as osteoporosis is one of those things whereby we often don’t learn something is wrong until it’s too late.
The author is a chiropractor, which doesn’t always have a reputation as the most robustly science-based of physical therapy options, but he…
- doesn’t talk about chiropractic
- did confer with a flock of experts (osteopaths, nutritionists, etc) to inform/check his work
- does refer consistently to good science, and explains it well
- includes 16 pages of academic references, and yes, they are very reputable publications
Bottom line: this one really does give what the subtitle promises: a whole body approach to avoiding (or reversing) osteoporosis.
Click here to check out The Whole Body Approach To Osteoporosis; sooner is better than later!
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Chatter – by Dr. Ethan Kross
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This book is about much more than just one’s internal monologue. It does tackle that, but also the many non-verbal rabbit-holes that our brains can easily disappear into.
The author is an experimental psychologist, and brings his professional knowledge and experience to bear on this problem—citing many studies, including his own studies from his own lab, in which he undertook to answer precisely the implicit questions of “How can I…” in terms of tackling these matters, from root anxiety (for example) to end-state executive dysfunction (for example).
The writing style isn’t dense science though, and is very approachable for all.
The greatest value in this book lies in its prescriptive element, that is to say, its advice, especially in the category of evidence-based things we can do to improve matters for ourselves; beyond generic things like “mindfulness-based stress reduction” to much more specific things like “observe yourself in the 3rd person for a moment” and “take a break to imagine looking back on this later” and “interrupt yourself with a brief manual task”. With these sorts of interventions and more, we can shift the voice in our head from critic to coach.
Bottom line: if you would like your brain to let you get on with the things you actually want to do instead of constantly sidetracking you, this is the book for you.
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Steps vs Cardio | Which is Best for Fat Loss, Health, & Performance?
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“Move more”, they say; but does it matter how quickly?
Use it or lose it
For general performance:
- More steps per day do offer slight aerobic benefits but do not significantly improve endurance.
- Higher-intensity cardio (ideally, HIIT) is essential for improving aerobic fitness.
- Training should match endurance goals (e.g. long-distance running vs team sports vs whatever it is that you care about for you).
For general health:
- Both cardio and step tracking reduce mortality risk and improve longevity.
- 2–3 hours of cardio per week provides most health benefits, with diminishing returns after 8 hours per week.
- 10,000+ steps/day is optimal, but 5,000+ steps/day still benefits health. And, not mentioned in this video, but really (per science) there seem to be diminishing returns after about 8,000 steps per day.
Fun fact: the reason it’s 10,000 steps per day that everyone talks about as the default goal, is just because the Japanese person who popularized it noted that the kanji for 10,000 looks a bit like a walking person: 万
For fat loss:
- Both step tracking and cardio do help.
- Step tracking better reflects total daily movement, while cardio burns calories in sessions—but if it’s not HIIT, there is likely to be a compensatory metabolic slump afterwards.
- High-intensity cardio increases fatigue, which may impact resistance training and diet adherence.
- Excessive endurance training can slightly inhibit muscle growth, but low-intensity steps have minimal interference.
So for fat loss, it’s best to get those steps in, and throw in a few HIIT sessions per week, with adequate recovery time between them.
For more on all of these things, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Do HIIT (Without Wrecking Your Body)
Take care!
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Winter Wellness & The Pills That Increase Your Alzheimer’s Risk
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This week in health news…
Do not go gentle into that good night
As wildfires rage in California, snow is falling from Texas to Georgia, meaning that a lot of people are facing weather they’re not accustomed to, in houses that were not built for it. And that’s the lucky ones; there are many thousands of people who are homeless, of whom many will die.
Hopefully all our readers are safe, but it pays to watch out for the signs of hypothermia as it is a condition that really sneaks up on people and, in the process, takes away their ability to notice the hypothermia. You and your loved ones are not immune to this, so it’s good to keep an eye on each other, looking out for:
- Shivering, first ← when this stops, assuming it’s not because the temperature has risen, it is often a sign of hypothermia entering a later stage, in which the body is no longer responding appropriately to the cold
- Slurred speech or mumbling
- Slow, shallow breathing
- A weak pulse
- Clumsiness or lack of coordination
- Drowsiness or very low energy
- Confusion or memory loss
- Loss of consciousness
- In infants, bright red, cold skin
How cold is too cold? It doesn’t even have to be sub-zero. According to the CDC, temperatures of 4℃ (40℉) can be low enough to cause hypothermia.
Read in full: The warning signs to notice if someone has hypothermia
Related: Cold Weather Health Risks
Lethal lottery of pathogens
In Minnesota, hospital emergency room waiting times have skyrocketed since yesterday (at time of writing), with 40% of Minnesota’s 1,763 flu-related hospitalizations this fall and winter occurring in the same week, according to yesterday’s report. To put it further into perspective, 17 out of 20 of this season’s flu outbreaks have occurred in the past two weeks.
And that’s just the flu, without considering COVID, RSV, and Norovirus, which are also all running rampant in MN right now.
The advice presently is:
❝Go to the ER if you are super-sick. If you are not super-sick, go to urgent care, go to your clinic, schedule a virtual appointment.❞
And if you’re not in Minneapolis? These stats won’t apply, but definitely consider, before going to the hospital, whether you might leave sicker than you arrived, and plan accordingly, making use of telehealth where reasonably possible.
Read in full: Minnesota ERs stressed by “quad-demic” of COVID, flu, RSV, norovirus
Related: Move over, COVID and Flu! We Have “Hybrid Viruses” To Contend With Now
Sleep, but at what cost?
This was a study looking at the effects of sleeping pills on the brain, specifically zolpidem (most well-known by its brand name of Ambien).
What they found is that while it does indeed effectively induce sleep, part of how it does that is suppressing norepinephrine oscillations (which might otherwise potentially wake you up, though in healthy people these oscillations and the micro-arousals that they cause shouldn’t disrupt sleep at all, and are just considered part of our normal sleep cycles), which oscillations are necessary to generate the pumping action required to move cerebrospinal fluid through the glymphatic system while asleep.
This is a big problem, because the glymphatic system is almost entirely responsible for keeping the brain free from waste products such as beta-amyloids (whose build-up is associated with Alzheimer’s disease and is considered to be a significant part of Alzheimer’s pathogensesis) and alpha-synuclein (same but for Parkinson’s disease), amongst others:
Read in full: Common sleeping pill may pave way for disorders like Alzheimer’s
Related: How To Clean Your Brain (Glymphatic Health Primer)
Take care!
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