Zero Sugar / One Month – by Becky Gillaspy
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We’ve reviewed books about the evils of sugar before, so what makes this one different?
This one has a focus on helping the reader quit it. It assumes we already know the evils of sugar (though it does cover that too).
It looks at the mechanisms of sugar addiction (habits-based and physiological), and how to safely and painlessly cut through those to come out the other side, free from sugar.
The author gives a day-by-day plan, for not only eliminating sugar, but also adding and including things to fill the gap it leaves, keeping us sated, energized, and happy along the way.
In the category of subjective criticism, it does also assume we want to lose weight, which may not be the case for many readers. But that’s a by-the-by and doesn’t detract from the useful guide to quitting sugar, whatever one’s reasons.
Bottom line: if you would like to quit sugar but find it hard, this book thinks of everything and walks you by the hand, making it easy.
Click here to check out Zero Sugar / One Month, and reap the health benefits!
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Water Water Everywhere, But Which Is Best To Drink?
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Well Well Well…
In Tuesday’s newsletter, we asked you for your (health-related) opinion on drinking water—with the understanding that this may vary from place to place. We got the above-depicted, below-described, set of responses:
- About 65% said “Filtered is best”
- About 20% said “From the mains is best”
- About 8% said “Bottled is best”
- About 3% said “Distilled is best”
- About 3% said “Some other source is best”
Of those who said “some other source is best”, one clarified that their preferred source was well water.
So what does the science say?
Fluoridated water is bad for you: True or False?
False, assuming a normal level of consumption. Rather than take up more space today though, we’ll link to what we previously wrote on this topic:
You may be wondering: but what if my level of consumption is higher than normal?
Let’s quickly look at some stats:
- The maximum permitted safety level varies from place to place, but is (for example) 2mg/l in the US, 1.5mg/l in Canada & the UK.
- The minimum recommended amount also varies from place to place, but is (for example) 0.7mg/l in Canada and the US, and 1mg/l in the UK.
It doesn’t take grabbing a calculator to realize that if you drink twice as much water as someone else, then depending on where you are, water fluoridated to the minimum may give you more than the recommended maximum.
However… Those safety margins are set so much lower than the actual toxicity levels of fluoride, that it doesn’t make a difference.
For example: your writer here takes a medication that has the side effect of causing dryness of the mouth, and consequently she drinks at least 3l of water per day in a climate that could not be described as hot (except perhaps for about 2 weeks of the year). She weighs 72kg (that’s about 158 pounds), and the toxicity of fluoride (for ill symptoms, not death) is 0.2mg/kg. So, she’d need 14.4mg of fluoride, which even if the water fluoridation here were 2mg/l (it’s not; it’s lower here, but let’s go with the highest figure to make a point), would require drinking more than 7l of water faster than the body can process it.
For more about the numbers, check out:
Acute Fluoride Poisoning from a Public Water System
Bottled water is the best: True or False?
False, if we consider “best” to be “healthiest”, which in turn we consider to be “most nutrients, with highest safety”.
Bottled water generally does have higher levels of minerals than most local mains supply water does. That’s good!
But you know what else is generally has? Microplastics and nanoplastics. That’s bad!
We don’t like to be alarmist in tone; it’s not what we’re about here, but the stats on bottled water are simply not good; see:
We Are Such Stuff As Bottles Are Made Of
You may be wondering: “but what about bottled water that comes in glass bottles?”
Indeed, water that comes in glass bottles can be expected to have lower levels of plastic than water that comes in plastic bottles, for obvious reasons.
However, we invite you to consider how likely you believe it to be that the water wasn’t stored in plastic while being processed, shipped and stored, before being portioned into its final store-ready glass bottles for end-consumer use.
Distilled water is the best: True or False?
False, generally, with caveats:
Distilled water is surely the safest water anywhere, because you know that you’ve removed any nasties.
However, it’s also devoid of nutrients, because you also removed any minerals it contained. Indeed, if you use a still, you’ll be accustomed to the build-up of these minerals (generally simplified and referenced as “limescale”, but it’s a whole collection of minerals).
Furthermore, that loss of nutrients can be more than just a “something good is missing”, because having removed certain ions, that water could now potentially strip minerals from your teeth. In practice, however, you’d probably have to swill it excessively to cause this damage.
Nevertheless, if you have the misfortune of living somewhere like Flint, Michigan, then a water still may be a fair necessity of life. In other places, it can simply be useful to have in case of emergency, of course.
Here’s an example product on Amazon if you’d like to invest in a water still for such cases.
PS: distilled water is also tasteless, and is generally considered bad, tastewise, for making tea and coffee. So we really don’t recommend distilling your water unless you have a good reason to do so.
Filtered water is the best: True or False?
True for most people in most places.
Let’s put it this way: it can’t logically be worse than whatever source of water you put into it…
Provided you change the filter regularly, of course.
Otherwise, after overusing a filter, at best it won’t be working, and at worst it’ll be adding in bacteria that have multiplied in the filter over however long you left it there.
You may be wondering: can water filters remove microplastics, and can they remove minerals?
The answer in both cases is: sometimes.
- For microplastics it depends on the filter size and the microplastic size (see our previous article for details on that).
- For minerals, it depends on the filter type. Check out:
The H2O Chronicles | 5 Water Filters That Remove Minerals
One other thing to think about: while most water filtration jugs are made of PFAS-free BPA-free plastics for obvious reasons, for greater peace of mind, you might consider investing in a glass filtration jug, like this one ← this is just one example product on Amazon; by all means shop around and find one you like
Take care!
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How To Reduce Your Alzheimer’s Risk
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Reduce Your Alzheimer’s Risk
Alzheimer’s is just one cause of dementia, but it’s a very notable one, not least of all because it’s
- a) the most common cause of dementia, and
- b) a measurably terminal disease.
For that reason we’re focusing on Alzheimer’s today, although most of the advice will go for avoiding dementia in general.
First, some things not everyone knows about Alzheimer’s:
- Alzheimer’s is a terminal disease.
- People who get a diagnosis at age 60 are typically given 4–8 years to live.
- Some soldier on for as many as 20, but those are rare outliers.
- Alzheimer’s begins 20 years or more before other symptoms start to develop.
- This makes this information very relevant for younger people approaching 40, for example.
- Alzheimer’s accounts for 60–80% of dementia, and affects around 6% of people over 60.
- By the age of 65, that figure is 10%. By the age of 70, however, the percentage is still about the same—this is because of the mortality rate preventing the accumulation of Alzheimer’s patients over time.
Want to know more? Read: 2023 Alzheimer’s Disease Facts And Figures Special Report ← this is a very comprehensive downloadablereference, by the way, including a lot of information about diagnosis, treatmentpathways, and earlyinterventions.
Speaking of diagnosis…
Know what the symptoms are… and aren’t!
Forgetting your car keys can be frustrating. Forgetting them frequently can be worrying.
But: there’s a difference between forgetting your car keys, and forgetting what car keys are used for. The latter is the kind of memory loss that’s more of a red flag for Alzheimer’s.
Similarly: forgetting someone’s name can be embarrassing. Forgetting someone’s name, asking them, forgetting asking them, asking them again, forgetting again (lather rinse repeat) is more of a red flag for Alzheimer’s.
There are other symptoms too, some of them less commonly known:
❝Difficulty remembering recent conversations, names or events; apathy; and depression are often early symptoms. Communication problems, confusion, poor judgment and behavioral changes may occur next. Difficulty walking, speaking, and swallowing are common in the late stages of the disease❞
If you or a loved one are experiencing worrying symptoms: when it comes to diagnosis and intervention, sooner is a lot better than later, so do talk to your doctor.
As for reducing your risk? First, the obvious stuff:
The usual 5 things that go for almost everything:
- Have a good diet—the Mediterranean Diet is once again recommended (we expect this will not be a surprise to regular readers!)
- Get regular exercise—in the case of avoiding Alzheimer’s and other dementias, typically the most important thing here is heart health, so getting regular cardiovascular exercise, such walking, running, or dancing is great. Cycling too. Swimming, not so much. Not that swimming’s bad or anything, it’s just that when your body is horizontal, the heart has less work to do, especially in the upper part of the body, because it’s not defying gravity. Similarly, yoga is great for the health but won’t particularly help with this, nor will weight training.
- Get good sleep—as we get older, we tend to need less sleep, and tend more towards the lower end of the standard “7–9 hours” prescription, but getting at least those 7 hours makes a huge difference.
- Cut down (or eliminate) alcohol consumption—and especially avoid binge-drinking. While “binge-drinking” is typically associated with young people, that Christmas party where that one uncle gets very drunk is also binge-drinking, for example. Plus, heavy drinking in early life has also been correlated with higher risk of Alzheimer’s later.
- Don’t smoke. It’s bad for everything, and Alzheimer’s risk is no exception.
How much do lifestyle changes alone make a difference?
They make a big difference. This 2022 population-based cohort study (so: huge sample size) looked at people who had 4–5 of the healthy lifestyle factors being studied, vs people who had 0–1 of them. They found:
❝A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer’s dementia.❞
The numbers of years involved by the way ranged between 3 and 20 years, in terms of life expectancy and years without or with Alzheimer’s, with the average increase of healthy life years being approximately the same as the average increase in years. This is important, because:
A lot of people think “well if I’m going to go senile, I might as well [unhealthy choice that shortens lifespan]”, but they misunderstand a critical factor:
The unhealthy choices will reduce their healthy life years, and simply bring the unhealthy ones (and subsequent death) sooner. If you’re going to spend your last few years in ill-health, it’s better to do so at 90 than 50.
The other thing you may already know… And a thing about it that not everyone considers:
Keeping cognitively active is important. This much is broadly known by the general public, and to clinicians, this was the fourth “healthy factor” in the list of five (instead of the sleep that we put there, because we were listing the 5 things that go for most preventable health issues).
Everyone leaps to mention sudoku at this point, so if that’s your thing, great, enjoy it! (This writer personally enjoys chess, which isn’t everyone’s cup of tea; if it yours though, you can come join her on Chess.com and we’ll keep sharp together)
But the more parts of your mental faculties you keep active, the better. Remember, brainpower (as with many things in health and life) is a matter of “use it or lose it” and this is on a “per skill” basis!
What this means: doing sudoku (a number-based puzzle game) or chess (great as it may be) won’t help as much for keeping your language skills intact, for example. Given that language skills are one of the most impactful and key faculties to get lost to Alzheimer’s disease, neglecting such would be quite an oversight!
Some good ways to keep your language skills tip-top:
- Read—but read something challenging, if possible. It doesn’t have to be Thomas Scanlon’s What We Owe To Each Other, but it should be more challenging than a tabloid, for example. In fact, on the topic of examples:
- This newsletter is written to be easy to read, while not shying away from complex ideas or hard science. Our mission is literally to “make [well-sourced, science-based] health and productivity crazy simple”.
- But the academic papers that we link? Those aren’t written to be easy to read. Go read them, or at least the abstracts (in academia, an abstract is essentially an up-front summary, and is usually the first thing you’ll see when you click a link to a study or such). Challenge yourself!
- Write—compared to reading/listening, producing language is a (related, but) somewhat separate skill. Just ask any foreign language learner which is more challenging: reading or writing!
- Journaling is great, but writing for others is better (as then you’ll be forced to think more about it)
- Learn a foreign language—in this case, what matters it that you’re practicing and learning, so in the scale of easy to hard, or doesn’t matter if it’s Esperanto or Arabic. Duolingo is a great free resource that we recommend for this, and they have a wide range of extensive courses these days.
Now for the least obvious things…
Social contact is important.
Especially in older age, it’s easy to find oneself with fewer remaining friends and family, and getting out and about can be harder for everyone. Whatever our personal inclinations (some people being more introverted or less social than others), we are fundamentally a social species, and hundreds of thousands of years of evolution have built us around the idea that we will live our lives alongside others of our kind. And when we don’t, we don’t do as well.
See for example: Associations of Social Isolation and Loneliness With Later Dementia
If you can’t get out and about easily:
- Online socialising is still socializing.
- Online community is still community.
- Online conversations between friends are still conversations between friends.
If you don’t have much (or anyone) in the category of friends and family, join Facebook groups related to your interests, for example.
Berries are surprisingly good
^This may read like a headline from 200,000 BCE, but it’s relevant here!
Particularly recommended are:
- blueberries
- blackberries
- raspberries
- strawberries
- cranberries
We know that many of these berries seem to have a shelf-life of something like 30 minutes from time of purchase, but… Frozen and dried are perfectly good nutritionally, and in many cases, even better nutritionally than fresh.
Read: Effect of berry-based supplements and foods on cognitive function: a systematic review
Turmeric’s health benefits appear to include protecting against Alzheimer’s
Again, this is about risk reduction, and turmeric (also called curcumin, which is not the same as cumin) significantly reduces the build-up of amyloid plaques in the brain. Amyloid plaques are part of the progression of Alzheimer’s.
See for yourself: Protective Effects of Indian Spice Curcumin Against Amyloid Beta in Alzheimer’s Disease
If you don’t like it as a spice (and even if you do, you probably don’t want to put it in your food every day), you can easily get it as a supplement in capsule form.
Lower your homocysteine levels
Lower our what now? Homocysteine is an amino acid used for making certain proteins, and it’s a risk factor for Alzheimer’s.
Foods high in folate (and possible other B-vitamins) seem to lower homocysteine levels. Top choices include:
- Leafy greens
- Cruciferous vegetables
- Tomatoes
Get plenty of lutein
We did a main feature about specifically this a little while ago, so we’ll not repeat our work here, but lutein is found in, well, the same things we just listed above, and lower levels of lutein are associated with Alzheimer’s disease. It’s not a proven causative factor—we don’t know entirely what causes Alzheimer’s, just a lot of factors that have a high enough correlation that it’d be remiss to ignore them.
Catch up on our previous article: Brain Food? The Eyes Have It
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Vaccines and cancer: The myth that won’t die
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.
Two recent studies reported rising cancer rates among younger adults in the U.S. and worldwide. This prompted some online anti-vaccine accounts to link the studies’ findings to COVID-19 vaccines.
But, as with other myths, the data tells a very different story.
What you need to know
- Baseless claims that COVID-19 vaccines cause cancer have persisted online for several years and gained traction in late 2023.
- Two recent reports finding rising cancer rates among younger adults are based on pre-pandemic cancer incidence data. Cancer rates in the U.S. have been on the rise since the 1990s.
- There is no evidence of a link between COVID-19 vaccination and increased cancer risk.
False claims about COVID-19 vaccines began circulating months before the vaccines were available. Chief among these claims was misinformed speculation that vaccine mRNA could alter or integrate into vaccine recipients’ DNA.
It does not. But that didn’t prevent some on social media from spinning that claim into a persistent myth alleging that mRNA vaccines can cause or accelerate cancer growth. Anti-vaccine groups even coined the term “turbo cancer” to describe a fake phenomenon of abnormally aggressive cancers allegedly linked to COVID-19 vaccines.
They used the American Cancer Society’s 2024 cancer projection—based on incidence data through 2020—and a study of global cancer trends between 1999 and 2019 to bolster the false claims. This exposed the dishonesty at the heart of the anti-vaccine messaging, as data that predated the pandemic by decades was carelessly linked to COVID-19 vaccines in viral social media posts.
Some on social media cherry-pick data and use unfounded evidence because the claims that COVID-19 vaccines cause cancer are not true. According to the National Cancer Institute and American Cancer Society, there is no evidence of any link between COVID-19 vaccines and an increase in cancer diagnosis, progression, or remission.
Why does the vaccine cancer myth endure?
At the root of false cancer claims about COVID-19 vaccines is a long history of anti-vaccine figures falsely linking vaccines to cancer. Polio and HPV vaccines have both been the target of disproven cancer myths.
Not only do HPV vaccines not cause cancer, they are one of only two vaccines that prevent cancer.
In the case of polio vaccines, some early batches were contaminated with simian virus 40 (SV40), a virus that is known to cause cancer in some mammals but not humans. The contaminated batches were discovered, and no other vaccine has had SV40 contamination in over 60 years.
Follow-up studies found no increase in cancer rates in people who received the SV40-contaminated polio vaccine. Yet, vaccine opponents have for decades claimed that polio vaccines cause cancer.
Recycling of the SV40 myth
The SV40 myth resurfaced in 2023 when vaccine opponents claimed that COVID-19 vaccines contain the virus. In reality, a small, nonfunctional piece of the SV40 virus is used in the production of some COVID-19 vaccines. This DNA fragment, called the promoter, is commonly used in biomedical research and vaccine development and doesn’t remain in the finished product.
Crucially, the SV40 promoter used to produce COVID-19 vaccines doesn’t contain the part of the virus that enters the cell nucleus and is associated with cancer-causing properties in some animals. The promoter also lacks the ability to survive on its own inside the cell or interact with DNA. In other words, it poses no risk to humans.
Over 5.6 billion people worldwide have received COVID-19 vaccines since December 2020. At that scale, even the tiniest increase in cancer rates in vaccinated populations would equal hundreds of thousands of excess cancer diagnoses and deaths. The evidence for alleged vaccine-linked cancer would be observed in real incidence, treatment, and mortality data, not social media anecdotes or unverifiable reports.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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In This Oklahoma Town, Most Everyone Knows Someone Who’s Been Sued by the Hospital
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McALESTER, Okla. — It took little more than an hour for Deborah Hackler to dispense with the tall stack of debt collection lawsuits that McAlester Regional Medical Center recently brought to small-claims court in this Oklahoma farm community.
Hackler, a lawyer who sues patients on behalf of the hospital, buzzed through 51 cases, all but a handful uncontested, as is often the case. She bantered with the judge as she secured nearly $40,000 in judgments, plus 10% in fees for herself, according to court records.
It’s a payday the hospital and Hackler have shared frequently over the past three decades, records show. The records indicate McAlester Regional Medical Center and an affiliated clinic have filed close to 5,000 debt collection cases since the early 1990s, most often represented by the father-daughter law firm of Hackler & Hackler.
Some of McAlester’s 18,000 residents have been taken to court multiple times. A deputy at the county jail and her adult son were each sued recently, court records show. New mothers said they compare stories of their legal run-ins with the medical center.
“There’s a lot that’s not right,” Sherry McKee, a dorm monitor at a tribal boarding school outside McAlester, said on the courthouse steps after the hearing. The hospital has sued her three times, most recently over a $3,375 bill for what she said turned out to be vertigo.
In recent years, major health systems in Virginia, North Carolina, and elsewhere have stopped suing patients following news reports about lawsuits. And several states, such as Maryland and New York, have restricted the legal actions hospitals can take against patients.
But with some 100 million people in the U.S. burdened by health care debt, medical collection cases still clog courtrooms across the country, researchers have found. In places like McAlester, a hospital’s debt collection machine can hum away quietly for years, helped along by powerful people in town. An effort to limit hospital lawsuits failed in the Oklahoma Legislature in 2021.
In McAlester, the lawsuits have provided business for some, such as the Adjustment Bureau, a local collection agency run out of a squat concrete building down the street from the courthouse, and for Hackler, a former president of the McAlester Area Chamber of Commerce. But for many patients and their families, the lawsuits can take a devastating toll, sapping wages, emptying retirement accounts, and upending lives.
McKee said she wasn’t sure how long it would take to pay off the recent judgment. Her $3,375 debt exceeds her monthly salary, she said.
“This affects a large number of people in a small community,” said Janet Roloff, an attorney who has spent years assisting low-income clients with legal issues such as evictions in and around McAlester. “The impact is great.”
Settled more than a century ago by fortune seekers who secured land from the Choctaw Nation to mine coal in the nearby hills, McAlester was once a boom town. Vestiges of that era remain, including a mammoth, 140-foot-tall Masonic temple that looms over the city.
Recent times have been tougher for McAlester, now home by one count to 12 marijuana dispensaries and the state’s death row. The downtown is pockmarked by empty storefronts, including the OKLA theater, which has been dark for decades. Nearly 1 in 5 residents in McAlester and the surrounding county live below the federal poverty line.
The hospital, operated by a public trust under the city’s authority, faces its own struggles. Paint is peeling off the front portico, and weeds poke up through the parking lots. The hospital has operated in the red for years, according to independent audit reports available on the state auditor’s website.
“I’m trying to find ways to get the entire community better care and more care,” said Shawn Howard, the hospital’s chief executive. Howard grew up in McAlester and proudly noted he started his career as a receptionist in the hospital’s physical therapy department. “This is my hometown,” he said. “I am not trying to keep people out of getting care.”
The hospital operates a clinic for low-income patients, whose webpage notes it has “limited appointments” at no cost for patients who are approved for aid. But data from the audits shows the hospital offers very little financial assistance, despite its purported mission to serve the community.
In the 2022 fiscal year, it provided just $114,000 in charity care, out of a total operating budget of more than $100 million, hospital records show. Charity care totaling $2 million or $3 million out of a $100 million budget would be more in line with other U.S. hospitals.
While audits show few McAlester patients get financial aid, many get taken to court.
Renee Montgomery, the city treasurer in an adjoining town and mother of a local police officer, said she dipped into savings she’d reserved for her children and grandchildren after the hospital sued her last year for more than $5,500. She’d gone to the emergency room for chest pain.
Dusty Powell, a truck driver, said he lost his pickup and motorcycle when his wages were garnished after the hospital sued him for almost $9,000. He’d gone to the emergency department for what turned out to be gastritis and didn’t have insurance, he said.
“Everyone in this town probably has a story about McAlester Regional,” said another former patient who spoke on the condition she not be named, fearful to publicly criticize the hospital in such a small city. “It’s not even a secret.”
The woman, who works at an Army munitions plant outside town, was sued twice over bills she incurred giving birth. Her sister-in-law has been sued as well.
“It’s a good-old-boy system,” said the woman, who lowered her voice when the mayor walked into the coffee shop where she was meeting with KFF Health News. Now, she said, she avoids the hospital if her children need care.
Nationwide, most people sued in debt collection cases never challenge them, a response experts say reflects widespread misunderstanding of the legal process and anxiety about coming to court.
At the center of the McAlester hospital’s collection efforts for decades has been Hackler & Hackler.
Donald Hackler was city attorney in McAlester for 13 years in the ’70s and ’80s and a longtime member of the local Lions Club and the Scottish Rite Freemasons.
Daughter Deborah Hackler, who joined the family firm 30 years ago, has been a deacon at the First Presbyterian Church of McAlester and served on the board of the local Girl Scouts chapter, according to the McAlester News-Capital newspaper, which named her “Woman of the Year” in 2007. Since 2001, she also has been a municipal judge in McAlester, hearing traffic cases, including some involving people she has sued on behalf of the hospital, municipal and county court records show.
For years, the Hacklers’ debt collection cases were often heard by Judge James Bland, who has retired from the bench and now sits on the hospital board. Bland didn’t respond to an inquiry for interview.
Hackler declined to speak with KFF Health News after her recent court appearance. “I’m not going to visit with you about a current client,” she said before leaving the courthouse.
Howard, the hospital CEO, said he couldn’t discuss the lawsuits either. He said he didn’t know the hospital took its patients to court. “I had to call and ask if we sue people,” he said.
Howard also said he didn’t know Deborah Hackler. “I never heard her name before,” he said.
Despite repeated public records requests from KFF Health News since September, the hospital did not provide detailed information about its financial arrangement with Hackler.
McAlester Mayor John Browne, who appoints the hospital’s board of trustees, said he, too, didn’t know about the lawsuits. “I hadn’t heard anything about them suing,” he said.
At the century-old courthouse in downtown McAlester, it’s not hard to find the lawsuits, though. Every month or two, another batch fills the docket in the small-claims court, now presided over by Judge Brian McLaughlin.
After court recently, McLaughlin, who is not from McAlester, shook his head at the stream of cases and patients who almost never show up to defend themselves, leaving him to issue judgment after judgment in the hospital’s favor.
“All I can do is follow the law,” said McLaughlin. “It doesn’t mean I like it.”
About This Project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability.
KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
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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Glucomannan For Weight Loss, Gut Health, & More
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Glucomannan is a water-soluble dietary fiber found in the root of the konjac plant.
If you’ve had konjac noodles, also called shirataki, that’s what those are mostly made of, and it’s why they have next-to-no calories.
You may be wondering: if it’s water-soluble, how do the noodles not dissolve in water? And the answer is that the noodle-making process involves making a gel out of the fiber and water, which is then extruded into noodle shapes. In this gelatinous form, they’re fairly stable (it’s one of the most viscous dietary fibers), but yes, if you were to boil them for a long time, they would indeed turn the entire liquid contents of the saucepan into gel.
How it works for weight loss
Because of its viscosity, adding even a small amount of powdered* glucomannan to a glass of water will turn the whole thing into gel in seconds. This means that if you take glucomannan capsules with a glass of water, then so far as your stomach is concerned, you just ate a cup of gel, and the water is now processed as food, staying longer in the stomach than it otherwise would, and promoting feelings of fullness.
*i.e. dry powder, not in a gelatinous form like the noodles
As for its efficacy in weight loss, see for example:
❝Glucomannan was well-tolerated and resulted in significant weight loss in overweight and obese individuals❞
Read more: Glucomannan and obesity: a critical review
So, that covers the basic requirements, but may be wondering: does it have other benefits? And the answer is yes, it does:
❝Glucomannan appears to beneficially affect total cholesterol, LDL cholesterol, triglycerides, body weight, and fasting blood glucose❞
To further corroborate that and comment on safety…
❝Results showed a significant mean weight loss using glucomannan over an eight-week period. Serum cholesterol and low-density lipoprotein cholesterol were significantly reduced in the glucomannan treated group. No adverse reactions to glucomannan were reported.❞
Read more: Effect of glucomannan on obese patients: a clinical study
As to whether other gel-making agents work the same way, the answer is no, they don’t seem to:
❝Glucomannan induced body weight reduction in healthy overweight subjects, whereas the addition of guar gum and alginate did not seem to cause additional loss of weight❞
Read more: Experiences with three different fiber supplements in weight reduction
How it works for gut health
In the words of Dr. Yu Li et al.,
❝Konjaku flour can achieve positive effects on treating obesity, which manifest on reducing BMI, fat mass, blood glucose, and blood lipid, improving hepatic function, and also regulating intestinal microfloral structure.
Therefore, changes in gut microbiota may explain in part the effects of konjaku flour.❞
Read in full: Effects of Konjaku Flour on the Gut Microbiota of Obese Patients
This has extra positive knock-on effects too:
Want to try some?
We don’t sell it, but here for your convenience are example products on Amazon:
Konjac noodles | Glucomannan capsules
Enjoy!
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The S.T.E.P.S. To A Healthier Heart
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Stepping Into Better Heart Health
This is Dr. Jennifer H. Mieres, FACC, FAHA, MASNC. she’s an award-winning (we counted 9 major awards) professor of cardiology, and a leading advocate for women’s heart health. This latter she’s done via >70 scientific publications, >100 research presentations at national and international conferences, 3 books so far, and 4 documentaries, including the Emmy-nominated “A Woman’s Heart”.
What does she want us to know?
A lot of her work is a top-down approach, working to revolutionize the field of cardiology in its application, to result in far fewer deaths annually. Which is fascinating, but unless you’re well-placed in that industry, not something too actionable as an individual (if you are well-placed in that industry, do look her up, of course).
For the rest of us…
Dr. Mieres’ S.T.E.P.S. to good heart health
She wants us to do the following things:
1) Stock your kitchen with heart health in mind
This is tied to the third item in the list of course, but it’s a critical step not to be overlooked. It’s all very well to know “eat more fiber; eat less red meat” and so forth, but if you go to your kitchen and what’s there is not conducive to heart health, you’re just going to do the best with what’s available.
Instead, actually buy foods that are high in fiber, and preferably, foods that you like. Not a fan of beans? Don’t buy them. Love pasta? Go wholegrain. Like leafy greens in principle, but they don’t go with what you cook? Look up some recipes, and then buy them.
Love a beef steak? Well we won’t lie to you, that is not good for your heart, but make it a rare option—so to speak—and enjoy it mindfully (see also: mindful eating) once in a blue moon for a special occasion, rather than “I don’t know what to cook tonight, so sizzle sizzle I guess”.
Meal planning goes a long way for this one! And if meal-planning sounds like an overwhelming project to take on, then consider trying one of the many healthy-eating meal kit services that will deliver ingredients (and their recipes) to your door—opting for a plants-forward plan, and the rest should fall into place.
2) Take control of your activity
Choose to move! Rather than focusing on what you can’t do (let’s say, those 5am runs, or your regularly-scheduled, irregularly attended, gym sessions), focus on what you can do, and do it.
See also: No-Exercise Exercise!
3) Eat for a healthier heart
This means following through on what you did on the first step, and keeping it that way. Buying fresh fruit and veg is great, but you also have to actually eat it. Do not let the perishables perish!
For you too, dear reader, are perishable (and would presumably like to avoid perishing).
This item in the list may seem flippant, but actually this is about habit-forming, and without it, the whole plan will grind to a halt a few days after your first heart-health-focused shopping trip.
See also: Where Nutrition Meets Habits!
4) Partner with your doctor, family, and friends
Good relationships, both professional and personal, count for a lot. Draw up a plan with your doctor; don’t just guess at when to get this or that checked—or what to do about it if the numbers aren’t to your liking.
Partnership with your doctor goes both ways, incidentally. Read up, have opinions, discuss them! Doing so will ultimately result in better care than just going in blind and coming out with a recommendation you don’t understand and just trust (but soon forget, because you didn’t understand).
And as for family and friends, this is partly about social factors—we tend to influence, and be influenced by, those around us. It can be tricky to be on a health kick if your partner wants take-out every night, so some manner of getting everyone on the same page is important, be it by compromise or, in an ideal world, gradually trending towards better health. But any such changes must come from a place of genuine understanding and volition, otherwise at best they won’t stick, and at worst they’ll actively create a pushback.
Same goes for exercise as for diet—exercising together is a good way to boost commitment, especially if it’s something fun (dance classes are a fine example that many couples enjoy, for example).
5) Sleep more, stress less, savor life
These things matter a lot! Many people focus on cutting down salt or saturated fat, and that can be good if otherwise consumed to excess, but for most people they’re not the most decisive factors:
Hypertension: Factors Far More Relevant Than Salt ← sleep features here!
Stress is also a huge one, and let’s put it this way: people more often have heart attacks during a moment of excessive emotional stress—not during a moment when they had a bit too much butter on their toast.
It’s not even just that acute stress is the trigger, it’s that chronic stress is a contributory factor that erodes the body’s ability to handle the acute stress.
Changing this may seem “easier said than done” because often the stressors are external (e.g. work pressure, financial worries, caring for a sick relative, relationship troubles, major life change, etc), but it is possible to find peace even in the chaos of life:
Want to know more from Dr. Mieres?
You might like this book of hers, which goes into each of the above items in much more depth than we have room to here:
Heart Smarter for Women: Six Weeks to a Healthier Heart – by Dr. Jennifer Mieres
Enjoy!
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