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5 ways to protect your vision – Medical News Today

Your eyes play a significant role in your health. Many steps can be taken to ensure that your eyes are protected and remain as healthy as possible. We have selected the best vision-boosting tips to help you protect your eyes into your golden years.

Many steps can be taken to ensure that your eyes are protected from disease and damage.

Millions of individuals experience eye problems each year. Some eye issues result in permanent vision loss or blindness, while others can be corrected with contact lenses or glasses.

The National Eye Institute estimate that in the years between 2010 and 2050, the number of individuals affected by the commest eye diseases — including age-related macular degeneration (AMD), cataracts, diabetic retinopathy, and glaucoma — “will double.”

Many of us are resigned to the fact that as we age, our eyesight will deteriorate. But could we improve our vision, protect our sight, and prevent many of the diseases that compromise the health of our eyes?

Medical News Today present five ways to protect your eyes from damage and disease and maintain healthy sight.

1. Go for regular eye exams

The best thing you can do to look after your sight is to go for regular eye tests.

Go for regular eye checks with a trained eye specialist who can detect early signs of problems.

Although your vision may appear to be healthy, there is no way to be 100 percent certain unless a trained professional observes your eyes.

Not only does an eye test determine whether or not you need glasses, but it can also spot eye conditions that can be treated effectively if detected early enough.

A type of eye exam known as a comprehensive dilated eye exam is recommended from the age of 60 upwards, or earlier if you are at an increased risk of certain eye diseases.

During a comprehensive dilated eye exam, an eye care specialist adds drops into each eye to widen, or dilate, the pupil. Once dilated, more light enters the eye, which enables the eye care professional to view the macula, retina, and optic nerve and identify any signs of damage and disease.

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2. Eat vision-healthy foods

It is possible to eat your way to healthy vision. You often hear that eating carrots benefits the eyes, but there are plenty of other foods that are important for good eyesight, too.

Eating grapes has been tied to a lower risk of AMD.

Consuming a diet rich in fruits and vegetables has been shown to promote eye health. Dark leafy greens, in particular — including collard greens, kale, and spinach — contain lutein and zeaxanthin, which are antioxidants that help to prevent the formation of cataracts.

Evidence demonstrates that grapes may also support healthy eyes. In a laboratory model of retinal degeneration, scientists showed that a diet enriched with grapes protected the retina against the damaging effects of oxidative stress.

Other research indicated that grapes provide higher levels of antioxidant protection for eyes than lutein alone and may slow or help to prevent AMD.

Studies have found that there are eye health benefits from consuming fish rich in omega-3 fatty acids, such as salmon, halibut, mackerel, sardines, and tuna.

Omega-3 fatty acids may improve ocular surface inflammation and symptoms of ocular irritation that are associated with moderate to severe dry eye. They may also help vision cells to survive future disease or injury.


3. Keep your weight under control

Being overweight or obese puts you at a higher risk of developing conditions such as diabetes or other systemic disorders, which may eventually lead to vision loss.

Maintain a healthy weight to avoid obesity-related eye conditions.

It is never too late to get your weight under control by eating a healthful diet and exercising regularly to prevent vision complications.

Research conducted by the University of Melbourne in Australia and Leeds Beckett University in the United Kingdom discovered that considerable weight loss could potentially reverse eye damage caused by diabetes, high blood pressure, and obesity.

Another study recently presented at the 121st Annual Meeting of the American Academy of Ophthalmology, held in New Orleans, LA, reported that individuals who are physically active have a 73 percent lower risk of developing glaucoma than more sedentary individuals. This finding highlights the importance of leading an active lifestyle.

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4. Wear sunglasses when outside

In addition to being a trendy fashion accessory, the most important role of sunglasses is to protect your eyes from the ultraviolet (UV) rays emitted by the sun.

Wear sunglasses to protect your eyes from the sun’s UV-rays.

A report by the Vision Council in 2016 revealed that while three quarters of people in the U.S. were concerned about eye issues that may arise from UV rays, only 31 percent protect their eyes with sunglasses when they go outside.

When selecting sunglasses, never opt for style over safety. Look for shades that block 99–100 percent of UVA and UVB radiation and always buy from a reputable source.

Whether you are heading to the beach, surfing some waves, hiking up a mountain, or cheering for your favorite soccer team, be sure to protect your eyes and wear the appropriate sunglasses.


5. Rest your eyes regularly

If you work all day at a computer screen, you may forget to blink often and end up with fatigued eyes by the end of the day. The National Eye Institute suggest implementing a 20-20-20 rule.

Get outside as much as possible to prevent short-sightedness.

For every 20 minutes that you spend staring at a screen, look at something else that is around 20 feet in front of you for 20 seconds to reduce eye strain.

Research indicates that half of the world will be short-sighted by 2050 if we continue with the current trend of spending so much time on near-based electronic devices.

The study, which was published in the journal Ophthalmology, suggests that spending more time outdoors and less time doing activities that require constant up-close focusing could be a strategy that may help to reduce the number of people who experience vision loss.

If you need to wear protective eyewear or glasses as part of your job, get into the habit of wearing the appropriate gear at all times to keep your eyes in tip-top shape and prevent damage or eye strain.

Article source: https://www.medicalnewstoday.com/articles/320626.php

Insider tips to maximize your doctor visit

Here’s what Harvard physicians advise you to do at your next appointment.

You know the routine: you’re waiting in the exam room, and your doctor comes in for what seems like a very quick visit before leaving to see the next person. You’re left feeling that you didn’t ask all of your questions or get a good understanding of your treatment plan. What happened?

“We’re under incredible pressure, and we’re scrutinized to be sure we’re seeing enough patients,” explains geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School. “We don’t have many minutes, and yet we have to go over each person’s medical issues, medications, and even end-of-life issues. That doesn’t leave a lot of time to talk.”

Article source: https://www.health.harvard.edu/staying-healthy/insider-tips-to-maximize-your-doctor-visit

Trump’s ‘excellent’ health report called out as fake news on late-night TV circuit

Comedians took aim at President Donald Trump’s doctor on Tuesday after he said the president’s “overall health is excellent,” according to his recent physical assessment.

Dr. Ronny Jackson shared the outcome of Trump’s exam at a White House press briefing on Tuesday afternoon, including his 6-foot-3 height and 239-pound weight, which puts him right on the brink of obesity.

“That’s awfully convenient,” Stephen Colbert, host of “The Late Show,” said Thursday in his opening monologue, before going on to insinuate that Trump may have bribed the doctor with cash.

“Listen, Doc, I don’t want to be obese, but I feel like this wad of cash is about one pound. Why don’t you take this off my hands and weigh me again, OK,” Colbert said in his best Trump impersonation.

Jimmy Kimmel also opened “Live” with a few jokes on the president’s weight.

PHOTO: President Donald Trump and Melania Trump pass out food and meet people impacted by Hurricane Harvey during a visit to the NRG Center in Houston, Sept. 2, 2017.Susan Walsh/AP
President Donald Trump and Melania Trump pass out food and meet people impacted by Hurricane Harvey during a visit to the NRG Center in Houston, Sept. 2, 2017.

“Despite the fact that he is borderline obese, Trump is in excellent health. How could he be in excellent health? When he sneezes gravy comes out. Look at him,” Kimmel joked.

“The doctor said the is examination went exceptionally well, which means he stopped eating chicken long enough to get a reading,” Kimmel added, referring to Trump’s reported love of junk food.

Over on “The Daily Show,” host Trevor Noah said he still had a few questions about the health report.

“So it turns out, according to the official White House doctor, Trump is completely sane, which makes me more worried because that means he’s doing all of this s–t on purpose,” Noah said. “You covfefe in your normal mind?

“No heart problems, no dementia, no dentures? But did you test for racism,” he asked sarcastically.

Article source: http://abcnews.go.com/US/trumps-excellent-health-report-called-fake-news-late/story?id=52398094

Trump’s health report raises questions for late-night hosts

Trevor Noah, Stephen Colbert, and Jimmy Kimmel all have questions for the official White House physician, Dr. Ronny Jackson, who determined President Donald Trump to be in “excellent” health after his first physical as president.

“No heart problems, no dementia, no dentures? But did you test for racism?” Noah asked during a segment on The Daily Show Tuesday. But more concerning for the late-night TV host is what Trump’s flourishing health actually means.

“So it turns out, according to the official White House doctor, Trump is completely sane, which makes me more worried because that means he’s doing all of this s— on purpose?!” he said. “You ‘covfefe’ in your normal mind? Because to us, the non-experts, the only thing that looks healthy about Donald Trump is that he’s shaped like a food pyramid, right? To say that his health is excellent, it’s like medicine is gaslighting us now. I mean, how is this even possible?”

Even Dr. Jackson, who performed the exam, couldn’t determine the exact reason for Trump’s health score. When asked by a reporter how Trump could be in as good of health as Jackson says he is when the president “eats McDonald’s and fried chicken and all those Diet Cokes and never exercises,” he said, “It’s called genetics. I don’t know. Some people just have great genes.”

“Okay, great genes,” Colbert quipped on The Late Show, “but he can’t fit in them.”

Trump’s check-up — which included a cognitive test the president passed — came after Michael Wolff’s book Fire and Fury: Inside the Trump White House questioned his mental capacity. Colbert, though, is still skeptical of these new health results.

For one, Jackson told the press that Trump stands at 75 inches (6 feet 3 inches) and weighs 239 pounds. “According to the body mass index by the Federal Health and Human Services Department, Trump is overweight and just one pound shy of obesity,” Colbert said. “One pound shy of being obese! That’s awfully convenient.”

Even more perplexing for Colbert is that “despite all evidence, Donald Trump does have a heart.”

“How can he be in excellent health? When he sneezes, gravy comes out of his mouth,” Kimmel mocked on Jimmy Kimmel Live. “A quick way to figure out Trump is not in excellent health is to look at him.”

The host then put on a spoof of the White House press briefing to declare “President Trump’s hair has taken over his brain.”

“Our tests have discovered that the chemical used in his preferred shade of Just For Men, which is Burnt Marshmallow, has combined with the high levels of French-fry oil in his blood to create a hair parasite — or hairasite,” the fake doc said before he was literally devoured by the sentient hair.

Watch more of late-night TV’s reaction to Trump’s health report above.

Article source: http://ew.com/tv/2018/01/17/trump-health-report-trevor-noah-stephen-colbert-jimmy-kimmel/

EPA eases path for new chemicals, raising fears of health hazards

WASHINGTON — The Environmental Protection Agency is shifting course under the Trump administration on how it assesses new chemicals for health and environmental hazards, streamlining a safety review process that industry leaders say is too slow and cumbersome.

But some former EPA officials, as well as experts and advocates, say the agency is skipping vital steps that protect the public from hazardous chemicals that consumers have never used before, undermining new laws and regulations that Congress passed with overwhelming bipartisan support in 2016.

According to these critics, that could mean that manufacturers might get approval to introduce a new chemical for one purpose, without getting a thorough, timely review of the chemical’s safety if it is later used for a different purpose. Asbestos, for example, was commonly used in building insulation before the EPA cracked down on its use, but the carcinogenic chemical is still found in brake pads for automobiles — posing hazards for garage mechanics — and is widely used to manufacture chlorine.

Image: TPC petrochemical plant


Image: TPC petrochemical plant

In recent months, the EPA has quietly overhauled its process for determining whether new chemicals — used in everything from household cleaners and industrial manufacturing to children’s toys — pose a serious risk to human health or the environment. Among other changes, the agency will no longer require that manufacturers who want to produce new, potentially hazardous chemicals sign legal agreements that restrict their use under certain conditions.

Such agreements, known as consent orders, will still be required if the EPA believes that the manufacturer’s intended use for a new chemical poses a risk to the public health and the environment. But the agency won’t require consent orders when it believes there are risks associated with “reasonably foreseen” uses of the new chemical — ones that go beyond what a manufacturer says it’s intending to do, but which the agency believes are reasonable to anticipate in the future.

Instead the EPA will rely on a broader measure, known as significant new-use rules, to regulate chemicals that are likely to pose a risk if they’re used for a different purpose. The agency typically has to issue these rules whenever they want to restrict the broad use of potentially hazardous chemicals, since consent orders apply only to a single manufacturer.

Eliminating consent orders in these cases would be “more efficient,” said Jeff Morris, director of the EPA’s toxics program. He laid out the agency’s shift to significant new use rules at a public meeting in early December: “It’s our belief that they could be equally protective but eliminate this one step.”

Chemical industry lobbyists had pushed for the change, arguing that the EPA’s rising use of consent orders was unwarranted. Chemical manufacturers “are burdened by the delay of waiting for EPA to draft the orders, negotiating them with EPA, and then waiting for EPA to issue the orders,” the American Chemistry Council, the industry’s largest trade association, told the agency days before President Donald Trump took office.

But consumer advocates, along with some former agency officials and research experts, believe that EPA’s moves are sabotaging a safety review process that Congress had taken great pains to bolster. Richard Denison of the Environmental Defense Fund, an advocacy group, points out that the 2016 law requires the EPA to assess the broad use of chemicals because manufacturers frequently find different uses for hazardous substances over time, as in the use of asbestos.

“EPA is explicitly disavowing and downplaying a tool that’s really been a cornerstone of new chemical regulation,” said Bob Sussman, a former EPA attorney under Obama and counsel for the Safer Chemicals, Healthy Families coalition, which represents environmental and public health advocates. “We believe EPA is taking a big step backward in the protection of health and the environment without an offsetting benefit.”

‘Playing a dangerous game’

Under EPA administrator Scott Pruitt’s leadership, the agency has taken major industry-friendly steps to loosen its regulation of legacy chemicals. Last year, the EPA delayed bans on chemicals already in widespread use, including a lethal substance in paint strippers and a pesticide linked to developmental disabilities in children.

But the agency is also overhauling its process of reviewing new, unproven chemicals that have yet to hit the marketplace. The changes come in the wake of intense lobbying by the chemical industry, which complained that the EPA was taking too long to clear innovative new products for commercial use that the industry considered safe.

Image: Environmental Protection Agency (EPA) Administrator Scott Pruitt testifies about the fiscal year 2018 budget


Image: Environmental Protection Agency (EPA) Administrator Scott Pruitt testifies about the fiscal year 2018 budget

“We were very concerned as an industry — that was one of our top priorities when I talked to the administration,” said Robert Helminiak, a lobbyist for the Society of Chemical Manufacturers and Affiliates, who met with Pruitt last year.

When the Trump administration took office, the EPA was facing a serious backlog of new chemicals awaiting safety reviews. About 600 cases had piled up after Congress approved the sweeping reforms to the 1976 Toxic Substances Control Act (TSCA), which passed in June 2016 after decades of deliberation and was called the Frank R. Lautenberg Chemical Safety for the 21st Century Act, after the Democratic senator from New Jersey.

For the first time, the EPA under the act was required to make an explicit determination that a new chemical was safe before it could be sold to consumers, using stricter criteria to evaluate their health and environmental risks. The new law also required the EPA to evaluate the risks of chemicals already in commercial use, by specific deadlines.

At the urging of industry, Pruitt promised to expedite the post-Lautenberg review process for new chemicals “to make the process faster and more efficient, while ensuring chemical safety.” With great fanfare, he announced the EPA had cleared its backlog in August and unveiled its early reforms to the safety review process.

But some public-health experts and former officials say that the EPA’s efforts to streamline the program are undermining its newly expanded authority to require testing when it believes there is insufficient data, or when future uses may pose a risk.

“What I’m observing is an effort by the agency and also some in the industry to turn back the clock and behave as though the Lautenberg Act was never passed in the first place,” said Lynn Goldman, dean of George Washington University’s school of public health and a former EPA official under Clinton. “The agency has been granted more authority to do testing, then it put hands in its pockets and said it doesn’t want to use this authority.”

Critics say there’s a big difference between the consent orders they want the EPA to issue and the agency’s proposed alternative. Consent orders often include mandatory testing of new chemicals for potential health and environmental hazards. By contrast, significant new-use rules typically don’t require testing, though they can recommend that it should happen in the future if a manufacturer wants to use a restricted chemical.

At that point, however, the harm may have already been done, says Veena Singla, an environmental health researcher at the University of California, San Francisco. “Chemicals do end up being used for many different applications than what the manufacturer originally thought or intended,” she said. “After the fact, we’ve seen what the problem is: The chemical is out there.”



The Trump administration says that its safety reviews will be just as robust under its changes to the program. If a manufacturer wants to use a chemical for a new purpose that might be risky — say, by putting the substance in water — it’s still legally required to seek the EPA’s approval if there are significant new-use restrictions in place. The EPA can then mandate more testing at that point, said Morris: “The end result is that there would be the same amount of testing.”

But public-health advocates say there’s no guarantee that the EPA will require the same testing further down the line, arguing that consent orders provide far more assurance that the agency is properly scrutinizing toxic substances. They now fear that the EPA will go even further to relax the law: The agency is currently deciding whether it will allow manufacturers to commercialize new chemicals while it is still hammering out the rules restricting future, reasonably foreseen uses — something that industry groups are currently pushing for.

If the EPA lets these chemicals on the marketplace early, then it will be “blatantly violating the law” that Congress passed to tighten these safety reviews, said Sen. Tom Udall, D-N.M., who co-authored the Lautenberg Act and help push it into law after Lautenberg’s death in 2013.

The new law requires the EPA “to review the safety of all uses of a new, and potentially dangerous, chemical before allowing it to be sold to consumers, not just selective uses,” said Sen. Tom Carper, D-Del., the top-ranking Democrat on the Senate Environment and Public Works Committee. If the agency allows a chemical to be sold before putting all its restrictions into place, that “contradicts the spirit and letter of the law,” he added.

“This may please Pruitt’s corporate allies, but it is playing a dangerous game, with the safety of millions of Americans at stake,” Udall said.

‘Regrettable substitutions’

Consumer advocates say that it’s critical for the EPA to be aggressive about putting the 2016 law into effect, given the agency’s past failures to protect the public from toxic chemicals.

Older flame retardants linked to cancer were phased out in the 1970s, only to be replaced by new flame retardants that were also linked to cancer, hormone disruption and development problems, despite passing the EPA’s safety review process.

Image; GenX Protest


Image; GenX Protest

Other “regrettable substitutions” include BPA, which was intended to be a safe replacement for bisphenol-S; and GenX, a substitute for a carcinogenic substance used to make Teflon, only to be later linked to cancer as well. Right before Trump took office, the federal government agreed to pay more than $2 billion to veterans who developed leukemia, liver cancer and Parkinson’s disease after exposure to GenX-contaminated water at a North Carolina military base.

Such horror stories helped build broad bipartisan support for the 2016 overhaul, which Congress passed on a nearly unanimous vote. Under the old regime, the EPA didn’t have to sign off on new chemicals if it concluded that they were likely to be safe. If the manufacturer never heard anything from the agency within 90 days, it could go ahead and start making its new product. Under the new law, the EPA has to make an affirmative decision that a new chemical is safe before it can be commercialized — the crux of its new safety review process.

Getting to market sooner

The chemical industry, however, insists that the 2016 overhaul was never intended to make radical reforms across the board. The new law “really doesn’t do very much for new chemicals — the process was the part of TSCA that was really working pretty well,” Helminiak said.

Before the EPA had unveiled its Trump-era changes, industry groups argued that the agency was taking a needlessly draconian approach toward new chemicals reviews, requiring consent orders where none were necessary. When a manufacturer wants the EPA to approve a new chemical, it describes its intended use for the substance. So the EPA “accomplishes nothing useful” by subjecting them to consent orders for other purposes they have no intention of pursuing, the American Chemistry Council (ACC) said in January. Instead, it would simply burden manufacturers with onerous testing requirements and other conditions that make it harder for them to sell innovative new products, industry groups said.

The EPA’s new approach is likely to reduce the testing that manufacturers who first bring these new chemicals to market are required to do. Using significant new-use rules (SNURs) “reduces the testing that the EPA is seeking to impose, because testing is rarely required in a SNUR,” said Richard Engler, a former EPA scientist who now works for Bergeson Campbell, a law firm that represents chemical manufacturers. “If someone is of the view that every consent order should have testing in it, then yes, switching to SNURs is going to produce less data,” Engler said, though he believes EPA’s new approach will be just as protective.

But industry groups say the agency still hasn’t gone far enough to speed up the safety review process, warning that the latest reforms could bring their own delays.

Significant new-use rules can take far longer to finalize than consent orders, since they are regulations subject to a public notice and comment period. If the EPA determines that a new chemical is safe for its intended use, a manufacturer should be able to start making and selling that product immediately, without waiting for the EPA to finalize its new rules for separate, reasonably foreseeable uses, said the ACC’s Michael Walls: “There’s got to be a way to get to market earlier.”

Denison of the Environmental Defense Fund warns the EPA against giving the green light too early. Even if a company sticks to the use of a chemical that the agency has deemed safe, it can’t predict what other parties might do with it once it’s on the market, said Denison: “Companies say they can’t control how chemicals are being used.”

‘This EPA has worked very well with industry’

The EPA says that it’s still deliberating how long manufacturers will have to wait to bring their new chemicals to market. “This is an area that we are discussing,” Morris said in December.

Consumer advocates fear the EPA will ultimately heed industry’s call. Under the new administration, industry heavyweights have been able to appeal directly to their former colleagues: Trump appointee Nancy Beck, a former senior executive at the ACC, is now a top deputy for the EPA’s chemical safety office. Trump’s nominee to lead the office, Michael Dourson, spent decades conducting industry-friendly research for the ACC and Dow Chemical, among others. He worked as a senior EPA adviser for months before withdrawing his nomination in December, under fire for his industry ties.

Image: Nancy Beck


Image: Nancy Beck

In recent months, the agency has worked closely with the ACC to revamp the paperwork that manufacturers must submit to get new chemicals approved. With the group’s help, the EPA consulted three industry giants — Dow Chemical, Procter Gamble, and the BASF Corporation — to revise its new chemical application process.

“It’s always important to get feedback from companies using the document,” David Tobias, an EPA scientist, said at the agency’s December meeting. “We’ve already made some changes based on this consultation.” (The EPA declined to specify the changes it’s made and said it is working with “a variety of stakeholders” on the new chemicals program.)

Industry groups say they’re hardly getting a free pass: From their perspective, the EPA hasn’t hesitated to tighten its scrutiny of new chemicals, placing more stringent restrictions on their use and expanding the scope of their reviews. But they acknowledge that Pruitt’s EPA has been receptive to their concerns.

“This EPA has worked very well with industry,” Helminiak said. “They really have certainly listened to what the specialty chemical industry has to say.”

Article source: https://www.nbcnews.com/news/us-news/epa-eases-path-new-chemicals-raising-fears-health-hazards-n838201

Amazon is hiring a health privacy expert for ‘new initiative’

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Amazon is hiring a health privacy expert for 'new initiative'


Amazon is looking to hire an expert in a set of health privacy regulations known as HIPAA, according to a new job listing.

The company is looking for a professional who can “own and operate” the security and compliance aspects of a new initiative. The person will also ensure that it meets HIPAA business associate agreement requirements, meaning Amazon intends to work with outside partners that manage personal health information.

It is also hoping the new hire will provide a consultative resource for all health-care regulatory issues.

Amazon is the latest technology company, after Apple and Alphabet, to make moves in health care. As CNBC reported in spring 2017, the company strategized how it could carve out a slice of the multibillion-dollar pharmacy market. It also has a health-care team at Amazon.com in Seattle, known by many names including “1492.”

One more immediate reason that Amazon might be looking for a health privacy expert is to augment its efforts to bring its Alexa voice assistant to health care.

The technology is not yet HIPAA compliant, which means developers aren’t able to record patients’ lab results or other types of health information in a clinical setting.

Amazon Web Services’ health lead acknowledged the gap in September at an event to promote Alexa in hospitals. “While Alexa and Lex (the technology powering Alexa) are not HIPAA-eligible, this (challenge) has provided us an opportunity to envision what is possible,” she said.

In the summer, Amazon hired Missy Krasner, herself an expert in health policy, who formerly ran Box’s health care initiatives.

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Doctor Declares Trump’s Health Excellent, With Perfect Score on Cognitive Test

But he did say that Mr. Trump’s weight is 239 pounds and that he is too sedentary. His cholesterol is too high, despite taking medicine to lower it, and Dr. Jackson said Mr. Trump would be increasing the 10-milligram dosage of Crestor to better control it.

At 6 feet 3 inches tall, Mr. Trump has a body mass index of 29.9, which is just shy of officially being obese. A New York driver’s license issued in 2012 listed him as 6 feet 2 inches tall, which would put him just into the obese category.

“The president, he and I talked,” Dr. Jackson said. “He would like to lose 10 to 15 pounds. We talked about diet and exercise a lot. He’s more enthusiastic about the diet part than the exercise part, but we’re going to do both.”

Dr. Jackson said that despite expressions of concern, a cognitive test was not indicated for Mr. Trump and he had not planned to conduct one at the Walter Reed National Military Medical Center in Bethesda, Md., where the president underwent his annual physical on Friday.

“This has been the narrative for a while. He saw doing the physical as an opportunity to put some of that to rest,” Dr. Jackson said during a nearly hourlong question-and-answer session in the White House briefing room. “He actively asked me to include that in it, so we did.”

Dr. Jackson said that Mr. Trump received a score of 30 out of 30 on the Montreal Cognitive Assessment, a well-known test regularly used at Walter Reed and other hospitals.

The test is described as a “rapid-screening instrument for mild cognitive dysfunction” that focuses on “attention and concentration, executive functions, memory, language” and other mental skills. It asks patients to repeat a list of spoken words, identify pictures of animals like a lion or a camel, draw a cube or draw a clock face set to a particular time.

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Dr. Jackson said the president did “exceedingly well” on the screening test, adding evidence to the doctor’s own assessment that the president has been “very sharp” during numerous interactions he has had with him during the past year.

Psychiatric experts said the brief, 10- to 15-minute screening test is not comprehensive and might not catch all patients with early stages of dementia. Dr. Bandy Lee, the author of “The Dangerous Case of Donald Trump,” which expresses concern about the president’s mental health, said in a brief interview that the president requires a full, detailed neuropsychiatric evaluation.

However, Dr. Jackson said he had observed Mr. Trump closely, often several times a day, for the past year, and was satisfied that the Montreal test is “sensitive enough” to have picked up serious cognitive issues if they were present.

Asked about a much-discussed episode in which the president seemed to slur his words during a televised speech in December about the Middle East, Dr. Jackson said that he and his team of a dozen specialists conducted several tests, including an ultrasound of his carotid arteries, to determine whether there might be a clinical explanation.

Dr. Jackson said that the tests all were normal, leading him to believe that the slurred words might have been caused by Sudafed, a medicine for nasal congestion, that he prescribed for the president. He said Mr. Trump does not wear dentures “of any kind,” a popular theory on Twitter for the slurred words.

In response to speculation on television and elsewhere that the president has mental health problems, Dr. Jackson said, “In my opinion, that’s just tabloid psychiatry.”

The president’s most fierce critics are unlikely to be satisfied by Dr. Jackson’s pronouncements, but even top aides to former President Barack Obama were quick to praise Dr. Jackson, who also served as the White House physician to Mr. Obama.

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“Dr. Jackson is a phenomenal doctor and a really great guy,” Dan Pfeiffer, Mr. Obama’s senior adviser, posted Tuesday on Twitter. “He and his team took great care of all of us for many years.”

Dr. Jackson said several times that he did not hold back any information about the president’s health or the medicines he takes. He said the president had urged him to be forthcoming.

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“He said, ‘I want you to get out there, and I want you to talk to them, and I want you to answer every question that they have,’” Dr. Jackson said, adding that Mr. Trump told Sarah Huckabee Sanders, the White House press secretary, not to pull the doctor off the podium until reporters were finished.

Overall, Dr. Jackson repeatedly said he was impressed by the president’s health, saying tests revealed no evidence of cancer, lung problems, diabetes or joint problems. Tests of the liver, kidney and thyroid were all normal.

In addition to the cholesterol medicine, Mr. Trump takes small doses of aspirin for heart health and a small dose of Propecia, a medicine to treat male-pattern baldness.

Dr. Jackson said tests of the president’s heart indicated “excellent” cardiac health, especially for someone of his age. An echocardiogram showed that he had normal function of his main pumping chamber, at 60 to 65 percent. Mr. Trump also performed above average on a treadmill exercise test.

The president’s cholesterol was elevated, at 223, with an LDL measurement of 143 and an HDL level of 67. Dr. Jackson said that he hoped the higher dose of Crestor would help Mr. Trump lower his LDL to under 120 over the next year.

Dr. Richard A. Chazal, the immediate past president of the American College of Cardiology and the medical director of the Heart and Vascular Institute for Lee Memorial Health System in Fort Myers, Fla., called the report of Mr. Trump’s health “very reassuring.”

Based on the information Dr. Jackson provided about the president’s cholesterol, Dr. Chazal said the decision to increase the statin drug the president is taking is “thoughtful” and “a very reasonable approach.” Speaking of the remainder of the laboratory tests, “all else is very favorable,” Dr. Chazal said.

In December 2015, Dr. Harold N. Bornstein, Mr. Trump’s personal doctor, released a four-paragraph letter saying that, if elected, Mr. Trump would be “the healthiest individual ever elected to the presidency.”

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Dr. Jackson declined to repeat that statement, saying that it was his job to “give you my assessment of President Trump today.

“And I’m not going to make any comparisons with presidents over the last 200 years or anything,” he said.

Dr. Jackson said the president sleeps only four to five hours a night, but he said he was not concerned about it. He said he rarely sees the president overly stressed, saying that Mr. Trump “has a unique ability to just get up in the morning and just reset. He gets up and he just starts a new day.”

Asked about reports that Mr. Trump watches numerous hours of television each day, Dr. Jackson said that, as far as he was concerned, “He can watch as much TV as he wants.”

But Dr. Jackson repeatedly expressed concern about the president’s sedentary lifestyle, noting that Mr. Trump does not have a “dedicated, defined exercise program.”

Still, he said that the president has “a lot of energy and a lot of stamina,” and he said he is asking for a nutritionist to consult with the White House chefs to cut calories and fat in dishes served to the president. But he said the president remains healthy.

“It’s called genetics,” Dr. Jackson said. “I told the president if he had eaten healthier over the last 25 years, he might live to be 200.”


Continue reading the main story

Article source: https://www.nytimes.com/2018/01/16/us/politics/trump-health-exam-doctor-cognitive-test.html

The Health-Care Industry Is Sick

I have ALS, a deadly, incurable neurological disease that is paralyzing my whole body, including my diaphragm. This makes it difficult for me to breathe while lying flat in bed. This month, my doctor prescribed me a Trilogy breathing-assistance machine, which would solve the problem (at least for now). Yet my insurance, Health Net, denied coverage, calling it “experimental.”

But Trilogy is normal standard of care. The doctor’s office told me they had never seen it denied in more than six years of prescribing it. I’m not alone in having my time and energy wasted; millions of Americans have had similar experiences with their insurance provider. Many have suffered or even died, because they didn’t get the care to which they were legally entitled. And, if we don’t fundamentally change our health-care system, there will be many more deaths. Instead of focusing on providing quality care, our system prioritizes shifting costs and maximizing profits.

But what if we had a system where all appropriate care was paid for smoothly and without struggle? We could save enormous amounts of time and money, allow doctors to do their jobs, and let patients focus on living more dignified and fulfilling lives.

My complaint about the denial of coverage on Twitter went a bit viral. I asked the Twitterverse what I should do about the problem: start a petition, file a complaint with the insurance commissioner, or maybe hold a protest. (The vote was a tie between launching a petition and filing a complaint.)

In the end, none of the options was necessary. Health Net called my doctor’s office. “We made a mistake,” they said. The machine will be covered.

I’m glad the problem got resolved. I’m looking forward to breathing and sleeping better at night. But I am outraged about this health-care system. There is zero chance Health Net would have moved so quickly if I didn’t have a Twitter following.

Millions of Americans are denied care every year. Few of them have megaphones to intimidate large companies into quick action. And so they suffer and spend their precious hours fighting with profit-seeking, opaque bureaucracies.

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So I have some questions for Health Net about what the company did to me and what it is doing to its other customers. I believe it has a moral obligation to all of us to answer these questions publicly.

  1. Why was my Trilogy deemed experimental? By whom?
  2. Are the first-line decision-making employees given incentives or instructions to deny coverage when possible?
  3. How many times did Health Net use “experimental” as a reason to deny coverage in 2018? How many times did it use another reason to deny coverage?
  4. How many times did Health Net customers appeal a denial of coverage in 2018? How many of those customers ultimately obtained coverage?
  5. Following this episode, does Health Net plan to adopt any changes to its policies or practices in order to reduce the frequency of improper denials like mine?
  6. What is Health Net’s best estimate of how the 2017 tax-code changes will impact its tax liability and net profits in 2018–20?
  7. How much money did Health Net spend on federal lobbying (directly or through intermediaries) in 2017? On what issues?
  8. What was the total compensation for each member of Health Net’s executive-level leadership in 2017?
  9. Approximately how much money will my Trilogy ventilator cost Health Net?
  10. Does Health Net believe that health care is a human right?

You can tell from the evolution of my questions, I believe that Health Net’s behavior is a symptom of a broader sickness not just in our health-care system but in our political economy. The flaws in the for-profit health industry derive from and exemplify the most inhumane aspects of capitalism: how the constant pursuit of lower costs and higher revenue incentivizes the erasure of the individual, and of her dignity, from the firm’s consideration. And thus from consideration by the body politic.

It’s an unjust way to run a health-care system. It’s an unjust way to run a country.

And the Republican Party is trying to make it worse. Republicans spent all of 2017 trying to deregulate the health-insurance industry, making it even easier for companies to abuse consumers. Their tax scam kicks out one of the three legs of the ACA stool—the individual mandate, which requires people sign up for insurance—and destabilizes the entire system by removing 13 million people from coverage. And just last Thursday, the Trump administration announced that it would impose unreasonable work requirements for people who need Medicaid—a backhanded way to make it harder for people to access benefits.

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Americans are outraged. We see what is going on. More than at any other point in my life, the American people are ready for significant change to our economy and our politics. This year, millions of us will take to the streets and the halls of Congress to demand a very different country. We will say #HandsOff our Medicare, Medicaid, Social Security, and food stamps. We will work indefatigably for a #BlueTsunami2018. And then, throughout 2019 and 2020 we will resist, organize, and vote. In 2021, when we have built the foundation for a political revolution, we will win #MedicareForAll and end this inefficient, for-profit health-denial system. And then we will start to roll back the power of money in our democracy.

Through this collective struggle, we will transcend our individual limitations. And we will all breathe freely soon.

Article source: https://www.thenation.com/article/the-health-care-industry-is-sick/

Presidential health: Here’s what we know about health of Obama, Bush and Clinton

President Trump’s physician has declared that the commander-in-chief is in “excellent health.”

It’s not quite to the “healthiest individual ever elected to the presidency” level — something Trump’s personal doctor declared during the 2016 presidential campaign — but it’s a description that has often been used during previous administrations and does indicate that the president is fit to serve.

More: White House doctor: President Trump ‘is in excellent health’ and physical ‘went exceptionally well’

More: Will Trump’s exercise and eating habits catch up to him as stress mounts?

So how does that compare to past presidents? Let’s take a look back.

Barack Obama

Over the course of Obama’s eight years in office, his physical reports pointed to one thing: Obama was healthy and enjoyed “all the benefits of good health.” The reports listed Obama’s vitals, as well as his lab results and previous medical history. 

“The president continues to focus on healthy lifestyle choices,” Dr. Ronny Jackson, the physician to the president, wrote in 2016. “He eats a healthy diet, remains tobacco free and only drinks alcohol occasionally and in moderation. He continues to exercise daily with a focus on aerobic fitness and resistance weight training.”

George W. Bush

Per a 2001 physical Bush underwent in the first year of his presidency, he was in “outstanding health and fit for duty.”

In addition to listing his vitals and other key information, the report notes Bush’s previous activity- and sports-related injuries and surgeries. It also noted that Bush had the “occasional cigar” and didn’t drink alcohol.

“The President is in the top 2% of men his age in cardiovascular fitness,” the report reads. “This fitness level would place him in the Excellent category for men 40-44 and Superior range for men 45 and older. He is stratified to a very low coronary risk profile.”

Bill Clinton

Clinton’s health was an ongoing subject throughout his campaign and presidency.

During the 1992 campaign, his doctors told journalists that Clinton was in excellent health, but noted that he had allergies, mild hearing loss, chronic laryngitis and needed to lose weight.

By 1997, Clinton was fitted with a hearing aid. His weight, cholesterol levels and blood pressure fluctuated throughout his presidency. By the end of his time in office, his physician had given him a prescription to lower his cholesterol and he had a lesion removed from his back.

Clinton himself noted that it was important for the public to know about his health, though.

“The public has a right to know the condition of the president’s health,” he said in 1996.

George H.W. Bush

According to a 1989 physical, Bush was in “extremely sound physical condition.”

He underwent the typical physical examination that indicated he had mild osteoarthritis, but no other significant changes to his health. He also had a cyst drained.

“He keeps fit through a number of physical activities, which we recommend he continue on a regular basis,” his doctor said at the time. “Today’s examination shows him to be in excellent health.”

Ronald Reagan

Reagan underwent a number of physicals throughout his presidency. In his first in 1981, the report noted that he was in “excellent health” and had recovered from the gunshot wounds he suffered during an assassination attempt earlier in the year.

By 1985, his doctor was positive about both Reagan’s physical and mental health.

“President Reagan continues to enjoy good health,” the physician said. “His overall physical and mental condition is excellent.”

That same year, Reagan underwent three surgeries. During the first, he had a polyp removed from his colon. He had a second polyp — discovered during the first surgery — later removed, and that polyp was found to be cancerous.

The White House provided regular updates on his health, including one note from his doctors: “He is fast returning to championship form.”

In 1987, he also a basal cell epithelioma removed from his nose, and in 1989, he had voluntary surgery on his hand.

Article source: https://www.usatoday.com/story/news/politics/onpolitics/2018/01/16/presidential-health-heres-what-we-know-health-obama-bush-and-clinton/1035730001/

Good genes? How can Trump eat a lot of fast food, exercise little and be healthy?

The White House physician maintained President Trump is in “excellent health” Tuesday, despite what a new book describes as his strong attraction to fast food, including cheeseburgers in bed.  

Ronny Jackson, the White House physician, said the 71-year-old Trump stands 6 feet, 3 inches tall and weighs 239 pounds. He also said Trump has “above average” exercise capacity, even though he doesn’t exercise beyond golf. 

That height and weight gives Trump a body mass index (BMI) of 29.9 which places him in the overweight category on the verge of obesity, defined as a BMI of 30 or greater.

So how is he so healthy? 

“Incredible genes, i just assume,” said Jackson, who said he told Trump that if he ate better and exercised for the last 20 years he “might live to be 200.” 

While Trump’s may be the dream diet of a teenage boy, it’s a nightmare for those trying to model or message that healthy eating — and exercise — are the key to good health.  Tyson’s Corner, Va. internal medicine doctor Sam Pappas faced that dilemma the same afternoon Jackson was explaining Trump’s health data to the press.  A 50-something male patient described his “very Trumpesque” approach to diet and exercise during a follow up to his own physical as if it was okay.

Pappas, who frequently performs physicals for government and military personnel, said he had to remind his also-stocky, muscular man that unlike the teetotalling Trump “you like to have your wine.”  As with his own patient, Pappas said he would encourage lower Trump to eat lower carbohydrate diet with more healthy fats. 

Indeed, Jackson is going to work with Trump and a nutritionist on the president’s diet which will emphasize lower carbs and fats. 

“There are ‘good’ genes, but what research has shown us is that more than genes, more than health care, more than social circumstances, behaviors are the leading cause of premature death,” says Bernadette Melnyk, a professor and dean of Ohio State University’s college of nursing and the university’s chief wellness officer. “And there’s good evidence behind that.”

After all, one’s genes can only do so much. 

“Some gene variants are slightly more efficient at detoxifying harmful chemicals in the liver, which leads to a slightly decreased cancer risk,” says Maureen Murphy, a cancer geneticist with the Wistar Institute in Philadelphia. “But I don’t think good genetics trumps —  I mean beats —  bad lifestyle.” 

Trump’s supporters emphasize that the fact he’s never been a smoker or drinker is key to his good health, but most experts say diet and exercise are still critical to good health and longevity. 

Still, Pappas says Trump’s triglycerides level (the amount of fat in the blood) of 129 is good, his blood pressure of 122/74 is “very good” and his blood glucose level of 89 is “a very good marker” as it’s under 90. Above 90 is pre-diabetes. 

Pappas also says government physicals, including Trump’s, don’t have as much data as he would like, such as waist measurement which would be a better indicator of problems than BMI for someone with a muscular build like Trump. Jackson said the physical did not include body measurements.

Trump has stated openly that exercise is overrated, even going so far as to say that it can create more problems than it cures. 

 ‘‘All my friends who work out all the time, they’re going for knee replacements, hip replacements — they’re a disaster,’’ Trump said in a September 2015 New York Times Magazine article.

Jackson says he will come up with an exercise program for Trump that doesn’t put his joints at risk. 

Former House Speaker Newt Gingrich and media company owner Chris Ruddy told USA TODAY in earlier interviews that Trump is genetically high energy and benefits from his cleaner living habits. Jackson agreed Tuesday. 

Smoking is “about the worst” thing you can do for your health and “drinking isn’t too far behind,” says Murphy. But excess weight is a “terrible risk factor for poor health.”  Diet and exercise are “roughly equal” in importance to not smoking or drinking, says Murphy.

While fast food and sweets are hardly what she’d like to see the commander in chief eating, Melnyk and physician Bruce Lee of John Hopkins University’s Global Obesity Prevention Center advocate the 80/20 rule, or that if you adhere to a well balanced and healthy diet for about 80% of what you eat, the rest can be less healthy foods. 

“Everyone’s a human being and if they try to stick to a very strict diet, it’s difficult for anyone to be able to maintain that,” says Lee, who is also a professor at Johns Hopkins’ Bloomberg School of Public Health. 

More:

Will Trump’s exercise and eating habits catch up to him as stress mounts?

Will Trump’s exercise and eating habits catch up to him as stress mounts?

Is chronic sleep deprivation impairing President Trump’s brain, performance?

Trump doesn’t get any exercise beyond golfing with a cart that Jackson or others know of.  Asked if that’s moderate to vigorous activity as described by the federal government, Lee says “not necessarily.” Walking back and forth to a cart and swinging a club, don’t bring golf anywhere close to sports such as basketball or swimming, Lee says, but he does note it “gets you out in nature.” 

Playing golf while riding a cart burns only about half as many calories than walking, or an average of 411 calories for nine holes, according to a study by Neal Wolkendoff of the Colorado Center for Health and Sport Science. 

Even if Trump has had good health until his early 70s, that doesn’t mean his lifestyle will lead to longevity beyond what he’s already experienced or for the typical 71-year-old, which is what Jackson predicted he would at least achieve.  

If your gene variants have helped prevent disease, it’s “not because of lifestyle — you’ve been lucky,” says Murphy. “Luck is a huge part and it might not last.”

 

Article source: https://www.usatoday.com/story/news/politics/2018/01/16/good-genes-how-can-trump-eat-lot-fast-food-exercise-little-and-healthy/1036518001/