U.S. Education Secretary heavily invested in questionable “brain training” clinic. I would call it “Snake Oil of the Brain”

 

The Washington Post has published a detailed report on Neurocore, a “brain performance” company owned by the family of Education Secretary Betsy DeVos. DeVos resigned her Neurocore board seat when she joined the Trump Cabinet, but she and her husband maintain a financial stake between $5 million and $25 million, according to a disclosure statement filed with the Office of Government Ethics. The Neurocore program is claimed to improve brain performance through sessions in which the patient watches television while hooked up to an electroencephalograph (EEG) machine. The report’s author underwent a $250 program evaluation, examined the relevant experimental evidence, interviewed several experts, and concluded:

I’ll admit that before I stepped into Neurocore, I had little intention of signing up for the company’s treatment. I had read too many articles skeptical of brain training to think that I should pay for its services. But it took talking to experts and a visit to Florida to discover that the firm was also hurtful — a Trump University for people with cognitive struggles. By wrapping weak science in sleek packaging, by promising something that it cannot fully deliver, Neurocore offers false hope to people who need honest help. In this regard, what’s most remarkable is that DeVos, the nation’s foremost pedagogue, is behind it all, promoting a form of education that doesn’t actually seem to educate.

After having read this article and coming from a scientific background, I can firmly state that there is nothing to be derived from an EEG that allows for psychological assessment, and therefore, no chance that such “information” could be used for any type of management. I guess one might conclude that this is more “fake news,” this time emanating from the White House!! Does this come as a surprise to any rational person?

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UPDATED INFORMATION ON DIETS: NO NEED FOR FADS

Researchers analyzed nutrition studies in a new review published in the Journal of the American College of Cardiology, which intends to cut through the confusion about the best dietary patterns to reduce cardiovascular disease, our greatest killer. The review concludes that current evidence strongly supports eating plenty of fruits, vegetables, whole grains, legumes, and nuts in moderation. Although more controversial, some heart–healthy diets may also include very limited quantities of lean meat, fish, low–fat and nonfat dairy products, and liquid vegetable oils.

The review examined several of these dietary patterns as well as “hypes and controversies” surrounding nutrition to provide the population with information about dietary habits.

Their advice: “There is a growing consensus that a predominantly plant–based diet that emphasizes green, leafy vegetables, whole grains, legumes and fruit is where the best improvements are seen in heart health.”

Other nutrition topics covered in the review include:

  • Eggs and cholesterol. Although a government report issued in 2015 dropped specific recommendations about upper limits for cholesterol consumption, the review concludes, “it remains prudent to significantly limit intake of dietary cholesterol in the form of eggs or any high cholesterol foods.”
  • Vegetable oils. Coconut oil and palm oil should be discouraged due to limited data supporting routine use. The most heart–healthy oil is olive oil, though perhaps in moderation as it is still higher calorie, research suggests.
  • Berries and antioxidant supplementation. Fruits and vegetables are the healthiest and most beneficial source of antioxidants to reduce heart disease risk. There is no evidence to support adding high–dose antioxidant dietary supplements benefits cardiovascular health.
  • Nuts. Nuts can be part of a heart–healthy diet. But beware of consuming too many, because nuts are high in calories.
  • Juicing. While the fruits and vegetables contained in juices are heart–healthy, the process of juicing concentrates calories, which makes it is much easier to ingest too many. Eating whole fruits and vegetables is preferred, with juicing primarily reserved for situations when daily intake of vegetables and fruits is inadequate. If you do juice, minimize calories by avoiding adding extra sugar or honey.
  • Gluten. People who have celiac disease or other gluten sensitivity (about 1% of the population) must avoid gluten—wheat, barley and rye. For patients who don’t have any gluten sensitivities, many of the claims for health benefits of a gluten–free diet are unsubstantiated and are best ignored .
  • The authors also addressed why there can be confusion surrounding nutrition studies. Unfortunately, many of these studies are funded and/or influenced by the food industry and likely have some bias, or are totally inaccurate.

Confounding the issue further, it’s very hard to separate the effects of specific nutrients in a food. For example, an apple contains many components including proteins, vitamins and fiber..

Many people who eat a healthy diet also have other healthy lifestyle behaviors, such as regular physical activity, getting enough sleep, and not smoking, and it can be hard to pinpoint the diet’s effect separate from these other behaviors. Moreover, some nutrition studies tend to be based on surveys that rely on people’s memories of what they ate, which isn’t always reliable.

The founder of modern medicine, Hippocrates, said, “Let food be thy medicine.” If we can get the population to understand the value of nutrition, they could enjoy a greater reduction of cardiovascular and other diseases, and that is certainly more cost–effective than treating diseases before they are causing symptoms or signs.

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What the American Health Care Act Would REALLY Mean to Society

I have always agreed with most members of our society, as well as the entire western civilization, that healthcare was a right and not merely a privilege. Now I find that most of my fellow physicians’ groups, as well as others, also share the same opinion in principle, as demonstrated by their near universal rejection of the latest healthcare proposal (AHCA) by the Republican house of representatives.

Primarily due to the access issues raised by the bill, primary care medical societies oppose the AHCA, and it is hard to find any mainstream medical group that supports it.

“This bill would dismantle the Medicaid program,” the American Academy of Pediatrics said in a statement. The bill is “an extreme attack on access and coverage for millions of Americans,” the American College of Physicians stated.

The AHCA is “a highly flawed proposal that will destabilize our health care system, cause significant loss of coverage, and allow for the discrimination against patients based on their gender, age, and health status,” the American Academy of Family Physicians stated.

The American Medical Association also came out against the bill, stating “America should not go backward to the time when our fellow citizens with preexisting health conditions faced high costs for limited coverage, if they were able to obtain coverage at all.”

In a March statement on the original bill, the two major US neurosurgery groups (American Academy of Neurological Surgeons and Congress of Neurological Surgeons) said they had not supported the ACA’s Medicaid expansion but they now questioned the AHCA’s plan to roll it back. “Medicaid is an important safety net program for patients with low incomes, and we do not want to see these individuals lose coverage,” they stated.

In its March statement on the bill, the American College of Surgeons (ACS) praised the expansion of Health Savings Accounts (HSAs) but was concerned about the decline in Medicaid funding and regretted the loss of exchange subsidies. This loss could “affect access to surgical care. As a result of the reduction in subsidies, individuals may only be able to afford insurance with high deductibles or, possibly, may not be able to afford any insurance at all,” the ACS stated.

Even the American Academy of Orthopaedic Surgeons (AAOS), which had endorsed the nomination of Dr Price (one of its members), has not supported the bill. “We’re not really in support [of] or against the bill,” an AAOS leader told Medscape in April. “We’re trying to understand it better at this point.” A check of AAOS press releases shows no statements on the bill since then.

Conclusion

The American Health Care Act represents a totally new direction in US healthcare policy, shifting control from the federal government to the states and to the market. It strips away expansions in coverage under the ACA and replaces billions of dollars in subsidies with modest tax credits. Much of organized medicine actively opposes the AHCA, mainly because of its plans to reduce or eliminate coverage of Americans. Many other groups, such as the AARP, also oppose the bill. Although possible, the AHCA will likely not be enacted in its present form. Furthermore, it is highly doubtful that the Senate will offer anything of real substance, but the jury is still out.

FURTHER COMMENT

As I have stated previously, (http://www.mortontavel.com/2015/12/31/), I believe the only viable system, while in need of modification, is that of a “public option,” i.e. Medicare for all.

Let’s demonstrate how deadly the effects of having little or no insurance plays out in the example of breast cancer: According to a recent study involving more than 52,000 individuals, insurance status and certain demographic variables were linked to breast cancer mortality. Participants studied were those diagnosed with breast cancer in 2007 and 2008. Investigators looked at how insurance status and social factors impacted mortality. Among the results:

  • Women who received Medicaid or were uninsured were more than twice as likely to be diagnosed at a later stage, vs those with commercial insurance.
  • Blacks were 18% more likely than whites to experience such delays.
  • Compared with commercially insured patients, death rates from breast cancer in Medicaid and uninsured women were 40% and 60% higher, respectively.Thus even Medicaid, although better than nothing, provides a sub-optimal form of healthcare, further supporting the Medicare concept.

Sadly, this is but one of many examples that could be cited in a society that paradoxically prides itself in providing equal rights for all!

 

 

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DIET SODAS: MORE REASONS TO AVOID THEM

 

Possible cause of strokes and dementia

A new study published in the journal Stroke finds that artificially sweetened beverages are associated with dementia and stroke. Researchers analyzed data from nearly 3000 participants and found that those who consumed 1 or more artificially sweetened beverages per day were more likely to suffer from subsequent dementia and stroke. Interestingly, they did not see the same effects for sugar-sweetened beverages; however, this is anything but a ringing endorsement of these latter drinks! Aspartame, commonly known by the brand name NutraSweet, is the dominant sweetener in these products, and, therefore, may ultimately prove to be the responsible cause, but this awaits further confirmation.

Other studies have also found associations between consuming artificially sweetened beverages and poor health outcomes, and as I have previously noted (http://www.mortontavel.com/2015/03/30/), there is little or no advantage to consuming such beverages in the attempt to lose weight.

Obviously, finding a statistical relationship in such studies does not definitively establish a causative role of such drinks, but it sure should induce some reservations about the consumption of these products.

The bottom line: There is no way to beat drinking drinking plain water, but if you can’t abide by that dictum, how about carbonated water or unsweetened tea?

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SUN EXPOSURE: PROBLEMS AND MYTHS

Are you a person who loves to be tan? Do you wish for the bronzed look of jet-setting celebrities just back from the tropics?

If so, you’re not alone — let’s face it, we’re a culture that’s obsessed with being tan. It’s attractive, fashionable, and a sign of good health, right? Wrong!

Actually, sun exposure or spending time in tanning booths has many health experts worried: it damages skin and increases the risk of skin cancer. The risk rises if tanning leads to a sunburn — according to the American Academy of Dermatology, a single blistering sunburn can nearly double one’s lifetime risk of melanoma, the most deadly form of skin cancer. So, “looking” healthy carries with it a very high price indeed!

The prevalence of skin cancer (and the costs of its treatment) is rising: nearly five million people in the United States will be treated for skin cancer this year (an increase of 50% from the prior decade) at a cost of more than $8 billion (twice the cost of a decade earlier).

The myth of the base tan

Have you heard of the idea of a base tan? It may seem reasonable enough: before you head off to the beach for vacation, getting a tan ahead of time might help you avoid burning, and there’s the added benefit of not looking pale when you first arrive.

So does a base tan prevent burning? Experts estimate that going out in the sun with a base tan is equivalent to wearing a sunscreen with a sun protection factor (SPF) of 3 to 4. This means the skin can be exposed to up to four times more sun before burning than without the base tan. For example, if you would ordinarily burn after 20 minutes in the sun, a base tan might mean you can be in the sun for up to 80 minutes before burning. While it’s better than nothing, it’s a modest benefit; most recommended sunscreens have SPFs of at least 15 to 30. Since wearing sunscreen is much more effective than relying on a base tan to protect you from burning, the real question is whether having a tan on day one of your vacation is worth the time and expense at the tanning salon before you leave.

Tanning among teens is a particular concern

The earlier one starts tanning, the longer the lifetime skin damage and the higher the skin cancer risk. So there has long been worry about teenagers who spend hours tanning outside or in tanning booths. Because of this concern, a number of states have passed bans or restrictions in recent years requiring parental consent for teenagers to use tanning booths. In 2009, only five states had such restrictions; in 2015, 42 states did.

And it’s working. According to a new study of more than 15,000 U.S. high school students, indoor tanning decreased from nearly 16% in 2009 to just over 7% in 2015. But that’s still a lot of kids — a million or so in the U.S. — putting themselves at unnecessary risk.

What about vitamin D?

There’s been controversy for years regarding safe levels of sun exposure. Some suggest that we should not limit sun exposure too much, because the sun helps increase stores of vitamin D by converting inactive forms of the vitamin in the skin to the active form. This reaction takes far less time than tanning. And vitamin D can be good for your bones, your immune system, and perhaps other parts of the body.

Meanwhile, warnings about the dangers of tanning and sun exposure argue that even brief exposure to intense sun can damage skin and increase cancer risk. And, there are other ways to get vitamin D, such as dairy products and supplements. In my view, it makes little sense to justify sun worship by invoking the health benefits of vitamin D.

So what’s a tan-lover to do?

If your goal is to get a good suntan (or to look like you have one the day you arrive at the beach), think about using “sunless” tanning lotions, gels, or sprays that temporarily stain the skin. You’ll still need sunscreen, though, as these products do not protect against sunburn.

Better yet, rethink whether you really need a tan to look good. After all, today’s swarthy glow is tomorrow’s wrinkled, weathered, leathery hide — or worse, skin cancer.

If your goal is to prevent sunburn, there are better options than getting a base tan:

  • Stay out of the sun when the sun in most intense (from about 10 a.m. to 3 p.m. in most of the United States).
  • Use sunscreen liberally: choose a sunscreen that offers an SPF of at least 15 to 30 and protects against both UVA and UVB radiation. (This is also called “broad spectrum.”) Re-apply at least every two to three hours, more often if you’ve been sweating, swimming, or rubbing your skin with a towel.
  • Wear protective clothing: a long-sleeved shirt, wide-brimmed hat, and long pants offer good protection from sun exposure. Dark fabrics that are tightly woven are best.

These measures are most effective in combination, and are particularly important for children or for anyone with fair skin. Remember that you can burn even on cloudy days. Check your local UV index, which predicts the level of UV radiation and indicates the risk of overexposure on a scale from 0 (low) to 11 or more (extremely high). The National Weather Service calculates the index for most ZIP codes. You can search for the UV index in your ZIP code on the Environmental Protection Agency’s website, or download its mobile app. This advice presupposes that Trump hasn’t trashed this department before you get there!

What’s next?

As with most public health worries, we need more research. For example, how do you know when you’ve had too much sun? It’s not always easy to know when you’ve been out too long and passed the point of no return for a sunburn.

We need more education to correct misconceptions about tanning (such as the myth of the “healthy tan” or the benefits of the base tan), and we need to teach kids, parents, and schools that teens should avoid too much tanning, whether indoors or outside.

 

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