Food Reward Friday

This week's "lucky" winner... milkshakes!

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Insurance companies will have to pay out an average of 32 percent more for medical claims on individual

 

 

WASHINGTON (AP) — Insurance companies will have to pay out an average of 32 percent more for medical claims on individual health policies under President Barack Obama's overhaul, the nation's leading group of financial risk analysts has estimated.

 

That's likely to increase premiums for at least some Americans buying individual plans.

The report by the Society of Actuaries could turn into a big headache for the Obama administration at a time when many parts of the country remain skeptical about the Affordable Care Act.

While some states will see medical claims costs per person decline, the report concluded the overwhelming majority will see double-digit increases in their individual health insurance markets, where people purchase coverage directly from insurers.

The disparities are striking. By 2017, the estimated increase would be 62 percent for California, about 80 percent for Ohio, more than 20 percent for Florida and 67 percent for Maryland. Much of the reason for the higher claims costs is that sicker people are expected to join the pool, the report said.
The report did not make similar estimates for employer plans, the mainstay for workers and their families. That's because the primary impact of Obama's law is on people who don't have coverage through their jobs.

The administration questions the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick. The study also doesn't take into account the potential price-cutting effect of competition in new state insurance markets that will go live on Oct. 1, administration officials said.

At a White House briefing on Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can't be compared to the comprehensive coverage available under the law. "Some of these folks have very high catastrophic plans that don't pay for anything unless you get hit by a bus," she said. "They're really mortgage protection, not health insurance."

A prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does "a credible job" of estimating potential enrollment and costs under the law, "without trying to tilt the answers in any particular direction."

"Having said that," Foster added, "actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully." Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago.

Kristi Bohn, an actuary who worked on the study, acknowledged it did not attempt to estimate the effect of subsidies, insurer competition and other factors that could mitigate cost increases. She said the goal was to look at the underlying cost of medical care.

"Claims cost is the most important driver of health care premiums," she said.
"We don't see ourselves as a political organization," Bohn added. "We are trying to figure out what the situation at hand is."

On the plus side, the report found the law will cover more than 32 million currently uninsured Americans when fully phased in. And some states — including New York and Massachusetts — will see double-digit declines in costs for claims in the individual market.

Uncertainty over costs has been a major issue since the law passed three years ago, and remains so just months before a big push to cover the uninsured gets rolling Oct. 1. Middle-class households will be able to purchase subsidized private insurance in new marketplaces, while low-income people will be steered to Medicaid and other safety net programs. States are free to accept or reject a Medicaid expansion also offered under the law.

Obama has promised that the new law will bring costs down. That seems a stretch now. While the nation has been enjoying a lull in health care inflation the past few years, even some former administration advisers say a new round of cost-curbing legislation will be needed.
Bohn said the study overall presents a mixed picture.

Millions of now-uninsured people will be covered as the market for directly purchased insurance more than doubles with the help of government subsidies. The study found that market will grow to more than 25 million people. But costs will rise because spending on sicker people and other high-cost groups will overwhelm an influx of younger, healthier people into the program.

Some of the higher-cost cases will come from existing state high-risk insurance pools. Those people will now be able to get coverage in the individual insurance market, since insurance companies will no longer be able to turn them down. Other people will end up buying their own plans because their employers cancel coverage. While some of these individuals might save money for themselves, they will end up raising costs for others.

Part the reason for the wide disparities in the study is that states have different populations and insurance rules. In the relatively small number of states where insurers were already restricted from charging higher rates to older, sicker people, the cost impact is less.
"States are starting from different starting points, and they are all getting closer to one another," said Bohn.

The study also did not model the likely patchwork results from some states accepting the law's Medicaid expansion while others reject it. It presented estimates for two hypothetical scenarios in which all states either accept or reject the expansion.

Larry Levitt, an insurance expert with the nonpartisan Kaiser Family Foundation, reviewed the report and said the actuaries need to answer more questions.

"I'd generally characterize it as providing useful background information, but I don't think it's complete enough to be treated as a projection," Levitt said. The conclusion that employers with sicker workers would drop coverage is "speculative," he said.

Another caveat: The Society of Actuaries contracted Optum, a subsidiary of UnitedHealth Group, to do the number-crunching that drives the report. United also owns the nation's largest health insurance company. Bohn said the study reflects the professional conclusions of the society, not Optum or its parent company.

Neuronal Control of Appetite, Metabolism and Weight

Last week, I attended a Keystone conference, "Neuronal Control of Appetite, Metabolism and Weight", in Banff.  Keystone conferences are small, focused meetings that tend to attract high quality science.  This particular conference centered around my own professional research interests, and it was incredibly informative.  This post is a summary of some of the most salient points.

Rapid Pace of Scientific Progress

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105 US kids died of flu; most didn't get vaccine

 NEW YORK (AP) — The flu season is winding down, and it has killed 105 children so far — about the average toll.

The season started about a month earlier than usual, sparking concerns it might turn into the worst in a decade. It ended up being very hard on the elderly, but was moderately severe overall, according to the Centers for Disease Control and Prevention.


Six of the pediatric deaths were reported in the last week, and it's possible there will be more, said the CDC's Dr. Michael Jhung said Friday.

Roughly 100 children die in an average flu season. One exception was the swine flu pandemic of 2009-2010, when 348 children died.

The CDC recommends that all children ages 6 months and older be vaccinated against flu each season, though only about half get a flu shot or nasal spray.

All but four of the children who died were old enough to be vaccinated, but 90 percent of them did not get vaccinated, CDC officials said.

This year's vaccine was considered effective in children, though it didn't work very well in older people. And the dominant flu strain early in the season was one that tends to cause more severe illness.

The government only does a national flu death count for children. But it does track hospitalization rates for people 65 and older, and those statistics have been grim.

In that group, 177 out of every 100,000 were hospitalized with flu-related illness in the past several months. That's more than 2 1/2 times higher than any other recent season.

This flu season started in early December, a month earlier than usual, and peaked by the end of year. Since then, flu reports have been dropping off throughout the country.

"We appear to be getting close to the end of flu season," Jhung said.

Food Reward Friday

This week's luck winner(s)... pastries!!

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Toddler With HIV Is Cured—So What’s Next?

In a landmark announcement, researchers said they'd cured the first child with HIV, the virus that causes AIDS. The 26-month-old toddler was born to a mother also infected with the virus, and was started on combination antiretroviral treatment (ART) when she was just 30 hours old. A press release issued by Johns Hopkins University School of Medicine, home to Deborah Persaud, Ph.D., a virologist and the study's lead author, said the news "may help pave the way to eliminating HIV infection in children."

'Do One Thing' With the AIDS Healthcare Foundation
 

The announcement of the case was presented in Atlanta at a conference on retroviruses and opportunistic infections. The researchers called the finding a "functional cure," which means that a patient shows remission of the virus over a long period of time without treatment and that tests can't detect HIV replication in the blood.

Karin Nielsen, M.D., M.P.H., a clinical professor of pediatric infectious diseases at the University of California, Los Angeles, calls the announcement "exciting news."  What seems to be most important about how this little girl was cured was when her treatment started: She began ART very soon after birth, which seems to have prevented what HIV/AIDS specialists call a "latent reservoir" where dormant HIV cells can hide, making them hard to treat and allowing for the infection to start up again once treatment stops. "Prompt antiviral therapy in newborns that begins within days of exposure may help infants clear the virus and achieve long-term remission without lifelong treatment by preventing such viral hideouts from forming in the first place," said Persaud in a press release.

Adds Nielsen, who was not involved in the study, says the news supports "the hypothesis that many of us who work in perinatal/ pediatric HIV suspected—that early treatment with antiretrovirals can not only prevent or abort infection, but also impede seeding of reservoirs and revert what seems to have been an established infection," she explains. "If these findings are reproduced in further studies this could definitely change the HIV treatment paradigm in early infant infection, with the emphasis being 'treat to cure.' "

The child continued to receive treatment and by the time she was 29 days old the virus could no longer be detected in her blood. The study's authors say she continued treatment until she was 18 months old, then, for unknown reasons, stopped. Ten months later, she was tested again and the doctors could not find any trace of HIV or HIV-specific antibodies.

The current standard care for babies at risk for acquiring HIV is to give them a lower dose of combination ART for six weeks to prevent infection and continue with a therapeutic dose if an infection is found. But standard treatment may start to change as the result of this watershed case. "These findings will lead to studies of very early treatment in HIV-exposed infants at high risk of infection," notes Nielsen. "If further research confirms that early treatment reverts HIV infection in infants, early intense treatment of infected babies will likely become standard of care."

And is there anything in the announcement that might help HIV-infected adults—could they, too, benefit from very early treatment, right after infection? "Early intense treatment can be instituted, which is something that has been done in selected studies," Nielsen explains. "Cure, however has not been observed to date." The reasons may have to do with the timing of therapy, how the virus was acquired, or other factors that are different between adults and babies, she says. "Nevertheless, if the infant cure findings are duplicated, they serve as a model for achievement of a functional cure which can potentially be extrapolated to adults once details on the pathogenesis are better understood." And that's something to hope for and work toward—for infants, children, and adults.

14 HIV Patients Have 'Functional Cure'

Early and effective HIV treatment may, in a small fraction of patients, lead to a so-called functional cure, French researchers found.

Fourteen patients who were treated within the first two months of infection were later able to stop combination antiretroviral therapy without an HIV rebound, according to Asier Sáez-Cirión of the Institut Pasteur in Paris.

While all 14 still have HIV, in most cases it can only be detected with ultrasensitive laboratory tests and is undetectable by standard methods, Sáez-Cirión and colleagues reported in the journal PLoS Pathogens.

Read this story on www.medpagetoday.com.

But in all cases, the infection appears to be under control without the use of drugs – the definition of a functional cure, which unlike a "sterilizing" cure does not completely get rid of HIV.

The report is the second in several days of what appears to be curative early treatment for HIV.

Researchers reported at the recent Conference on Retroviruses and Opportunistic Infections that combination antiretroviral treatment in the first few hours of life appears to have eliminated HIV infection in a baby.

 Nonetheless, in general, stopping HIV treatment is not recommended, said Dr. Michael Saag of the University of Alabama Birmingham.

"In my practice," he told MedPage Today, "I would start everyone with acute infection on antiretroviral therapy, but in general I would just continue that therapy and not stop."

Several studies of so-called treatment interruption have showed that for most people, stopping therapy leads to sharp and dangerous increases in HIV replication, Saag noted.

The difference in this group, the researchers suggested, is that they were treated very early, in what's called primary or acute infection, and spent between a year and 7.6 years on therapy, with a median of 36.5 months.

Their reasons for stopping, Sáez-Cirión told MedPage Today in an email, included a desire to take a vacation from therapy and participation in a treatment-interruption study.

The 10 men and four women have now been off therapy for between four and 10 years. Their plasma viral loads are below 40 copies of HIV RNA per milliliter in all but three cases, and below five copies in five patients.

The virus is conventionally regarded as "undetectable" if the plasma viral load is below 50 copies per milliliter, although so-called single-copy assays – only rarely used outside the lab – can detect smaller amounts of HIV.

What Sáez-Cirión and colleagues are calling "post-treatment controllers" are not common, they noted.

When they looked at the French database of HIV patients from 1997 to 2011, they found just 756 patients who were treated within 6 months of infection and who maintained therapy for at least a year.

Of those who had a detectable viral load before therapy and an undetectable one afterward, just 70 stopped treatment and had subsequent viral load measurements.

Kaplan-Meier estimates of that population suggested the probability of maintaining viral control after a year was 15.3 percent.

That means, Saag noted, that about 85 percent of patients treated early will still face viral rebound if they stop treatment.

Although the phenomenon may not have immediate clinical implications, he said, it's "proof of concept" that the immune system can control HIV in some circumstances.

It may also offer hope for a vaccine, he said. "It shows there is some immune response," he said, "that can be stimulated not just to control infection but to prevent infection if that part of the immune system can be primed and activated."

Indeed, the researchers argued that study of these patients and others like them could "open up new therapeutic perspectives" for people with HIV.

Among other things, they found that the immune systems of post-treatment controllers don't resemble those of "elite controllers" – the 1 percent of the HIV-positive population that appears to have a natural ability to control the virus.

The elite controllers tend to have protective HLA class I alleles, but the 14 patients tended to have HLA variants associated with a higher risk of HIV progression, they reported.

As well, elite controllers have large numbers of highly efficient HIV-specific CD8-positive T cells; the post-treatment controllers have "very weak" and in some cases barely detectable HIV-specific CD8 responses.

On the other hand, there's at least one important similarity: Both groups have small HIV "reservoirs" -- groups of infected cells that give rise to new virus, leading to viral rebound when therapy is stopped.

The finding suggests that "limiting the pool of infected cells is crucial for the successful control of viral replication in the absence of therapy," Sáez-Cirión and colleagues argued.

And, they concluded, early therapy, continued over a prolonged period, "likely played an important role in reducing the reservoirs."

That said, it remains "unclear" what factors distinguish the patients who achieved control from those who did not.

 

New York mayor wants to ban stores from displaying cigarettes

New York Mayor Michael Bloomberg on Monday proposed requiring that cigarettes be hidden from view in retail stores as a means to reduce smoking in what he said would be the first law of its kind in the United States.

Bloomberg plans to introduce to the City Council on Wednesday two bills that would require retailers to keep cigarettes in a drawer, behind a curtain or in some other concealed location.
 Some retail trade groups and tobacco companies criticized the proposed display ban as an unnecessary burden.

Bloomberg, a former smoker, is accustomed to industry opposition from previous measures to improve the health of New Yorkers, including bans on smoking in most offices, restaurants, bars, parks and on beaches.

Bloomberg has also taken steps to curtail the use of trans fats and salt in the city's restaurants. Last week a court unexpectedly struck down his attempt to limit the size of sugary drinks, in part because it did not go through the City Council. The city is appealing that ruling.

"These laws would protect New Yorkers, especially young and impressionable New Yorkers, from pricing, discounts and exposure to in-store displays that promote tobacco products," Bloomberg told a news conference at a city hospital.

"Such displays suggest that smoking is a normal activity and they invite young people to experiment with tobacco. This is not a normal activity," he said.

Stores would still be allowed to advertise and display pricing information but the actual tobacco products would only be visible during a sale or restocking.

Under current federal and state laws, cigarettes must be accessible only to a store's cashiers, and in many city stores they are prominently stacked on a wall behind the cash register.

The proposal would also increase penalties on stores that illegally resell cigarettes smuggled in from states with lower tobacco taxes, which Bloomberg said cost the city $30 million in lost tax revenue every year.

Over the last 18 months, inspectors visiting 1,800 cigarette retailers found 46 percent were selling untaxed or unstamped tobacco products, city officials said. New York City cigarettes are the most expensive in the nation at around $12 or $13 a pack after federal, state and city taxes.

The legislation would also prohibit retailers from redeeming discount coupons on tobacco sales.

The Food Industry Alliance of New York State, a trade group representing groceries and convenience stores, said the display law would be an unnecessary additional and potentially costly burden on retailers without any proven effect.

"I'm not a proponent of smoking. I am a proponent of retailers who are licensed to sell a legal product being able to do so without undue government interference," said Michael Rosen, the alliance's vice president for government relations.

Altria -- the parent company of Philip Morris USA, the nation's largest cigarette manufacturer -- also said it opposed the display ban and that it should be left to the U.S. Food and Drug Administration to regulate tobacco sales.

"We believe it goes too far," said David Sutton, an Altria spokesman.

The company still needed to see the details of the legislation but suspected it could breach free speech rights, Sutton said.

Bloomberg expected to have the council's support, although a vote was not expected immediately, a spokeswoman for the mayor said.

Christine Quinn, the council speaker and a leading candidate to replace Bloomberg in the November election, supported the goals of the bills but needed to review details before commenting further, a council spokeswoman said.

Bloomberg's previous bans on smoking in public places have corresponded with a decline in the number of New Yorkers who smoke, from 21.5 percent in 2002 to 14.8 percent in 2011, according to the city's health department.

Smoking remains the leading preventable cause of death among New Yorkers, the department says.

7 Steps to Cut Cancer Risk in Half

Following six of the steps can even cut  cancer risk in half, said Laura Rasmussen-Torvik, a professor of preventive medicine at Northwestern University’s Feinberg School of Medicine. She said she and her colleagues just had a hunch that following healthy-heart guidelines would also decrease the risk of cancer.

And their findings confirmed that hunch. Adhering to four of the  steps in Life’s Simple 7 resulted in a 33 percent cancer risk reduction, and following  six or seven led to a 51 percent cancer risk reduction, according to the study, which was  published today in the journal Circulation.

“We just wanted to test that hypothesis,” Rasmussen-Torvik said. “We hoped the information would provide extra motivation for the public to check out  Life’s Simple 7.”

The American Heart Association developed the seven steps in 2010 with the goal of reducing heart attack and stroke deaths by 20 percent by 2020.

Rasmussen-Torvik and her fellow researchers examined two decades of data from the Atherosclerosis Risk in Communities study, looking at the health records of 13,253 patients from 1987 to 2006. They found that the more steps patients followed, the less likely they were to develop cancer.

Here are the steps in the Life Simple 7:

1.    Get active —  AHA recommends at least 150 minutes of exercise a week.

2.   Control cholesterol — Cholesterol should be lower than 200 milligrams per deciliter.

3.   Eat better — This means foods high in whole grain, fruits, vegetables and lean protein such as  fish. Limiting sodium, added sugars, trans and saturated fats is also important.

4.    Manage blood pressure — It should be less than 120/80.

5.    Lose weight — body mass index should be below 25.

6.    Reduce blood sugar — Fasting blood sugar level should be below 100, which can be achieved  by avoiding soda, candy and other desserts, as well as getting exercise.

7.    Stop smoking — AHA says  do “whatever it takes.”

The steps are cumulative, but quitting smoking was especially helpful, the researchers found.  There’s also a considerable amount of overlap in the steps, considering that getting active and eating better — steps 1 and 3 — help with cholesterol, blood pressure, weight  and blood sugar – steps 2, 4, 5, and 6.

The National Cancer Institute estimated that 12.5 million people had cancer in the United States as of Jan. 1, 2009. The Centers for Disease Control and Prevention estimated that 5.7 million people had heart disease.

Rasmussen-Torvik, who couldn’t say why these steps lowered cancer risk because cancer was not her area of study, said she hoped patients would  be willing to follow the Simple 7  because they decrease the risk of two potentially deadly health ailments.

“Any little added encouragement for people to adopt these recommendations is great,” she said.

Is Cancer Contagious? Could Hugo Ch vez Have Been Deliberately Infected?

Venezuelan officials announced this week that they would investigate whether enemies could have deliberately infected late President Hugo Chávez with cancer. Chávez died on March 5, apparently of a heart attack, after battling cancer for two years.

When the former Venezuelan president was diagnosed with an undisclosed form of cancer in 2011, he speculated that his enemies could have given him the disease. He also implied that U.S. agents could have developed a technology to induce cancer, according to a CNN news story at the time. The U.S. State Department called the accusation “absurd.”

The theory that someone could be infected with cancer is not biologically impossible, but it is unlikely. A healthy immune system will combat any foreign cells, including cancerous ones. Only three types of contagious cancers have been identified, and all occur in non-primates.

Scientific American spoke with Katherine Belov, professor of comparative genomics at the University of Sydney who studies a contagious cancer called Tasmanian devil facial tumor disease. She explains why contagious cancers are rare and whether cancer could infect another person.

[An edited transcript of the interview follows.]

What are contagious cancers?
 In humans, we know that you can catch viruses, like the human papillomavirus, which make you more likely to get cancer. [ HPV can cause cervical cancer in women, and genital warts and anal cancer in men.] In humans, environmental causes play an important role, too—cigarette smoke and radiation exposure can cause cancer. However, we don't have any clear examples of [naturally occurring] transmissible cancers in humans.

There is a transmissible cancer in dogs. It’s a sexually transmitted disease called canine transmissible venereal tumor, or CTVT. And there is also the Tasmanian devil facial tumor disease, which I work on. The devil’s cancer causes large ulcerations in their mouth and around their jaw. When they fight—and they fight a lot—they are biting other animals, and the cancerous cells are implanting in other animals’ wounds.

In both the Tasmanian devils and in the case of CTVT, the tumor evolved in really inbred populations of animals. There was a lack of diversity and so the cancer is genetically very similar to the animals it passes to.

Why does lack of diversity help the cancer jump from animal to animal?
 The cancer is transmitted to animals that are genetically similar to one another and also to the tumor. The immune system doesn't "see" it and doesn't mount an immune response. The cancer can then grow until it kills the animal.

Over time the devil’s facial tumor disease would have encountered animals that were genetically dissimilar to it. But the cancer found a way to down-regulate [or produce fewer] cell-surface molecules, which are sort of red flags to the immune system in genetically different animals. These flags are part of the major histocompatibility complex [a set of molecules attached to cells that regulate interactions with immune cells]—they are MHC molecules. Without those special immune molecules the cancer is able to fly under the radar of the immune system and pass from animal to animal.
So the immune system doesn’t just identify viruses and bacteria—it also keeps watch for any types of foreign cells?
 And even cells from your own body that are dangerous. Cancers are just from a mutation in a cell. Our immune system is patrolling and looking for those cancerous cells. If our immune system sees a cell is cancerous, it will kill it. So cancers arise often, but we don't really know about them.

Why hasn’t contagious cancer evolved in humans?
 One of the key reasons is our genetic diversity. In a population where there is a lot of genetic diversity, we all have very different versions of the flags I’m talking about. So if a cell gets into us and has a different combination of flags, our immune system will kill it.

And that's why, if you need organ transplantation, you go to close family members. They are more likely to share the same flags as you do, [making it more likely for the transplanted organ to be tolerated by your immune system]. Still, there will be some variation in the combination of these cell surface flags that they have, which is why usually recipients of organ transplantation are given immunosuppressant drugs.

There are rare cases when a cancer has been passed from one person to another. Can you describe any examples?
 A mother can pass cancer on to a fetus—for example, things like melanoma have been passed from mother to fetus.

Also, during organ transplantation, if the organ donor has cancer, it is possible to transmit cancer that way. Again melanoma is a clear example there. Someone may not even realize that they have a small melanoma that metastasizes and spreads to an organ. When they transplant that organ, the recipient develops melanoma as well.

Would it be possible to get cancer from a blood transfusion?
 I guess [that would be possible] if there are blood cancer cells in the transfusion. But normally the cancer cells would look foreign to yours, so there is a very good chance your immune system would mount a response. If that cancer in some way could be invisible to your immune system, either because it is genetically similar to your cells or the cancer has been modified or evolved in some way to be overlooked by the immune system, I suppose [a cancer] could [happen].

In the case of organ recipients they are being immunosuppressed to help their body accept the new organ—if you were on immunosuppressant drugs and you got a blood transfusion, then [a cancer infection] would be more likely to happen.

Would injecting someone with cancerous cells infect them with cancer?
 There has been a case where a surgeon received a cut during surgery and developed cancer at the site of the cut. And so presumably in that way the cancer cells found a way to implant in his skin and begin to grow.

You cannot catch cancer easily, however. These cases are rare. I know there have been cases in the literature where cancer has deliberately been transmitted between people and it has successfully taken. But it’s a situation where they've been close relatives. Otherwise the immune system would kill the foreign cell.

Would it be possible to induce cancer in someone else—not by giving the person cancer but by exposing him or her to something that causes cancer?
 I suppose it's possible. We know that viruses can cause cancer, for instance. If you could make sure that a cancer-causing virus infected a person, he or she could develop cancer. The same would be true with radiation, asbestos or other carcinogens.

I just can't imagine someone deliberately giving someone else cancer. What a horrible thing to have happen! It had never occurred to me before I had this conversation. But I suppose people have an amazing capacity to do horrible things to each other. I couldn't say it was impossible, but I'd like to think it is highly unlikely.

Food Reward Friday

This week's lucky "winner"... fried Coke!

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Atherosclerosis in Ancient Mummies Revisited

Many of you are already aware of the recent study that examined atherosclerosis in 137 ancient mummies from four different cultures (1).  Investigators used computed tomography (CT; a form of X-ray) to examine artery calcification in mummies from ancient Egypt, Peru, Puebloans, and arctic Unangan hunter-gatherers.  Artery calcification is the accumulation of calcium in the vessel wall, and it is a marker of severe atherosclerosis.  Where there is calcification, the artery wall is thickened and extensively damaged.  Not surprisingly, this is a risk factor for heart attack.  Pockets of calcification are typical as people age.

I'm not going to re-hash the paper in detail because that has been done elsewhere.  However, I do want to make a few key points about the study and its interpretation.  First, all groups had atherosclerosis to a similar degree, and it increased with advancing age.  This suggests that atherosclerosis may be part of the human condition, and not a modern disease.  Although it's interesting to have this confirmed in ancient mummies, we already knew this from cardiac autopsy data in a variety of non-industrial cultures (2, 3, 4, 5).

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Help Your Liver Remove Toxins

In two previous articles (here and here) I examined liver function, detoxification and the environmental chemicals we all encounter. I also addressed serum liver testing and how to monitor your liver function without blood tests. In this article I’ll discuss what you can do to keep your liver in optimal health.

Clean Up Your Environment

There are hundreds of untested chemicals (endocrine disruptors) in our personal care products and cosmetics. There are fumes in household cleaners. There are chemicals like food dyes and additives in food. All these comprise your “body burden” and are known to exacerbate physical symptoms from allergies and asthma to headaches and fatigue.

But is it really possible to eliminate harmful environmental chemicals in this modern world? Not completely, I don’t think; but we can go a long way. Here are some ideas to consider for helping your body cope (the most important first).
 Eat mostly raw, whole foods. Start with fruit/nut smoothies. Drink fresh juice. Do all you can to eliminate processed and “fake” foods that contain additives, dyes and preservatives.
 Choose your personal care products (soap, deodorant, shampoo, face cream, etc.) carefully. All these products with ingredient names that are long and difficult to pronounce are likely to be synthetic chemicals that were never intended to make you healthier. At your health food store you can find natural alternatives containing herbs and plants instead. Expect to pay more for these and be glad you found them.
 Use plastics wisely. Don’t microwave food in plastic containers. Use only glass or BPA-free food containers and baby bottles.
 If you use Teflon pans, avoid heating to where they begin to smoke (generally beyond 450° F) and release toxic gases. Use glass bakeware and stainless steel or cast iron pots and pans.
 Switch from the standard cleaning products (containing chlorine bleach) to vinegar, baking soda and hydrogen peroxide. There is a great recipe for whitening laundry without using chlorine bleach here.
 Avoid toxic pest control in your home and on your lawn, garden or fruit trees.
 Clean your air by ventilating often. The more green plants you have indoors the better, because they serve as natural air detoxifiers.
 Clean your water by getting a shower filter and a drinking water filter.
 Reduce electromagnetic frequencies (EMF) from cellphones, laptops and other machinery that produce or use electricity.

Further Measures

Your liver is the “vacuum cleaner” of your bloodstream. Therefore, fewer toxins in your body cells and fluids allow the liver to more efficiently detoxify.

Drink six 8-ounce cups of water a day to help flush out metabolic by-products (though this really is not going to have a sufficient effect).

If you add lemon to your water, you’ll support phase 2 liver detoxification; but that is still not enough. Add on an exercise routine that causes a good sweat, and you’ll start to move toxins out of your body. Furthermore, a liquid cleanse can really jump-start your health and liver-cleansing function.

A liquid cleanse can be done safely without a doctor’s guidance if you understand some basic rules.

Liquid cleansing can be performed at one of three different intensity levels for three to 10 days or more. The easiest is a fresh juice “feast” with no solid food. The lemonade cleanse described below is one such cleanse. Alternatively, the most intense version of a cleanse consists of a water fast. (You ingest only water.) I recommend that water fasts should be done only under supervision of a healthcare professional.

Depending on the intensity of your cleanse method and your health level, you can expect to experience the symptoms of detoxification that include sweating, increased urination, diarrhea or decreased bowel movement, mild weakness, a change in breath odor, and possibly aches and pains. The aches and pains occur in weaker body areas and only during the first two to three days before improvement ensues. For example, if you have arthritis, then expect your joints to ache. We call this a “Herxhiemer reaction” (feeling worse before feeling better). This is thought to be an effect of tissue cells releasing stored chemical waste.

The Lemonade Cleanse

Ingredients needed:
 Grade B maple syrup. (Do not use grade A or “pancake” maple syrup.)
 Large bag of fresh lemons or limes. (Do not use from concentrate.)
 Cayenne spice. (This may already be in your kitchen)
 Six water bottles so you can prepare several at once and store in refrigerator for up to six hours.

Directions:

Mix the following ingredients into 16-ounce water bottles to desired taste:
 Water. (Nearly fill up bottle.)
 Juice from half to one fresh-squeezed lemon or lime.
 Grade B maple syrup. (Can use stevia drops.)
 Cayenne pepper. (Begin with only a pinch and adjust amount for desired taste; greater cayenne amounts stimulate more cleansing.)

On the second and succeeding bottles, experiment with more or less citrus juice, more or less maple syrup and more or less cayenne. For lunch or dinner, consider using hot water (like a soup broth) with increased cayenne to get a powerful spice taste. Drink six to 12 of these full bottles per day. Remember, this is your food and your drink for each day you are on the liquid cleanse. You will find that your hunger decreases substantially after the third day.

Following a liquid cleanse, you must be careful to return slowly over three to seven days to cleansing foods (mostly raw whole foods). These liver-supporting foods are the raw whole foods. (Have you heard that before?) Some of the more powerful ones are garlic, onions, artichoke, beets, burdock and green leafy vegetables (kale, spinach, beet greens, dandelion greens). Of course, you can eat clean animal meats (organic, free range) and foods with healthy fats (fish, oils, nuts, avocado).

In my next article I’ll go into detail on what liver protective and cleansing supplements you’ll want to know about.

To your ongoing great health and feeling good,
http://hnfshop.blogspot.com/

What Dieting Does To You

Millions of Americans diet to lose weight, eating skimpy portions and struggling to control what they consume. Researchers in the Netherlands, however, find that these diets don’t keep off the pounds. But they do have another big effect.

Dieting, according to this study, produces huge helpings of depression, anxiety, lowered self-esteem and guilt. The Dutch scientists found that dieters, by the end of the day, eat just as much as non-dieters but they just feel a lot guiltier about it.

The researchers conclude: “(Dieting) is not an indicator of actual restricted food intake, but rather a reflection of concerns about food and eating manifested in eating-related guilt.”

The Habit That Doubles Your Risk Of A Fatal Brain Bleed

More than 45 million Americans do this activity every day. And it doubles their risk of a fatal brain bleed from a burst aneurysm.

 

The nasty habit is smoking. Research shows that smoking more than a pack a day doubles your risk of an aneurysm bursting in your brain and killing you.

 An aneurysm is a bulge in a weakened artery, which, if it bursts, causes blood to leak into the brain. The chances of surviving a ruptured aneurysm are only about 50-50; and if you survive, you’ll be disabled for life.

 In the short term, smoking thickens blood and drives up blood pressure, both of which can increase the risk of a brain bleed. These effects can be reversed by stopping smoking.

But smoking also induces permanent changes in the structure of artery walls, say the scientists. These changes may be greater in heavy smokers.

Students Lose Combined 756 Pounds at S.C. Boarding School

 

A dozen Missouri teens shed 756 pounds after spending a semester at a South Carolina boarding school, where getting fit is part of the curriculum.

 

 Set on 43 acres in Bluffton, S.C., Mindstream Academy caters to overweight middle and high school students who are serious about getting healthy but not missing class. The school offers a wide range of activities, from Zumba to horseback riding.

Cameron Larkin, one of the dozen students from Missouri who spent a semester at Mindstream Academy, said he learned how to exercise and build his endurance at the school.

"It's really not easy," he said. "You have to have the confidence to say, 'I can go do this.'"

Cameron, and his friends from Independence, had their nearly $29,000 tuition paid for by the Independence School District, along with their families and several charities.

A typical day at Mindstream Academy begins with stretching, followed by a light half-mile walk or run around the lake, according to the school's website.

Students then go to classes and have a pre-lunch workout, such as martial arts, that helps them focus on proper mechanics, the school said.

PHOTOS: Ups and Downs of Celebrity Weight

During the mid-afternoon, classes break for team sports activities, such as soccer or kick ball.

In the evening, a stroll around campus or a pick-up game of basketball rounds out the day.

At the end of the four month program, the 12 students from Independence shed a combined 756 pounds.

Chelsea Neely, one of the dozen students from Independence, said the investment was worth every penny.

"I've proven to myself that I am important," she said. "And what's to come is the greatest thing."

13 Secrets the Weight Loss Pros Don't Tell You

" Good Morning America" teamed up with Reader's Digest on a special series, " 13 Things Experts Won't Tell You."

This month, Reader's Digest unveils the secrets weight loss professionals won't tell you, like how to maximize your workouts, what may be holding you back from losing weight and how to get the most bang for your buck.


*Special thanks to Sports Club/LA for letting "GMA" film in their San Francisco location.
 1. Do not arrive at a training session in the following states: a. on an empty stomach, b. coming off a cold/stomach bug, or c. on four hours' sleep. It wastes your time and a personal trainer's when your body isn't fueled, hydrated and ready to work.

2. If you find your workouts are getting a little stale, a trainer is a great way to put some pep in your push-ups. If you can't afford one, get some friends together for a small group session. They cost less per person - and working out with friends is proven to improve your commitment and overall weight loss.

3. To kick start your metabolism, opt for intervals. In a recent study, women who did 20 minutes of cycling sprints lost three times as much fat as those who cycled slowly and steadily for 40 minutes.

4.When you hit the point where you think you can't go on, imagine you have a trainer right next to you, cheering for you. Studies show that actively encouraging yourself improves outcomes.

5.You can do OK at the drive thru. There are now some reasonable options if you look for them. Stay away from anything with the word "crispy," steer clear of all mayo-heavy sauces (use mustard instead) and stick to no-fat dressing.

6.Nibble on the move. If you are shopping and fading from hunger, avoid settling in at the food court and, instead, nibble your way through a shopping marathon. Pick up a snack, such as a hot pretzel, a small bag of roasted nuts from a kiosk or even a chicken taco and nibble on the move. Portable meals can still weigh you down, so check calorie counts on your mobile phone before you go.

7. Douse your afternoon slump or hunger pangs with water. The energy drop that hits in afternoon is likely a combination of perfectly natural factors - the results of a light lunch, mild dehydration, a momentarily lack of iron or a crash off that coffee you had at the late-morning meeting. Before wandering to the cafeteria or fridge, start your recovery with a tall glass of water, which boosts your blood flow and, as a side benefit, makes you feel full.

8. It's hard to win against a cookie. While food is not addictive the way cocaine or alcohol is, there are some uncanny similarities. When subjects at Monell Chemical Senses Center in Philadelphia were shown the names of foods they liked, the parts of the brain that got excited were the same parts activated in drug addicts.

9. Your bedroom, not the kitchen might be making you fat. Sleep deprivation upsets our hormone balance, triggering both a decrease in the hormone leptin (which helps you feel full) and an increase of the hormone ghrelin (which triggers hunger). As a result, we think we're hungry even though we aren't - and so we eat. Sleep may be the cheapest and easiest obesity treatment there is.

10. Your weight really is genetic. When scientists first discovered a gene in certain chubby mice, they called it simply the fatso gene. Turns out, people with two copies of the gene were 40 percent more likely to have diabetes and 60 percent more likely to be obese than those without it. Those with only one copy of the gene weighed more too. But your "destiny" is no excuse.

11. Ear infections can taint your taste buds. In one study of more than 6,000 people, researchers found that people over age 35 who had suffered several ear infections had almost double the chance of being obese. Why? These infections can damage a taste nerve running through the middle ear. When researchers found the at former ear-infection patients were a little more likely to love sweets and fatty foods, they theorized that the damaged nerve might cause them to have a higher threshold for sensing sweetness and fattiness.

12. Fat might be your mom's fault. A growing body of science suggests that sugary and fatty foods consumed even before you're born can mess with your weight.

13. At dinner, make yourself useful serving people and cleaning up. It gets you away from your plate, but still makes you a vital part of the meal.

*Web Extra Tips: What Your Personal Trainer Won't Tell You*
If you concentrate on the exercise you are doing with the same intensity as talking about the latest gossip about your life, you would find it easier.
Trainers know you are eating more than you tell them.
It takes more than writing a check or showing up for training sessions to make you fit and healthy. It's what you do before and after you meet with your trainer, including choices with food, alcohol and workouts, and a commitment to a new lifestyle.
Ask you trainer what she or he does to keep educated in the field. An educated trainer will get better results and provide variety to keep you engaged and motivated in your workouts.
When you are late, it is a waste of your money, a waste of my time and disrespectful.
Trainers see through your stall tactics. "I think I need to fill my water bottle." "Let me get a dry towel real quick." "Oh, I need to go to the bathroom again." Nice try. But you're paying for the session, so make every minute count.
There is a difference between pain and burn, and you need to be honest with your trainer about which you're feeling. If you push so hard that you injure yourself, you both lose.
Whatever the text or email says, it can wait until you're done with your workout. And no, you cannot text and put forth 100 percent effort at the same time.
The trainer does not have time to get sick. Cancel your session if you're carrying germs.
Gear matters. Don't expect to get maximum performance and results by working out in the ratty gym shoes and shorts you dug out of that old box of college dorm clothes. Invest in a good pair of sneakers. Your feet and joints will thank you, and so will your trainer.
Remember that a 30-minute session at max effort is better - and cheaper - than 60 minutes of dawdling and half-effort.
Stop whining and push through those last few reps.

Food Reward Friday

This week's lucky "winner"... Yoplait Go-Gurt!

Read more »

Tips and Resources for Good Health & Longer Life Spans

Health (Photo credit: Tax Credits)

Want to live longer? Yes / No..... If Yes.

Then eat less. When animals (as reported in a journal of the National Academy of Sciences) were fed a nutritious, calorie-restricted diet (about 30 percent fewer calories than normal), they experienced less sickness, reduced rates of cancer, less heart disease, and less diabetes, and lived longer.

Researchers believe that if humans would cut out their usual amounts of saturated fats, hydrogenated vegetable oils, pastries, cookies, and other junk food and help themselves to sensible portions of fruits and vegetables instead, they, like the animals in the study, would enjoy improved health.--HealthWise.

Sodas Settle Around the Waistline.
Drinking just one can of sugary soda per day, without adjusting the amount of food eaten or increasing one's exercise level, can add 15 pounds of body weight over a year's time. A 12-ounce can of sugary soda has 150 calories. Americans now drink twice as much sugared soda per person as they did 25 years ago.

Fruit and vegetable juices, and water with a bit of lemon, are great alternatives to the soda habit.--University of Texas Southwestern Medical Center at Dallas.

Pure Water Can Be a Wonderful Doctor!
If you are suffering from fatigue, you feel depressed or too stressed, and you are looking for more energy, water could be just the ticket. Also, if you are interested in losing weight and/or controlling your appetite, if you suffer from dry skin, indigestion, backaches, or headaches, drinking more water might be the solution, at least partly. Water makes up between 70 and 80 percent of our bodies--the blood and brain are 90 percent water! Your cells need it to do everything they're assigned by God, and your kidneys use it to filter out harmful elements. It also helps to lubricate our joints, metabolize fat, keep the brain thinking, and a host of other life-sustaining processes.

Water is a great way to help control one's physical body--as more water consumption typically results in less food consumption. In addition, drinking adequate amounts of water will significantly reduce the daily calories so readily consumed when drinking juice, soft drinks, and milk.

There are several ideas about how much water we need to consume to maintain good health. One rule of thumb is eight ounces a day for every 25 pounds of body weight. You should check with your doctor before changing your diet, but it is a fact that for most people more water will greatly benefit their health.

Your body recycles water in a way only God could have devised, but you will naturally lose water through breathing, sweating, and elimination. To avoid losing excess water, stay away from alcohol, caffeine, and sugar, which slow the absorption of water.--Adapted from Amazing Facts, Inside Report, May/June 2003, p. 30.

More About Fatigue.
75 percent of Americans are chronically dehydrated. In 37 percent of Americans, the thirst mechanism is so weak that it is often mistaken for hunger. Even MILD dehydration will slow down one's metabolism as much as 3 percent. One glass of water shuts down midnight hunger pangs for almost 100 percent of dieters in a University of Washington study. Lack of water is the #1 trigger for daytime fatigue. Preliminary research indicates that 8-10 glasses of water a day significantly eases back and joint pain for up to 80 percent of sufferers. A mere 2 percent drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen or on a printed page. Drinking 5 glasses of water daily decreases the risk of colon cancer by 45 percent, plus it can slash the risk of breast cancer by 79 percent, and be 50 percent less likely to develop bladder cancer.

Why Risk Alcohol?
There is nothing in wine that isn't in grapes, except for the alcohol. You can add a variety of red and purple table grapes to your diet instead of the wine. In addition, berries, plums, currants, and other deep red-blue fruits are also excellent sources of the anthocyanin phenols found in wine. And quercetin, another phytonutrient in wine, is actually more plentiful in apples with skin. Onions, whole buckwheat, oranges, and grapefruits provide some too.

A healthy dose of colorful fruits and vegetables provides an abundance of other health-protective nutrients not found in wine.--Environmental Nutrition.

Change Your Behavior Today!
I do not want to be the person I am (fat, sick, medication dependent, lethargic, incapacitated, etc.). I want my health and personal appearance back.
1. Recognize that you are worth the effort--you deserve the best life possible.
2. Make a list of personal reasons you want to change.
3. Remove obstacles to change--like avoiding friends and family who sabotage you and removing junk food from your surroundings.
4. Surround yourself with healthy foods--stock your kitchen right, find an accommodating restaurant.
5. Commit yourself to change--pick the specific day and do it.
6. Gather all your strength--everything else in your life must be secondary to this effort.
7. Never give in to the old ways--not even once. But, if you make a mistake--it's only one meal (if it is food) --start right in again.
8. Tell others about your changes--they will help keep you on track.
9. Associate with like-minded people--find friends with good habits.
10. Appreciate your success for beating the most powerful enemies in your life.

Tips for Handling Stress.
Regulate your life as much as possible; take some creative control of your activities. Exercise adequately; take a long walk outside if possible, breathe deeply, get some sunlight. Shower regularly and drink plenty of water. Eat nourishing food with an adequate supply of B vitamins. Don't take yourself too seriously. Take time for rest and relaxation. Reach out to help someone. Keep life--present and future--in proper perspective.--A Key Encounter.

Nuts Are Good for You!
Adults who substitute two ounces of almonds for other foods can reduce their LDL cholesterol (the bad kind) by 10 percent in just a month. Almonds are high in monounsaturated fat, a good type of fat also found in avocados, olive oil, and other nuts. When monounsaturated fat replaces saturated or trans fats in your diet, cholesterol levels fall.

Nuts also are a good source of protein. But researchers stress that without substituting nuts for other foods, the resulting weight gain can negate their cholesterol-lowering effect. --Circulation.

The Benefits of Eating Wheat.
An important battle in the war against disease may be whole-grain wheat. While it has long been believed that wheat's fiber content might prevent cancer, new research shows that wheat contains powerful antioxidants that strongly contribute to the prevention of colon cancer, and possibly diabetes and heart disease. These antioxidants are found in the wheat's orthophenols, and orthophenols survive the baking process. --Kansas State University.

A Safe Diet for Everyone.
C. Everett Koop, former surgeon general of the United States, suggests the best menu is a "a varietal diet rich in complex carbohydrates and protein obtained from whole grains, beans, peas, legumes and a selection of root vegetables. Daily servings of leafy vegetables, daily servings of fruit, a few nuts and 8-10 glasses of water."--North Pacific Union Conference Gleaner, October 2002.

Walking--the Perfect Exercise!
There's growing agreement among exercise researchers that the intense physical activities offered by most health clubs are not the only--or even the preferable--path to better health. Indeed, the best thing for most of us may be to just walk.

Yes, walk. At a reasonably vigorous clip (three to four m.p.h.) for half an hour or so, maybe five or six times a week. You may not feel the benefits all at once, but the evidence suggests that over the long term, a regular walking routine can do a world of preventive good.

Walking, in fact, may be the perfect exercise. For starters, it's one of the safest things you can do with your body. It's much easier on the knees than running and doesn't trigger untoward side effects.

Because walking affects you in so many ways at once, it can be difficult to determine precisely why it's good for you. But much of the evidence gathered so far is compelling:

Walking briskly for at least half an hour consumes a couple hundred calories and boosts your metabolic rate for the rest of the day, giving you a better chance of winning the battle of the bulge.

Studies show that women who exercised regularly as children and young adults and had a healthy intake of calcium decreased their risk of developing osteoporosis later in life.

Top 45 Health Tips Ever

 We've done the legwork for you and here they are: the 45 best health tips. Make that 46 - taking the time to read this tops the list.

1. Copy your kitty: Learn to do stretching exercises when you wake up. It boosts circulation and digestion, and eases back pain.

2. Don’t skip breakfast. Studies show that eating a proper breakfast is one of the most positive things you can do if you are trying to lose weight. Breakfast skippers tend to gain weight. A balanced breakfast includes fresh fruit or fruit juice, a high-fibre breakfast cereal, low-fat milk or yoghurt, wholewheat toast, and a boiled egg.

3. Brush up on hygiene. Many people don't know how to brush their teeth properly. Improper brushing can cause as much damage to the teeth and gums as not brushing at all. Lots of people don’t brush for long enough, don’t floss and don’t see a dentist regularly. Hold your toothbrush in the same way that would hold a pencil, and brush for at least two minutes. This includes brushing the teeth, the junction of the teeth and gums, the tongue and the roof of the mouth. And you don't need a fancy, angled toothbrush – just a sturdy, soft-bristled one that you replace each month.

4. Neurobics for your mind. Get your brain fizzing with energy. American researchers coined the term ‘neurobics’ for tasks which activate the brain's own biochemical pathways and to bring new pathways online that can help to strengthen or preserve brain circuits. Brush your teeth with your ‘other’ hand, take a new route to work or choose your clothes based on sense of touch rather than sight. People with mental agility tend to have lower rates of Alzheimer's disease and age-related mental decline.

5. Get what you give! Always giving and never taking? This is the short road to compassion fatigue. Give to yourself and receive from others, otherwise you’ll get to a point where you have nothing left to give. And hey, if you can’t receive from others, how can you expect them to receive from you?

6. Get spiritual. A study conducted by the formidably sober and scientific Harvard University found that patients who were prayed for recovered quicker than those who weren’t, even if they weren’t aware of the prayer.

7. Get smelly. Garlic, onions, spring onions and leeks all contain stuff that’s good for you. A study at the Child’s Health Institute in Cape Town found that eating raw garlic helped fight serious childhood infections. Heat destroys these properties, so eat yours raw, wash it down with fruit juice or, if you’re a sissy, have it in tablet form.

8. Knock one back. A glass of red wine a day is good for you. A number of studies have found this, but a recent one found that the polyphenols (a type of antioxidant) in green tea, red wine and olives may also help protect you against breast cancer. It’s thought that the antioxidants help protect you from environmental carcinogens such as passive tobacco smoke.

9. Bone up daily. Get your daily calcium by popping a tab, chugging milk or eating yoghurt. It’ll keep your bones strong. Remember that your bone density declines after the age of 30. You need at least 200 milligrams daily, which you should combine with magnesium, or it simply won’t be absorbed.

10. Berries for your belly. Blueberries, strawberries and raspberries contain plant nutrients known as anthocyanidins, which are powerful antioxidants. Blueberries rival grapes in concentrations of resveratrol – the antioxidant compound found in red wine that has assumed near mythological proportions. Resveratrol is believed to help protect against heart disease and cancer.

11. Curry favour. Hot, spicy foods containing chillies or cayenne pepper trigger endorphins, the feel-good hormones. Endorphins have a powerful, almost narcotic, effect and make you feel good after exercising. But go easy on the lamb, pork and mutton and the high-fat, creamy dishes served in many Indian restaurants.

12. Cut out herbs before ops. Some herbal supplements – from the popular St John's Wort and ginkgo biloba to garlic, ginger, ginseng and feverfew – can cause increased bleeding during surgery, warn surgeons. It may be wise to stop taking all medication, including herbal supplements, at least two weeks before surgery, and inform your surgeon about your herbal use.

13. I say tomato. Tomato is a superstar in the fruit and veggie pantheon. Tomatoes contain lycopene, a powerful cancer fighter. They’re also rich in vitamin C. The good news is that cooked tomatoes are also nutritious, so use them in pasta, soups and casseroles, as well as in salads. The British Thoracic Society says that tomatoes and apples can reduce your risk of asthma and chronic lung diseases. Both contain the antioxidant quercetin. To enjoy the benefits, eat five apples a week or a tomato every other day.

14. Eat your stress away. Prevent low blood sugar as it stresses you out. Eat regular and small healthy meals and keep fruit and veggies handy. Herbal teas will also soothe your frazzled nerves. Eating unrefined carbohydrates, nuts and bananas boosts the formation of serotonin, another feel-good drug. Small amounts of protein containing the amino acid tryptamine can give you a boost when stress tires you out.

15. Load up on vitamin C.We need at least 90 mg of vitamin C per day and the best way to get this is by eating at least five servings of fresh fruit and vegetables every day. So hit the oranges and guavas!

16. No folly in folic acid. Folic acid should be taken regularly by all pregnant mums and people with a low immunity to disease. Folic acid prevents spina bifida in unborn babies and can play a role in cancer prevention. It is found in green leafy vegetables, liver, fruit and bran.

17. A for Away. This vitamin, and beta carotene, help to boost immunity against disease. It also assists in the healing process of diseases such as measles and is recommended by the WHO. Good natural sources of vitamin A are kidneys, liver, dairy products, green and yellow vegetables, pawpaw, mangoes, chilli pepper, red sorrel and red palm oil.

18. Pure water. Don’t have soft drinks or energy drinks while you're exercising. Stay properly hydrated by drinking enough water during your workout (just don't overdo things, as drinking too much water can also be dangerous). While you might need energy drinks for long-distance running, in shorter exercise sessions in the gym, your body will burn the glucose from the soft drink first, before starting to burn body fat. Same goes for eating sweets.

19. GI, Jane. Carbohydrates with a high glycaemic index, such as bread, sugar, honey and grain-based food will give instant energy and accelerate your metabolism. If you’re trying to burn fat, stick to beans, rice, pasta, lentils, peas, soya beans and oat bran, all of which have a low GI count.

20. Mindful living. You've probably heard the old adage that life's too short to stuff a mushroom. But perhaps you should consider the opposite: that life's simply too short NOT to focus on the simple tasks. By slowing down and concentrating on basic things, you'll clear your mind of everything that worries you. Really concentrate on sensations and experiences again: observe the rough texture of a strawberry's skin as you touch it, and taste the sweet-sour juice as you bite into the fruit; when your partner strokes your hand, pay careful attention to the sensation on your skin; and learn to really focus on simple tasks while doing them, whether it's flowering plants or ironing your clothes.

21. The secret of stretching. When you stretch, ease your body into position until you feel the stretch and hold it for about 25 seconds. Breathe deeply to help your body move oxygen-rich blood to those sore muscles. Don't bounce or force yourself into an uncomfortable position.

22. Do your weights workout first. Experts say weight training should be done first, because it's a higher intensity exercise compared to cardio. Your body is better able to handle weight training early in the workout because you're fresh and you have the energy you need to work it. Conversely, cardiovascular exercise should be the last thing you do at the gym, because it helps your body recover by increasing blood flow to the muscles, and flushing out lactic acid, which builds up in the muscles while you're weight training. It’s the lactic acid that makes your muscles feel stiff and sore.

23. Burn fat during intervals. To improve your fitness quickly and lose weight, harness the joys of interval training. Set the treadmill or step machine on the interval programme, where your speed and workload varies from minute to minute. Build up gradually, every minute and return to the starting speed. Repeat this routine. Not only will it be less monotonous, but you can train for a shorter time and achieve greater results.

24. Your dirtiest foot forward. If your ankles, knees, and hips ache from running on pavement, head for the dirt. Soft trails or graded roads are a lot easier on your joints than the hard stuff. Also, dirt surfaces tend to be uneven, forcing you to slow down a bit and focus on where to put your feet – great for agility and concentration.

25. Burn the boredom, blast the lard. Rev up your metabolism by alternating your speed and intensity during aerobic workouts. Not only should you alternate your routine to prevent burnout or boredom, but to give your body a jolt. If you normally walk at 6.5km/h on the treadmill or take 15 minutes to walk a km, up the pace by going at 8km/h for a minute or so during your workout. Do this every five minutes or so. Each time you work out, increase your bouts of speed in small increments.

26. Cool off without a beer. Don’t eat carbohydrates for at least an hour after exercise. This will force your body to break down body fat, rather than using the food you ingest. Stick to fruit and fluids during that hour, but avoid beer.

27. ‘Okay, now do 100 of those’. Instead of flailing away at gym, enlist the help – even temporarily – of a personal trainer. Make sure you learn to breathe properly and to do the exercises the right way. You’ll get more of a workout while spending less time at the gym.

28. Stop fuming. Don’t smoke and if you smoke already, do everything in your power to quit. Don’t buy into that my-granny-smoked-and-lived-to-be-90 crud – not even the tobacco giants believe it. Apart from the well-known risks of heart disease and cancer, orthopaedic surgeons have found that smoking accelerates bone density loss and constricts blood flow. So you could live to be a 90-year-old amputee who smells of stale tobacco smoke. Unsexy.

29. Ask about Mad Aunt Edith. Find out your family history. You need to know if there are any inherited diseases prowling your gene pool. According to the Mayo Clinic, USA, finding out what your grandparents died of can provide useful – even lifesaving – information about what’s in store for you. And be candid, not coy: 25 percent of the children of alcoholics become alcoholics themselves.

30. Do self-checks. Do regular self-examinations of your breasts. Most partners are more than happy to help, not just because breast cancer is the most common cancer among SA women. The best time to examine your breasts is in the week after your period.

31. My smear campaign. Have a pap smear once a year. Not on our list of favourite things, but it’s vital. Cervical cancer kills 200 000 women a year and it’s the most prevalent form of cancer among black women, affecting more than 30 percent. But the chances of survival are nearly 100 percent if it’s detected early. Be particularly careful if you became sexually active at an early age, have had multiple sex partners or smoke.

32. Understand hormones. Recent research suggests that short-term (less than five years) use of HRT is not associated with an increase in the risk of breast cancer, but that using it for more than ten years might be. Breast cancer is detected earlier in women using HRT, as they are more alert to the disease than other women.

32. Beat the sneezes. There are more than 240 allergens, some rare and others very common. If you’re a sneezer due to pollen: close your car’s windows while driving, rather switch on the internal fan (drawing in air from the outside), and avoid being outdoors between 5am and 10 am when pollen counts are at their highest; stick to holidays in areas with low pollen counts, such as the seaside and stay away from freshly cut grass.

33. Doggone. If you’re allergic to your cat, dog, budgie or pet piglet, stop suffering the ravages of animal dander: Install an air filter in your home. Keep your pet outside as much as possible and brush him outside of the home to remove loose hair and other allergens. Better yet, ask someone else to do so.

34. Asthma-friendly sports. Swimming is the most asthma-friendly sport of all, but cycling, canoeing, fishing, sailing and walking are also good, according to the experts. Asthma need not hinder peak performance in sport. 11 percent of the US Olympic team were asthmatics – and between them they won 41 medals.

35. Deep heat. Sun rays can burn even through thick glass, and under water. Up to 35 percent of UVB rays and 85 percent of UVA rays penetrate thick glass, while 50 percent of UVB rays and 77 percent of UVA rays penetrate a meter of water and wet cotton clothing. Which means you’ll need sunscreen while driving your car on holiday, and water resistant block if you’re swimming.

36. Fragrant ageing. Stay away from perfumed or flavoured suntan lotions which smell of coconut oil or orange if you want your skin to stay young. These lotions contain psoralen, which speeds up the ageing process. Rather use a fake-tan lotion. Avoid sun beds, which are as bad as the sun itself.

37. Sunscreen can be a smokescreen. Sunscreen is unlikely to stop you from being sunburned, or to reduce your risk of developing skin cancer. That’s because most people don’t apply it properly, and stay in the sun too long. The solution? Slather on sunscreen daily and reapply it often, especially if you’ve been in the water. How much? At least enough to fill a shot glass.

38. Laugh and cry. Having a good sob is reputed to be good for you. So is laughter, which has been shown to help heal bodies, as well as broken hearts. Studies in Japan indicate that laughter boosts the immune system and helps the body shake off allergic reactions.

39. It ain’t over till it’s over. End relationships that no longer work for you, as you could be spending time in a dead end. Rather head for more meaningful things. You could be missing opportunities while you’re stuck in a meaningless rut, trying to breathe life into something that is long gone.

40. Strong people go for help. Ask for assistance. Gnashing your teeth in the dark will not get you extra brownie points. It is a sign of strength to ask for assistance and people will respect you for it. If there is a relationship problem, the one who refuses to go for help is usually the one with whom the problem lies to begin with.

41. Save steamy scenes for the bedroom. Showering or bathing in water that’s too hot will dry out your skin and cause it to age prematurely. Warm water is much better. Apply moisturiser while your skin is still damp – it’ll be absorbed more easily. Adding a little olive oil to your bath with help keep your skin moisturised too.

42. Here’s the rub. Improve your circulation and help your lymph glands to drain by the way you towel off. Helping your lymph glands function can help prevent them becoming infected. When drying off your limbs and torso, brush towards the groin on your legs and towards the armpits on your upper body. You can do the same during gentle massage with your partner.

43. Sugar-coated. More than three million South Africans suffer from type 2 diabetes, and the incidence is increasing – with new patients getting younger. New studies show this type of diabetes is often part of a metabolic syndrome (X Syndrome), which includes high blood pressure and other risk factors for heart disease. More than 80 percent of type 2 diabetics die of heart disease, so make sure you control your glucose levels, and watch your blood pressure and cholesterol counts.

44. Relax, it’s only sex. Stress and sex make bad bedfellows, it seems. A US survey showed that stress, kids and work are main factors to dampen libido. With the advent of technology that allows us to work from home, the lines between our jobs and our personal lives have become blurred. People work longer hours, commutes are longer and work pervades all aspects of our lives, including our sexual relationships. Put nooky and intimacy on the agenda, just like everything else.

45. Good night, sweetheart. Rest heals the body and has been shown to lessen the risk of heart trouble and psychological problems.

Top 10 Health Problems in America

According to the Mayo Clinic, the top health problems in America vary slightly between men and women. Men are more likely to commit suicide, and it is the eighth most common health problem for men. Men and women both need to be concerned, however, about the health problems that are common to both of them.



Heart Disease
For both men and women, heart disease kills the largest number of Americans per year. According to the American Heart Association, heart disease, which causes heart attacks and strokes, kills more people than all forms of cancer combined. Quit smoking and eat a diet low in fat and sodium to cut your risk.
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Cancer
Lung cancer is the cancer responsible for the most deaths in both men and women. Women are also affected greatly by breast and colorectal cancers, according to the Mayo Clinic. Reduce your risk of cancers by not smoking, eating a healthy diet, using sunscreen and getting regular cancer screenings.
Stroke

Stroke is the number three cause of death in women, and the number four cause of death in men. Lifestyle changes that can reduce your risk of stroke, according to the Mayo Clinic, include quitting smoking, losing excess weight, exercising and eating a healthy diet.

Respiratory Diseases
Respiratory diseases such as bronchitis and emphysema belong to a class of diseases called COPD, or chronic obstructive pulmonary disease. The National Heart, Lung and Blood Institute recommends quitting smoking to prevent COPD, as it is the largest risk factor.
Injuries

According to the Mayo Clinic, the Centers for Disease Control states that the leading cause of fatal injuries in both men and women is motor vehicle accidents. Wearing your seatbelt, driving safely and not mixing alcohol and driving can prevent these accidents. Other causes of fatal accidents include poisoning and falls.

Diabetes
Type 2 diabetes can cause kidney damage, heart disease and blindness. It is also a leading cause of death in both men and women. Lose extra weight, exercise and eat a healthy diet to prevent diabetes.

Alzheimer's Disease
Alzheimer's disease is the fifth-leading cause of death in women, and the tenth in men. Doctors do not know exactly what causes Alzheimer's disease, but there may be a link between this disease and heart disease, as well as head injuries.
Influenza and Pneumonia

Most healthy people can fight off a simple case of influenza, but in some people, it may cause complications such as pneumonia, which are potentially fatal. Wash your hands frequently and get a flu vaccine each year as recommended by your doctor. Also, ask your doctor if a pneumonia vaccine is right for you.

Kidney Disease
Kidney disease is the ninth-leading cause of death for both male and female Americans. It can be caused by high blood pressure or diabetes, according to the Mayo Clinic. The American Diabetes Association stresses the importance of keeping your blood sugar under control if you are a diabetic in order to prevent kidney disease.

Septicemia
Septicemia, or blood poisoning is the tenth-leading cause of death among women. It is usually a complication of a bacterial infection such as a lung or urinary tract infection. The best ways to prevent septicemia are to wash your hands often, seek medical care for any infections in the body and to change tampons often and avoid using tampons that are more absorbent than you need.

fluenza and Pneumonia
Most healthy people can fight off a simple case of influenza, but in some people, it may cause complications such as pneumonia, which are potentially fatal. Wash your hands frequently and get a flu vaccine each year as recommended by your doctor. Also, ask your doctor if a pneumonia vaccine is right for you.

Kidney Disease
Kidney disease is the ninth-leading cause of death for both male and female Americans. It can be caused by high blood pressure or diabetes, according to the Mayo Clinic. The American Diabetes Association stresses the importance of keeping your blood sugar under control if you are a diabetic in order to prevent kidney disease.

Septicemia
Septicemia, or blood poisoning is the tenth-leading cause of death among women. It is usually a complication of a bacterial infection such as a lung or urinary tract infection. The best ways to prevent septicemia are to wash your hands often, seek medical care for any infections in the body and to change tampons often and avoid using tampons that are more absorbent than you need.

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