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Good Health analyses 12 lunchtime options | Daily Mail Online

For a lunch that doesn’t break the bank, a meal deal — typically a sandwich, snack and drink for around £3 — is tempting. But some are loaded with sugar, fat and as many as 900 calories.

‘An average woman won’t need more than 600 calories at lunchtime,’ says registered dietitian Helen Bond. ‘Regularly exceeding this by just 100 calories a month could lead to nearly a pound of weight gain.’

Common pitfalls include ‘healthy’ veggie options that are anything but, and ‘grab bag’ crisps that are bigger than ones you’d put in a packed lunch.

ANGELA DOWDEN shopped for lunch deals and asked Helen for her verdict. We then gave them a health rating. 

Tesco 

Falafel  houmous wrap PLUS Lindt Lindor chocolate treat bar PLUS Juicy Water orange and lemon 420ml — £3

Falafel houmous wrap PLUS Lindt Lindor chocolate treat bar PLUS Juicy Water orange and lemon 420ml — £3

Falafel houmous wrap PLUS Lindt Lindor chocolate treat bar PLUS Juicy Water orange and lemon 420ml — £3

Calories, 798; saturated fat, 16g; sugar, 58.4g; protein, 13g; salt, 1.6g

VERDICT: You might think this wholesome wrap — a tomato tortilla filled with falafel, houmous and chutney — and fruity water would allow you a chocolate treat. But the drink has almost as much sugar as a can of cola and the meal itself provides nearly 15 teaspoons. This combination also has 80 per cent of your daily limit of saturated fat and exceeds the 600-calorie lunch limit.

Better to swap the drink for water, and the chocolate for an 80g snack bag of apples and grapes.

Health rating: 1/10 

Boots

Shapers Moroccan Style Veggie Couscous salad PLUS Boots melon, apple and kiwi pot PLUS Diet Coke 500ml — £3.39

Shapers Moroccan Style Veggie Couscous salad PLUS Boots melon, apple and kiwi pot PLUS Diet Coke 500ml — £3.39

Shapers Moroccan Style Veggie Couscous salad PLUS Boots melon, apple and kiwi pot PLUS Diet Coke 500ml — £3.39

Calories, 204; saturated fat, 0.4g; sugar, 18.1g; protein, 6.1g; salt, 0.6g

VERDICT: The salad, packed with roasted butternut squash, aubergine and cos lettuce provides two of your five-a-day, while the fruit pot provides a third, so this is definitely a good choice — but it’s so low in energy that you could swap the fruit for an egg and spinach pot, which would add protein and another 60 calories.

If you have fruit and a handful of nuts as a snack later, this would still be a slimline day’s eating. The caffeine in the Diet Coke (around 63mg in 500ml) can give you a bit of a boost, but the acidity of soft drinks can damage teeth, so don’t have this regularly.

Health rating: 8/10 

Co-op 

Bacon, lettuce and tomato sandwich PLUS 150g Greek-style raspberry yoghurt PLUS Rubicon Spring black cherry raspberry drink 500ml — £3

Bacon, lettuce and tomato sandwich PLUS 150g Greek-style raspberry yoghurt PLUS Rubicon Spring black cherry raspberry drink 500ml — £3

Bacon, lettuce and tomato sandwich PLUS 150g Greek-style raspberry yoghurt PLUS Rubicon Spring black cherry raspberry drink 500ml — £3

Calories, 547; saturated fat, 7.2g; sugar, 23g; protein, 28.5g; salt, 2g

VERDICT: The malted sandwich supplies more than a fifth of your daily fibre and uses lower-fat mayonnaise, so it isn’t as bad as you’d think.

The drink is low in sugar, while yoghurt is a valuable source of calcium. The yoghurt contains the equivalent of over four teaspoons of sugar, but a third is natural sugar from milk.

However, you shouldn’t eat bacon too frequently — some research has suggested we should eliminate processed meat completely, given its high salt content and the link with bowel cancer, but eating it just once a week is a realistic limit.

Health rating: 6/10 

Morrisons

Ham, cheese and pickle sandwich PLUS millionaire shortbread PLUS Volvic Touch of Fruit strawberry 750ml — £3

Ham, cheese and pickle sandwich PLUS millionaire shortbread PLUS Volvic Touch of Fruit strawberry 750ml — £3

Ham, cheese and pickle sandwich PLUS millionaire shortbread PLUS Volvic Touch of Fruit strawberry 750ml — £3

Calories, 933; saturated fat, 19.2g; sugar, 71.4g; protein, 26.9g; salt, 2.5g

VERDICT: You won’t choose this thinking it’s healthy, but you may not realise quite how bad it is either. As well as more than 900 calories, there are 17 teaspoons of sugar here — most of it the added type!

Shockingly, more of the sugar comes from the flavoured water (34.5g, more than eight teaspoons) than the millionaire shortbread (26.5g, almost seven teaspoons). This combination also supplies virtually all your 20g daily limit of saturated fat and contains 40 per cent of your daily salt allowance. It’s salvageable as a treat if you swap the drink for plain water.

Health rating: 0/10 

MS 

Wild salmon and cucumber sandwich PLUS Count On Us sour cream and chive potato crisps PLUS Still Water 500ml — £3.50

Wild salmon and cucumber sandwich PLUS Count On Us sour cream and chive potato crisps PLUS Still Water 500ml — £3.50

Wild salmon and cucumber sandwich PLUS Count On Us sour cream and chive potato crisps PLUS Still Water 500ml — £3.50

Calories, 477; saturated fat, 3.4g; sugar, 4.2g; protein, 24.9g; salt, 2.1g

VERDICT: This sandwich provides healthy omega 3 fats from the salmon plus 15 per cent of your daily vitamin D needs from the fortified bread. The baked crisps are made with whole sliced potatoes, better for controlling blood sugar than other baked snacks.

This meal deal contains the highest fibre here, with 30 per cent of your daily needs. Although it’s a pity there’s no fruit or veg included: everyone should aim to have at least one piece with their lunch. Buy an apple or a banana — or an MS fruit pot (185g) — and this lunch would score a perfect ten.

Health rating: Expert’s choice

Boots

Halloumi courgetti wrap PLUS Go Go’s Protein Snack Oat Boost PLUS Sunsoul kaffir lime lemon 100 per cent natural energy drink 250ml — £3.39

Halloumi courgetti wrap PLUS Go Go’s Protein Snack Oat Boost PLUS Sunsoul kaffir lime lemon 100 per cent natural energy drink 250ml — £3.39

Calories, 720; saturated fat, 12.3g; sugar, 27g; protein, 25g; salt, 2.1g

VERDICT: The wrap (423 calories) counts as one of your five-a-day because of the courgette, grilled peppers, spinach and butternut squash, but in total the lunch is over 700 calories — a lot if you’re sitting at a desk all afternoon.

Together, the wrap and snack (a trio of roasted beans, cheese and flapjack bites) provide 60 per cent of your maximum daily saturated fat and a third of your salt: it would be better to keep the wrap but swap the snack for a 100g pot of melon, apple and kiwi.

The energy drink will provide a lift similar to a cup of coffee, but has more than four teaspoons of added sugar.

Health rating: 3/10 

Morrisons

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3 

Calories, 529; saturated fat, 3.9g; sugar, 28.9g; protein, 20g; salt, 2.2g

VERDICT: The salad of couscous, ham and pea shoots is a decent source of protein and low in saturated fat, though high in salt (1.94g). Ham is a processed meat so don’t choose it more than once a week.

Also, the greens aren’t high in fibre and won’t count as one of your five-a-day. Look for a salad with baby tomatoes or grated carrot to make it count. Malt loaf is a good option, with the dried fruit a source of fibre and iron. The drink lets this lunch down as it contains four-and-a-half teaspoons of sugar. Swapping it for water would be a healthier choice.

Health rating: 5/10 

Sainsbury’s

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3

Calories, 742; saturated fat, 7.1g; sugar, 23g; protein, 35.3g; salt, 2.7g

VERDICT: By itself, a chicken salad sandwich is fairly nutritious, but when eaten with the 50g of snacks, this lunch is no longer healthy.

The Mini Cheddars have over 250 calories — as a rule, don’t pick a bag of crisps or savoury snacks bigger than 25g.

The high-calorie lunch also has 45 per cent of your daily limit of salt, and over a third of your daily saturated fat.

The drink is OK — it’s made with diluted orange juice and has 50 per cent less sugar than the standard version, and is a good source of vitamin C and folate, needed for a healthy immune system.

Health rating: 3/10 

Greggs

Honey roast ham and egg sub roll PLUS tea with milk — £3

Honey roast ham and egg sub roll PLUS tea with milk — £3

Honey roast ham and egg sub roll PLUS tea with milk — £3

Calories, 341; saturated fat, 1.8g; sugar, 2.9g; protein, 17g; salt, 1.6g

VERDICT: The Greggs meal deal is just a sandwich and a beverage, which can be a hot drink. This cuts back the risk of overdoing the calories.

A ham and egg sub with a cup of tea and milk is straightforward but nutritious, with low levels of sugar and saturated fat. Eggs are protein-rich, so will keep you feeling full, and the ham provides iron — but don’t have this processed meat more than once a week.

A piece of fruit will make this a decent lunch. The sub is white so a better choice from Greggs would be the egg mayonnaise sandwich on malted brown for more fibre (and to skip the processed meat). 

Health rating: 7/10

Tesco

Beef and horseradish sandwich PLUS Walkers ready salted 32.5g PLUS Fanta Orange 500ml — £3

Beef and horseradish sandwich PLUS Walkers ready salted 32.5g PLUS Fanta Orange 500ml — £3

Beef and horseradish sandwich PLUS Walkers ready salted 32.5g PLUS Fanta Orange 500ml — £3

Calories, 632; saturated fat, 2.4g; sugar, 28.8g; protein, 25.1g; salt, 2.2g

VERDICT: This combination obviously isn’t the healthiest, but it’s not as dreadful as you might expect, either.

The sandwich is a reasonably good choice (365 calories) — the lean beef is high in protein, low in saturated fat and provides anaemia-protective iron.

Swapping the Fanta for the ‘zero sugar’ version would cut out 21g (more than five teaspoons) of sugar and 80 calories.

Although the crisps provide some fibre as well as vitamin C, swapping them for a bag of apples and grapes would make it healthier still.

Health rating: 5/10 

Sainsbury’s

On The Go tuna and cucumber sandwich PLUS On The Go carrot batons PLUS Innocent Seriously Strawberry smoothie 250ml — £3

On The Go tuna and cucumber sandwich PLUS On The Go carrot batons PLUS Innocent Seriously Strawberry smoothie 250ml — £3

On The Go tuna and cucumber sandwich PLUS On The Go carrot batons PLUS Innocent Seriously Strawberry smoothie 250ml — £3

Calories, 442; saturated fat, 0.6g; sugar, 35.6g; protein, 20.2g; salt, 1.5g

VERDICT: This meal deal is high in protein and provides more than a quarter of your daily fibre, without being high in calories, saturated fat or salt.

Together, the carrots and smoothie provide two of your five-a-day.

Smoothies are naturally high in sugar and have received bad publicity but if — like this 250ml serving — they’re not grossly oversized and contain whole crushed fruit, they can be a convenient replacement for snacking on fruit.

Just don’t have a smoothie every day.

Health rating: 9/10 

Co-op 

Cheese and tomato pasta PLUS Manzanilla olives PLUS San Pellegrino orange 330ml — £3

Cheese and tomato pasta PLUS Manzanilla olives PLUS San Pellegrino orange 330ml — £3

Cheese and tomato pasta PLUS Manzanilla olives PLUS San Pellegrino orange 330ml — £3

Calories, 653; saturated fat, 6g; sugar, 40.7g; protein, 14.53g, salt, 3.5g

VERDICT: Around ten per cent of the pasta pot is Cheddar cheese, which provides calcium. Pasta salads are a source of resistant starch (formed when pasta is cooked and cooled), which helps feed friendly bacteria in the gut.

However, the lunch is let down by high levels of salt and sugar — the olives are the main salt culprit. You may think fruity San Pellegrino is better than cola, but it has seven teaspoons of sugar — your daily limit. Switch the olives for pineapple chunks and the can for a low sugar option or water to make this lunch much healthier. 

Health rating: 4/10 

Article source: http://www.dailymail.co.uk/health/article-5168863/Twelve-12-lunchtime-options-healthy.html

People say they want to live longer — if in good health

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Article source: https://www.sciencedaily.com/releases/2017/12/171211152811.htm

Why People with Good Health Insurance Go into Medical Debt

Personal finance experts are always telling you that you must have health insurance to avoid a financial catastrophe. And we’re not wrong: Health insurance does keep more money in your pocket and get you access to better care, compared with going uninsured. (See How Health Insurance Helps Manage Financial Risk.)

But our simple advice ignores a terrible problem: Many people who do have health insurance – good health insurance, at that – still find themselves in medical debt. In fact, “Most people who experience difficulty paying medical bills have health insurance,” the Kaiser Family Foundation (KFF) reports. And a 2014 report from the Consumer Financial Protection Bureau showed that 43 million Americans have overdue medical bills on their credit reports, with half of all overdue debt on credit reports coming from medical bills.

Defining “Good” Health Insurance

What makes a health insurance policy good? There is no universal answer.

A good health insurance policy for you might be a terrible one for your best friend or for the guy who sits in the cubicle next to you at work. You might have a chronic health condition, for example, that makes a policy with a low deductible, broad network and 90/10 coinsurance worth the high monthly premiums.

Your coworker might be a semiprofessional cyclist who hasn’t gotten so much as a cold in the past five years; the ideal policy for him asks for the lowest possible monthly premiums while providing catastrophic coverage if he should get, say, a cancer diagnosis. (See How Catastrophic Health Insurance Works and Is Catastrophic Health Insurance Right For You?)

So let’s assume you have a policy that’s good for you. How might you still end up with tons of medical debt?

Charging Medical Bills to Credit Cards

NerdWallet’s 2017 American Household Credit Card Debt Study found that over the past decade, median household income has grown by 20% while medical costs have increased by 34% – more than any other major spending category.

Indeed, almost one-third of Americans reported having trouble paying medical bills in a 2016–17 KFF survey, and NerdWallet estimates that nearly 27 million Americans could be putting medical bills on credit cards. High credit card interest rates can then cause medical debt to grow quickly and make it harder to pay off.

Skipping Checkups and Cutting Corners

With hidden, sky-high prices – not to mention busy schedules and a general aversion to doctors and hospitals – many people decide to cut corners on healthcare. They don’t take their medicine as prescribed, which means they may fail to get better or not keep a chronic condition under control. They skip annual checkups and don’t catch problems while they’re minor and inexpensive to treat. Then they end up with bigger, more expensive problems that they can’t ignore and are stuck paying huge bills. (See 20 Ways to Save on Medical Bills.)

Getting a Serious Medical Diagnosis

The bad news of a negative medical diagnosis may be just the beginning of your problems. Let’s say you’re 29 years old and have a $7,150 annual deductible, the highest allowed for 2017. You have in-network coinsurance of 80% and out-of-network coinsurance of 50%.

When you start getting hammered with bills for doctor’s visits, screenings, prescriptions and treatments, the first $7,150 of that comes straight out of your pocket.

Your annual out-of-pocket maximum (thank goodness for those) is also $7,150 for marketplace plans in 2017, thanks to the Affordable Care Act.  If you have a family plan, the out-of-pocket maximum is a less-manageable $14,300. If you have an employer plan, your limits may differ.

Your treatment will probably not fall neatly within a single calendar year. When the new year arrives, you have to pay that deductible and work your way up to the out-of-pocket maximum all over again. At that point, you may have switched to a lower-deductible plan, which will help, but it will be offset somewhat by the higher premiums you’ll pay for that plan.

Kevin Gallegos is vice president of Phoenix operations for Freedom Financial Network, a family of companies that empowers people to improve their finances. He shared the story of one of the company’s clients, a retired couple in the Dallas area who were on Medicare and had supplemental insurance when the husband was diagnosed with cancer. Neither insurance plan paid in full for the treatment he was prescribed.

“Their cost was close to $1,000 each month,” Gallegos says. “Over a couple of years, combined with other health-related expenses that were not covered, they were $30,000 in debt when he passed away. The wife has since moved to rural Nebraska, where living costs are lower and she can live in a home owned by a relative.”

Jeff Finn is a partner with Dynamic Worksite Solutions, in Katy, Texas, providing customized benefits programs for companies and brokers. He says that when it comes to cancer treatment, it’s generally experimental treatments that won’t be covered. Traditional and FDA-approved treatments will be covered, but some may come with annual limits.

Paying Hidden Costs

As discussed above, annual out-of-pocket maximums can keep your health spending down in a year when you need lots of care.

But out-of-network maximums can be significantly higher than in-network ones. Your out-of-pocket maximum for out-of-network care might be double your in-network one.

And try as you might to make sure you only receive in-network care, it’s easy to get slipped an out-of-network bill. You might have surgery at your local in-network hospital, but get a bill from an out-of-network assistant surgeon. You might visit your in-network primary care doctor but get an out-of-network bill from the lab she used for your blood work. (See 3 Big Medical Costs and How to Protect Against Them.) Or you may have a rare condition and need to see an out-of-network specialist who has expertise in treating it.

If you have trouble with huge bills you weren’t expecting, a medical-billing advocate may be able to help. Ruth Linden, the founder and president of Tree of Life Health Advocates in San Francisco, said she recently negotiated on behalf of an out-of-work client in Texas to cut a large, unpaid physical therapy bill in half and set up a manageable payment plan.

In addition, Gallegos points out that many policies limit the number of physical therapy visits per calendar year, but the doctor may recommend more than that number to get the patient back to functioning fully. However, any visits beyond the policy’s limit will come out of the patient’s pocket.

Then there’s another set of hidden costs: If you need frequent treatments for a health condition, your transportation costs will increase. Your childcare costs may increase, too, and your income may decrease if your illness interferes with work. If you’ve been caring for an aging parent, you might have to pay someone to care for mom or dad. You might need to hire a home health aide for your own care. If you’re too exhausted to cook, your food bill might go up. If you’re too exhausted to clean, you might find yourself hiring a housekeeper.

Other hidden costs that Finn pointed out are travel to specialty facilities, lodging, and lost income for a supporting spouse or partner.

Encountering Opaque Pricing

You can have good health insurance and still end up in medical debt when providers can’t or won’t give you prices before you agree to potentially expensive but necessary procedures.

Suppose you badly slice your finger in a kitchen accident. You visit the emergency room for stitches. Who knows how much the bill will be until you get it in the mail at least a month later? Good luck asking someone at the front desk to give you a cost estimate when you check in, because they don’t know what procedures you’ll need until a doctor or nurse sees you, at which point you will have at least incurred a bill for an ER visit. The  ER visit alone could cost anywhere from $533 to $3,000, according to the preliminary findings of a Vox study.

Visiting the ER may actually be a mistake in some circumstances.

“The emergency room is excellent for life-threatening emergencies,” Fox says. “But an urgent-care facility can treat most illnesses, burns, sprains and some fractures at a lower cost. For situations like flu or strep, a retail or urgent-care clinic might offer fast care at a low cost. Many of these clinics accept health insurance.”

What happens a few days after you get stitched up in the ER? Let’s say you visit a specialist about your nerve pain and numbness and learn that you need hand surgery to repair the nerve you severed. The hospital where you’ll be having the surgery can’t seem to tell you up front how much it will cost.

Finn says medical pricing is so opaque because the providers and insurance carriers have it set up that way. They have nondisclosure agreements so that neither party can reveal the provider’s billed rates or the insurance company’s discounts off those rates. Consumers also can’t get a straight answer about costs because the provider needs to know who the insurance company is and how the specific plan is designed in terms of deductibles and coinsurance. And patients are usually dealing with multiple providers for a procedure, such as a hospital or surgical facility, the surgeon, the anesthetist and others.

Sometimes pricing is opaque because doctors don’t know which services you will need before you receive care, similar to how a mechanic may not know how much it will cost to fix your car until he starts running diagnostics, says Sean McSweeney, founder and president of Apache Health, a medical-billing company serving physician practices, diagnostic testing facilities, hospitals and surgery centers nationwide. When it comes to surgery pricing, it should be easier to get pricing up front. “Most surgery groups are adept at getting pre-authorizations prior to the surgery, which include the CPT codes they are requesting be paid,” he says.

CPT codes are the five-digit billing numbers developed by the American Medical Association that are assigned to each medical service a patient receives. Insurers use these numbers to determine reimbursement rates. All healthcare practices use the same CPT codes.

To learn the cost of a procedure up front, Sean Fox, co-president of Freedom Debt Relief, a Phoenix-based company that has helped 450,000 Americans get out of debt, suggests asking for the billing manager and/or surgery coordinator. These positions have different titles at different practices, so it can take some work to get connected with the right person, he notes, adding, “It also can be very worthwhile to take the time and effort to get a second opinion on both cost and care.” 

The Bottom Line

These are just a few of the reasons why people with good health insurance can go into medical debt. Bad luck, denied claims, non-formulary prescriptions, huge cost discrepancies from one facility to another, chronic conditions and the astronomical price of COBRA premiums when you get laid off can also contribute. Even with an awareness of these problems in our current healthcare system, you may not be able to stay out of medical debt. But knowing how so many people find themselves in this situation may give you information that helps you at least reduce the extent of medical debt if it ever happens to you.

Finn says that for someone determined to stay out of debt, even the best planning won’t cover everything – especially in emergency situations. But the best things to do are be an educated consumer and take care of yourself.

“As educated consumers they will know what questions to ask and how to get the lowest cost and highest quality care possible,” Finn says. “By simply taking care of themselves, they not only reduce the amount of healthcare they will need over their lifetime, but when they do need care, the severity is likely to be reduced greatly.”

(For further reading, see When Health Insurance Doesn’t Cover Your Bills and What to Do When You Can’t Pay Your Medical Debts.)

 

Article source: https://www.investopedia.com/personal-finance/people-good-health-insurance-medical-debt/

Nostalgia is good for our emotional, physical and mental health

Working inside Downing Street as part of the prime minister’s team is, of course, a great privilege.

But, as I said recently in parliament, although it is a burden I would never have wanted to carry, it has been the honour of my professional life to continue work in Jo Cox’s name as co-chair of the Loneliness Commission she established before her death.

The Commission will issue its report on Friday and the government has promised a full response to our recommendations. We will be calling on ministers to take action, but loneliness is an issue none of us can shirk.

It has reached the scale of being a social epidemic and we must all play our parts in ensuring that Britain, in Jo’s words, is no longer ‘a country where thousands of people are living lonely lives forgotten by the rest of us.

I’ve learned a lot working alongside my Labour colleague and friend, Rachel Reeves, on the Commission….

Article source: http://www.telegraph.co.uk/news/2017/12/11/nostalgia-good-emotional-physical-mental-health/

Which meal deal has your ENTIRE daily ‘bad fat’ limit? Good Health analyses 12 lunchtime options that are anything …

For a lunch that doesn’t break the bank, a meal deal — typically a sandwich, snack and drink for around £3 — is tempting. But some are loaded with sugar, fat and as many as 900 calories.

‘An average woman won’t need more than 600 calories at lunchtime,’ says registered dietitian Helen Bond. ‘Regularly exceeding this by just 100 calories a month could lead to nearly a pound of weight gain.’

Common pitfalls include ‘healthy’ veggie options that are anything but, and ‘grab bag’ crisps that are bigger than ones you’d put in a packed lunch.

ANGELA DOWDEN shopped for lunch deals and asked Helen for her verdict. We then gave them a health rating. 

Tesco 

Falafel  houmous wrap PLUS Lindt Lindor chocolate treat bar PLUS Juicy Water orange and lemon 420ml ¿ £3

Falafel houmous wrap PLUS Lindt Lindor chocolate treat bar PLUS Juicy Water orange and lemon 420ml — £3

Falafel houmous wrap PLUS Lindt Lindor chocolate treat bar PLUS Juicy Water orange and lemon 420ml — £3

Calories, 798; saturated fat, 16g; sugar, 58.4g; protein, 13g; salt, 1.6g

VERDICT: You might think this wholesome wrap — a tomato tortilla filled with falafel, houmous and chutney — and fruity water would allow you a chocolate treat. But the drink has almost as much sugar as a can of cola and the meal itself provides nearly 15 teaspoons. This combination also has 80 per cent of your daily limit of saturated fat and exceeds the 600-calorie lunch limit.

Better to swap the drink for water, and the chocolate for an 80g snack bag of apples and grapes.

Health rating: 1/10 

Boots

Shapers Moroccan Style Veggie Couscous salad PLUS Boots melon, apple and kiwi pot PLUS Diet Coke 500ml ¿ £3.39

Shapers Moroccan Style Veggie Couscous salad PLUS Boots melon, apple and kiwi pot PLUS Diet Coke 500ml — £3.39

Shapers Moroccan Style Veggie Couscous salad PLUS Boots melon, apple and kiwi pot PLUS Diet Coke 500ml — £3.39

Calories, 204; saturated fat, 0.4g; sugar, 18.1g; protein, 6.1g; salt, 0.6g

VERDICT: The salad, packed with roasted butternut squash, aubergine and cos lettuce provides two of your five-a-day, while the fruit pot provides a third, so this is definitely a good choice — but it’s so low in energy that you could swap the fruit for an egg and spinach pot, which would add protein and another 60 calories.

If you have fruit and a handful of nuts as a snack later, this would still be a slimline day’s eating. The caffeine in the Diet Coke (around 63mg in 500ml) can give you a bit of a boost, but the acidity of soft drinks can damage teeth, so don’t have this regularly.

Health rating: 8/10 

Co-op 

Bacon, lettuce and tomato sandwich PLUS 150g Greek-style raspberry yoghurt PLUS Rubicon Spring black cherry raspberry drink 500ml ¿ £3

Bacon, lettuce and tomato sandwich PLUS 150g Greek-style raspberry yoghurt PLUS Rubicon Spring black cherry raspberry drink 500ml — £3

Bacon, lettuce and tomato sandwich PLUS 150g Greek-style raspberry yoghurt PLUS Rubicon Spring black cherry raspberry drink 500ml — £3

Calories, 547; saturated fat, 7.2g; sugar, 23g; protein, 28.5g; salt, 2g

VERDICT: The malted sandwich supplies more than a fifth of your daily fibre and uses lower-fat mayonnaise, so it isn’t as bad as you’d think.

The drink is low in sugar, while yoghurt is a valuable source of calcium. The yoghurt contains the equivalent of over four teaspoons of sugar, but a third is natural sugar from milk.

However, you shouldn’t eat bacon too frequently — some research has suggested we should eliminate processed meat completely, given its high salt content and the link with bowel cancer, but eating it just once a week is a realistic limit.

Health rating: 6/10 

Morrisons

Ham, cheese and pickle sandwich PLUS millionaire shortbread PLUS Volvic Touch of Fruit strawberry 750ml ¿ £3

Ham, cheese and pickle sandwich PLUS millionaire shortbread PLUS Volvic Touch of Fruit strawberry 750ml — £3

Ham, cheese and pickle sandwich PLUS millionaire shortbread PLUS Volvic Touch of Fruit strawberry 750ml — £3

Calories, 933; saturated fat, 19.2g; sugar, 71.4g; protein, 26.9g; salt, 2.5g

VERDICT: You won’t choose this thinking it’s healthy, but you may not realise quite how bad it is either. As well as more than 900 calories, there are 17 teaspoons of sugar here — most of it the added type!

Shockingly, more of the sugar comes from the flavoured water (34.5g, more than eight teaspoons) than the millionaire shortbread (26.5g, almost seven teaspoons). This combination also supplies virtually all your 20g daily limit of saturated fat and contains 40 per cent of your daily salt allowance. It’s salvageable as a treat if you swap the drink for plain water.

Health rating: 0/10 

MS 

Wild salmon and cucumber sandwich PLUS Count On Us sour cream and chive potato crisps PLUS Still Water 500ml ¿ £3.50

Wild salmon and cucumber sandwich PLUS Count On Us sour cream and chive potato crisps PLUS Still Water 500ml — £3.50

Wild salmon and cucumber sandwich PLUS Count On Us sour cream and chive potato crisps PLUS Still Water 500ml — £3.50

Calories, 477; saturated fat, 3.4g; sugar, 4.2g; protein, 24.9g; salt, 2.1g

VERDICT: This sandwich provides healthy omega 3 fats from the salmon plus 15 per cent of your daily vitamin D needs from the fortified bread. The baked crisps are made with whole sliced potatoes, better for controlling blood sugar than other baked snacks.

This meal deal contains the highest fibre here, with 30 per cent of your daily needs. Although it’s a pity there’s no fruit or veg included: everyone should aim to have at least one piece with their lunch. Buy an apple or a banana — or an MS fruit pot (185g) — and this lunch would score a perfect ten.

Health rating: Expert’s choice

Boots

Halloumi courgetti wrap PLUS Go Go’s Protein Snack Oat Boost PLUS Sunsoul kaffir lime lemon 100 per cent natural energy drink 250ml — £3.39

Halloumi courgetti wrap PLUS Go Go’s Protein Snack Oat Boost PLUS Sunsoul kaffir lime lemon 100 per cent natural energy drink 250ml — £3.39

Calories, 720; saturated fat, 12.3g; sugar, 27g; protein, 25g; salt, 2.1g

VERDICT: The wrap (423 calories) counts as one of your five-a-day because of the courgette, grilled peppers, spinach and butternut squash, but in total the lunch is over 700 calories — a lot if you’re sitting at a desk all afternoon.

Together, the wrap and snack (a trio of roasted beans, cheese and flapjack bites) provide 60 per cent of your maximum daily saturated fat and a third of your salt: it would be better to keep the wrap but swap the snack for a 100g pot of melon, apple and kiwi.

The energy drink will provide a lift similar to a cup of coffee, but has more than four teaspoons of added sugar.

Health rating: 3/10 

Morrisons

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml ¿ £3

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3 

Calories, 529; saturated fat, 3.9g; sugar, 28.9g; protein, 20g; salt, 2.2g

VERDICT: The salad of couscous, ham and pea shoots is a decent source of protein and low in saturated fat, though high in salt (1.94g). Ham is a processed meat so don’t choose it more than once a week.

Also, the greens aren’t high in fibre and won’t count as one of your five-a-day. Look for a salad with baby tomatoes or grated carrot to make it count. Malt loaf is a good option, with the dried fruit a source of fibre and iron. The drink lets this lunch down as it contains four-and-a-half teaspoons of sugar. Swapping it for water would be a healthier choice.

Health rating: 5/10 

Sainsbury’s

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml ¿ £3

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3

Chicken salad sandwich PLUS 50g Mini Cheddars PLUS Tropicana Trop 50 400ml — £3

Calories, 742; saturated fat, 7.1g; sugar, 23g; protein, 35.3g; salt, 2.7g

VERDICT: By itself, a chicken salad sandwich is fairly nutritious, but when eaten with the 50g of snacks, this lunch is no longer healthy.

The Mini Cheddars have over 250 calories — as a rule, don’t pick a bag of crisps or savoury snacks bigger than 25g.

The high-calorie lunch also has 45 per cent of your daily limit of salt, and over a third of your daily saturated fat.

The drink is OK — it’s made with diluted orange juice and has 50 per cent less sugar than the standard version, and is a good source of vitamin C and folate, needed for a healthy immune system.

Health rating: 3/10 

Greggs

Honey roast ham and egg sub roll PLUS tea with milk ¿ £3

Honey roast ham and egg sub roll PLUS tea with milk — £3

Honey roast ham and egg sub roll PLUS tea with milk — £3

Calories, 341; saturated fat, 1.8g; sugar, 2.9g; protein, 17g; salt, 1.6g

VERDICT: The Greggs meal deal is just a sandwich and a beverage, which can be a hot drink. This cuts back the risk of overdoing the calories.

A ham and egg sub with a cup of tea and milk is straightforward but nutritious, with low levels of sugar and saturated fat. Eggs are protein-rich, so will keep you feeling full, and the ham provides iron — but don’t have this processed meat more than once a week.

A piece of fruit will make this a decent lunch. The sub is white so a better choice from Greggs would be the egg mayonnaise sandwich on malted brown for more fibre (and to skip the processed meat). 

Health rating: 7/10

Tesco

Beef and horseradish sandwich PLUS Walkers ready salted 32.5g PLUS Fanta Orange 500ml ¿ £3

Beef and horseradish sandwich PLUS Walkers ready salted 32.5g PLUS Fanta Orange 500ml — £3

Beef and horseradish sandwich PLUS Walkers ready salted 32.5g PLUS Fanta Orange 500ml — £3

Calories, 632; saturated fat, 2.4g; sugar, 28.8g; protein, 25.1g; salt, 2.2g

VERDICT: This combination obviously isn’t the healthiest, but it’s not as dreadful as you might expect, either.

The sandwich is a reasonably good choice (365 calories) — the lean beef is high in protein, low in saturated fat and provides anaemia-protective iron.

Swapping the Fanta for the ‘zero sugar’ version would cut out 21g (more than five teaspoons) of sugar and 80 calories.

Although the crisps provide some fibre as well as vitamin C, swapping them for a bag of apples and grapes would make it healthier still.

Health rating: 5/10 

Sainsbury’s

On The Go tuna and cucumber sandwich PLUS On The Go carrot batons PLUS Innocent Seriously Strawberry smoothie 250ml ¿ £3

On The Go tuna and cucumber sandwich PLUS On The Go carrot batons PLUS Innocent Seriously Strawberry smoothie 250ml — £3

On The Go tuna and cucumber sandwich PLUS On The Go carrot batons PLUS Innocent Seriously Strawberry smoothie 250ml — £3

Calories, 442; saturated fat, 0.6g; sugar, 35.6g; protein, 20.2g; salt, 1.5g

VERDICT: This meal deal is high in protein and provides more than a quarter of your daily fibre, without being high in calories, saturated fat or salt.

Together, the carrots and smoothie provide two of your five-a-day.

Smoothies are naturally high in sugar and have received bad publicity but if — like this 250ml serving — they’re not grossly oversized and contain whole crushed fruit, they can be a convenient replacement for snacking on fruit.

Just don’t have a smoothie every day.

Health rating: 9/10 

Co-op 

Cheese and tomato pasta PLUS Manzanilla olives PLUS San Pellegrino orange 330ml ¿ £3

Cheese and tomato pasta PLUS Manzanilla olives PLUS San Pellegrino orange 330ml — £3

Cheese and tomato pasta PLUS Manzanilla olives PLUS San Pellegrino orange 330ml — £3

Calories, 653; saturated fat, 6g; sugar, 40.7g; protein, 14.53g, salt, 3.5g

VERDICT: Around ten per cent of the pasta pot is Cheddar cheese, which provides calcium. Pasta salads are a source of resistant starch (formed when pasta is cooked and cooled), which helps feed friendly bacteria in the gut.

However, the lunch is let down by high levels of salt and sugar — the olives are the main salt culprit. You may think fruity San Pellegrino is better than cola, but it has seven teaspoons of sugar — your daily limit. Switch the olives for pineapple chunks and the can for a low sugar option or water to make this lunch much healthier. 

Health rating: 4/10 

Article source: http://www.dailymail.co.uk/health/article-5168863/Twelve-12-lunchtime-options-healthy.html

More older people are doing yoga, but they are also racking up injuries

Yoga may hold a key to aging well, suggests a growing body of research into its potential benefits for body and mind — benefits that include reducing heart rate and blood pressure, relieving anxiety and depression, and easing back pain. One recent study even raised the possibility of positive changes in biological markers of aging and stress in people who do yoga.

So it’s no surprise that the number of yoga practitioners in the United States has more than doubled to 36.7 million over the last decade, with health benefits the main reason people practice, according to the Yoga in America Study conducted last year on behalf of Yoga Journal and the Yoga Alliance.

While yoga enthusiasts are often pictured as young and bendy, the reality, according to the Yoga in America study, is that 17 percent are in their 50s and 21 percent are age 60 and older.

Along with this upsurge of interest has been an upsurge in injuries, particularly among older practitioners. “Participants aged 65 years and older have a greater rate of injury from practicing yoga when compared with other age groups,” researchers wrote last year in a study of nearly 30,000 yoga-related injuries seen in U.S. hospital emergency departments from 2001 to 2014. “While there are many health benefits to practicing yoga, participants and those wishing to become participants should confer with a physician prior to engaging in physical activity and practice only under the guidance of certified instructors.”

As a yoga therapist who has been teaching in medical settings for nearly 20 years, I have found it distressingly common to hear about the negative experiences and injuries people have sustained in yoga classes. The stories my students relate suggest classes that were too difficult for them and/or were taught by an inexperienced or poorly trained instructor. Even instructors who are trained to teach able, young students typically have a limited understanding of safety considerations that are essential when working with middle-aged and older bodies and people with such health challenges as rotator cuff injuries, arthritis, glaucoma, hypertension and heart disease.

Fortunately, there is a growing recognition of the importance of safe yoga practice along with professionalization of the field. To practice yoga while reducing the risks, here are five strategies to help older adults — as well as people with health challenges — age well with yoga:

Start where you are, not where you think you should be. If you are new to yoga, try a beginner’s class — even if you’re fit and active — because yoga is not just about what you do, it’s about how you do it. Unlike Western exercise, the yogic approach is to balance effort with relaxation, which can be surprisingly difficult for many people used to our culture’s emphasis on striving, competing and being “in it to win it.” In fact, learning not to push yourself, or rush, or be ambitious to look a certain way, can be one of the most challenging (and therapeutic) parts of the practice. Give yourself time to learn how to move into a posture to a point where you feel challenged but not strained.

Recognize that styles of yoga vary widely. Yoga classes range from vigorous and athletic to relaxing and restorative — with a confusing array of trendy hybrids such as yoga with goats and kittens, and yoga offered on a paddleboard. To find a class designed for mature bodies, look for names such as “Yoga Over 50,” “Gentle Yoga” or “Senior Yoga.”

Hatha yoga is the name for any type of yoga that teaches physical postures. This means that virtually all yoga classes in the West are hatha yoga. But when a class is marketed as hatha yoga, it generally signifies a non-gimmicky approach to basic postures and breathing, which may be a good starting place. Viniyoga and Kripalu yoga are relatively gentle styles that may be appropriate for people with health concerns. Restorative yoga involves using supports (such as blankets and yoga blocks or bolsters) to prop students into passive poses that promote profound rest. Hospital-based wellness and integrative medicine centers may offer classes designed for people with specific ailments such as cancer or back pain.

Find a well-trained, experienced teacher. Ask prospective instructors about their credentials [see sidebar about yoga credentials], how long they’ve taught yoga and whether they’ve had special training and/or experience teaching older people. Ask to watch a class to see if it’s suitable, which is also a good way to assess the instructor. A good yoga teacher will act as a guide, helping students explore what works best for them as they try each posture. For people with health challenges, working one-on-one with a certified yoga therapist can be ideal.

Talk to your care provider. If you have medical issues, get guidance about specific movement precautions. For example, people with glaucoma may be advised to avoid “head-down” positions, which may increase pressure in the eye. Hot yoga may be problematic for people with heart conditions because high temperatures can increase cardiac workload. Recognize, however, that many doctors know little about yoga and may assume you’re planning to stand on your head. Tell your provider that you’d like to try gentle yoga consisting of simple movements, stretches and breathing practices.

Let go of excuses that you’re too old. You don’t have to be young or fit or flexible to try yoga. If you can breathe, you can practice yoga.

Krucoff is a yoga therapist at Duke Integrative Medicine in Durham, N.C., and co-author of “Relax Into Yoga for Seniors: A Six-Week Program for Strength, Balance, Flexibility and Pain Relief.”

Article source: https://www.washingtonpost.com/national/health-science/more-older-people-are-doing-yoga-but-they-are-also-racking-up-injuries/2017/12/08/270ce406-ca2e-11e7-b0cf-7689a9f2d84e_story.html

To Your Good Health: Anal Fissure Is Painful, Requires Treatment Plan

Dear Dr. Roach: My husband has been diagnosed with a rectal fissure. It has been a couple of months, and it isn’t any better. He has been treated only with a stool softener. What do you suggest? — A.T.S.

Answer: Anal fissures are painful. Although a stool softener is one part of management for people who have constipation, additional treatments also are appropriate, including a sitz bath, which is just a few inches of warm water in a basin or tub that you soak your bottom in. When I was an intern, I wondered about the origin of the term “sitz bath.” My resident, Dr. Lynn Brown, told me that it’s because you “sitz” in them, and it turns out she was right: It’s from the German “sitzen,” meaning “to sit.”

Other treatments include increased fiber and a topical painkiller (there are many over-the-counter preparations in ointment form). These treatments help heal the fissure by relieving anal spasms caused by a painful bowel movement. I’m afraid your husband hasn’t had adequate treatment, leading to a vicious cycle of pain, spasm and nonhealing.

In addition to these treatments, fissures heal more quickly with a medication to increase blood flow to the area: Nitroglycerin is available as a prescription ointment, and nifedipine can be compounded for topical use by a pharmacist, with better healing and fewer side effects than nitroglycerin (but both of these work better than no treatment). If this isn’t effective after a month, he should be re-evaluated. There are other options available before considering surgical treatment. A gastroenterologist is a good resource if his primary doctor hasn’t been successful.

One other concern is that occasionally anal fissures are a sign of Crohn’s disease, a serious inflammatory bowel disease. People with recurrent, atypical (not in the midline) or nonhealing fissures should be evaluated for Crohn’s disease.

Dear Dr. Roach: You recently wrote about exercise causing rhabdomyolysis, and I have a question about that. My 92-year-old mother-in-law fell, and wasn’t sure how long she laid there, but the doctors said she had no broken bones. However, she did develop rhabdomyolysis.

Since she does not exercise, how did she acquire this condition? The only medication she is on is one for blood pressure. — G.M.

Answer: Rhabdomyolysis is a very serious condition of muscle breakdown. The most common cause I have seen is your mother-in-law’s: pressure on muscle in someone who is unconscious or unable to move for a prolonged period (in normal sleep, the body changes position frequently, which prevents this).

However, it can happen in untrained people after heavy workouts, or even in trained athletes who do extreme workouts, especially in hot and humid conditions. Some medications rarely can cause it, such as colchicine or statin drugs. Rhabdomyolysis is treated conservatively, by removing the underlying cause, and trying to prevent damage to the kidney.

For elderly or frail people who live alone, I recommend a device that can be easily carried and pressed to get help. Some of these can recognize a fall and will send a signal automatically. Falls are common in the elderly, and these devices can help prevent some of the serious consequences of falling.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or at 628 Virginia Dr., Orlando, FL 32803.

Article source: http://www.vnews.com/To-Your-Good-Health-14206011

Even with good insurance, health conditions put great burden on …

The pill in question is a chemotherapy pill. Greg Murphy has been taking one every day for the past year since undergoing surgery to remove a large, cancerous tumor from his gastrointestinal tract. He’ll be on the pills for the next three to five years as a precautionary measure to keep his rare form of cancer at bay.

The prescription costs $19,000 per month.

Greg is lucky. He has good health insurance through his job at the North Dakota Mill and a large, supportive family nearby to help. But the costs of a catastrophic condition can still be a significant burden on a typical family here and across America.

For people like Murphy and even those facing less dire diagnoses, navigating systems of insurance coverage, costs and medical bureaucracy can be as harrowing as the disease, even for the well-insured. For many, a catastrophic condition is a crash course in the strengths and failures of our systems of treatment and coverage.

Cost of care

This year, 36,100 North Dakotans and 282,700 Minnesotans were among the 15.8 million Americans dealing with cancer, according to data from the Centers for Disease Control and Prevention and the National Cancer Institute. Many of those people will be fighting not only to get healthy, but to stay financially afloat.

A study from the Duke Cancer Institute published in August found one-third of insured cancer patients end up paying higher out-of-pocket costs than anticipated and 16 percent of insured cancer patients report feeling overwhelming financial distress.

“What we found was that basically a cancer diagnosis makes you underinsured,” said Dr. Fumiko Chino, a resident in radiation oncology at Duke who co-authored the study.

Chino said for most people a cancer diagnosis can be financially daunting even with the best private insurance. Her study of 300 insured cancer patients who received cancer care at Duke found the average patient was spending 11 percent of household income for out-of-pocket costs. Anyone paying 10 percent of household income on out-of-pocket health costs is technically considered underinsured, she said.

“There’s this idea that private insurance might be better and that it might insulate you from higher out-of-pocket costs, but we actually found that Medicare was actually the best thing, in terms of people’s costs,” Chino said.

A long road back

Murphy’s gastrointestinal stromal tumor snuck up on him. One day last May, he was at work and felt off, “like I was going to faint, but I never did.”

He was taken to the emergency room, where his hemoglobin was down to just 6.1 grams per deciliter. Doctors did a blood transfusion to get his levels stable, but couldn’t bring the hemoglobin back to healthy levels around 14 grams per deciliter. A barrage of tests was performed. One day, a doctor felt a hard lump in Greg’s lower abdomen, and asked him to get a CAT scan.

What they found was an tumor in his gastrointestinal tract. Greg was sent to the Mayo Clinic in Rochester, Minn., where on July 17, 2016, he was diagnosed with cancer.

After an August 2016 surgery that removed the 11-centimeter tumor, which had wrapped around his colon, bladder and small intestine — about 3 feet of which was also removed — Greg missed five months of work at the State Mill. He used up his sick leave and vacation days before being placed on a fixed reduced salary of about 70 percent of his wages.

Everyone handled it differently. Youngest son Jacob rarely let his father out of his sight. Oldest son Zachary began to weep after a football game in Jamestown last fall, the first game his father ever missed. Barb’s sister came to stay with them for two weeks after Greg’s surgery, becoming “Mom 2″ for the kids.

“They kept a positive attitude throughout the whole thing,” Greg said of his family.

Friends and neighbors would bring by large plates of food or gift cards to Papa Murphy’s. Both Greg and Barb’s parents live in town and helped a bunch.

But the bills don’t stop.

“Five months caught up,” Barb said.

The Mayo Clinic sent their hospital bills to collection agencies within a month, Barb said.

“If we didn’t have the insurance we have I don’t know how we could have managed,” she said. Every time the family goes to Mayo for a check-up, which had been every three months but is now every six months, it costs about $1,000 for travel, lodging and food for everyone.

The hospital costs alone come to about $4,000 each time, and the Murphys owe about $1,000 in co-insurance for each stay. Between the hospital stays and chemo pills, they hit their maximum out-of-pocket costs fast.

The family started to cut back. Their son Zachary, a senior hockey and football player at Grand Forks Central, didn’t play fall hockey this year to save money.

“We do all we can just to keep our heads above water,” Barb said.

Eventually, Greg’s sister-in-law Becky made a GoFundMe page for the family, which has raised about $14,000 in 15 months to help them pay off bills and for travel expenses for receiving treatments.

“It made a huge difference at the beginning,” Barb said. “It really kept us afloat.”

The majority of GoFundMe accounts in Grand Forks are related to medical costs. In 2016, GoFundMe said $930 million of the $2 billion raised from the crowdfunding site was for medical campaigns.

“Increasingly we’re in a world where GoFundMe is a type of supplementary insurance and it’s a tragedy,” Chino said.

Her study also explored financial toxicity, the concept that high costs associated with cancer care can exacerbate symptoms.

“It can actually affect the quality of your care,” Chino said. “Meaning that you’re not getting the medications you should because you can’t afford them, or you’re not getting the scans you should because you can’t afford them.”

Often, patients may skip treatments to keep their jobs or provide for loved ones.

“Ultimately we care about quality of life, and we want to make sure essentially that people receive the care they need to save their life or extend their life,” Chino said. “Not all cancers are curable, but it doesn’t mean it should bankrupt your family.”

The Murphys say they’ve had a hell of a year, but they’re optimistic about the future.

Greg has been back to work for about a year. Barb started a new job about nine months ago at MAK Construction, which she said has been very accommodating to any health-related issues.

Greg says he’s finally adjusted to the drain the chemo pills take on his body and has regained most of his energy. Things are starting to go back to normal.

“It’s a life-changing thing, but we try not to let it affect what we want to do,” Barb said.

Article source: http://www.duluthnewstribune.com/news/4371904-even-good-insurance-health-conditions-put-great-burden-families

Your Good Health: Natural over synthetic statin complicates dosage

Dear Dr. Roach: In a recent column, you said that red yeast rice acts as a kind of natural statin. Can natural and synthetic statins be used together?

M.P.A.

Red yeast rice is a traditional Chinese food and medicine used for circulation. It was found to decrease cholesterol by about 15 per cent, and analysis of the product shows that it contains a chemical called monacolin K, which is the active ingredient of the statin drug lovastatin.

I don’t recommend red yeast rice for most people because, like any natural product, the amount of the active compound varies. I prefer to give a known amount of the purified compound, so the person gets the same amount every day and I can adjust the dose if needed. I have patients who prefer natural products, so I recommend red yeast rice only for people who insist on this.

However, I would not combine it with another statin. In general, combining drugs of the same class — statins, blood pressure medicines, depression medicines or nonsteroidal anti-inflammatory medicines — does not increase the beneficial effect much, but it does dramatically increase the risk of toxicity and side-effects. It’s generally better to use a complementary class. In the case of cholesterol treatment, people who need more than a statin usually need a better diet and more exercise.

There are few people I treat for cholesterol with a medication other than a statin these days, but some might benefit from ezetimibe or one of the newer PCSK-9 inhibitors.

Dear Dr. Roach: I am a diabetic and take gabapentin for symptoms of diabetic neuropathy. My family doctor suggested I use a rolling pin: I put it under my feet and roll it back and forth for about five minutes while sitting in a chair. It takes away the tingling.

K.

I appreciate your writing. I often have talked about medical treatment for diabetic neuropathy, and this simple treatment might help some readers. Many physical therapists use a foam roller. An easy way to make one yourself is to cut a children’s “noodle” (a foam float used as a pool toy) into the appropriate size, rather than using a rolling pin. This can help some people with peripheral neuropathy, whether diabetic or non-diabetic. Everyone with peripheral neuropathy also should be taught how to inspect their feet daily for any potential problems and get a regular professional evaluation, as well.

Dr. Roach Writes: A recent column on tinnitus generated some interest among readers. Several readers wrote that tinnitus associated with hearing loss can be made better with hearing aids. I was asked about acupuncture and magnetic therapy, neither of which has strong evidence to support that it is better than placebo (more research is ongoing, with some promise). Another person noted that a family member’s tinnitus went away after 100 pounds of weight loss: In that case, I suspect that the overweight person might have had elevated intracranial pressure (sometimes called “pseudotumor cerebri”), which is a rare cause of tinnitus. Finally, some people noted that having background noise can “mask” the tinnitus. As always, I appreciate the interest and helpful comments. You can reach me by email or on my Facebook page, facebook.com/keithroachmdhttp://facebook.com/keithroachmd.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu

Article source: http://www.timescolonist.com/life/health/your-good-health-natural-over-synthetic-statin-complicates-dosage-1.23117871

Adorable, Cuddling Lemurs Show Cooties Are Good For Our Health

Researchers have shown that the health of red-bellied lemurs could be improved by close contact and huddling, a finding that might have something to say about the health benefits of physical touching in humans as well.

While scientists already knew there were benefits to sharing germs among group members, this study looked into the link between social dynamics (such as cuddling) and the spread of helpful gut bacteria.

What they found is that the closer these animals get to each other, the more their microbes are shared, and over time this synchronisation could work into a cooperative immunity against unfamiliar sources of infection.

As far as humans go, the researchers says, getting up close and personal with each other could sync our gut microbes and might also be enough to ensure we’re collectively ready for whatever new pathogens might appear in our population.

“In close social groups like red-bellied lemurs, social environment is key to immunity,” says one of the team, Aura Raulo from the University of Oxford in the UK.

“Sharing microbial allies and enemies makes infections by opportunistic pathogens less likely.”

Gut microbes are important in humans and animals alike, responsible for fine-tuning the immune system and helping the digestive process. When something goes wrong with our gut bacteria, a host of health issues can follow.

Here, the researchers looked at faeces samples from 36 red-bellied lemurs in Ranomafana National Park in Madagascar.

Lemurs are known to be a very tactile, social type of animal, and they spend a lot of time together in groups, making them perfect for this type of study.

Sure enough, the samples showed that the gut microbiomes of lemur groups were “markedly similar”, with close friends within those groups also showing signs of sharing similar gut bacteria.

Similar results have been seen in other animals, including baboons, and it’s known to happen in humans too.

“The gut microbiome of red-bellied lemurs most closely resembles that of their group members,” explains one of the researchers, anthropologist Andrea Baden from the University of Oxford.

“They are extremely cohesive and in contact a great deal, and rarely if ever interact with other groups, so this makes sense.”

The team was able to work out who had been in contact with whom in the lemur community just by looking at the gut bacteria, and suggest this acts as a safety measure for the community that might also apply to humans.

In fact scientists have previously suggested actions like cuddling and kissing might have evolved in part to keep us healthy, and intimate kissing is definitely one method by which we share bacteria with each other.

Both genetics and a host of other factors, including diet and stress and who we come into close contact with, are known to influence the human microbiome.

“When people with different gut microbiomes interact, they share their symbiotic bacteria through touch,” says Raulo.

“This bacterial transmission can make us more or less healthy, depending on how compatible our guts are with our friends.”

“For example, I might host a bacteria in my gut that is well-behaved, and fits my symbiotic gut community, but might turn out to be an invasive pathogen in another person who is not accustomed to it.”

However, more research needs to be done to prove the link between close contact, gut bacteria synchronisation, and better health.

Right now a lot of the microbes the researchers studied are unknown to science, so they can’t say whether they’re good or bad bacteria – just that the bacteria match up.

If further tests can show the way that a shared mix of microbes can keep us better protected against illness, we’ve got one more reason to cuddle up more often.

There’s still a long way to go though before we’ve unlocked all the mysteries of gut bacteria.

“It is important to understand what builds up a healthy gut microbiome, and the role that the wider social and ecological environment plays in this,” says Raulo.

“Understanding that social environment and stress are directly linked to gut microbiome, could go some way to explaining why the western world experiences so many epidemics of autoimmune diseases, and help us to better treat people with them.”

The findings have been published in the Journal of Animal Ecology.

Article source: https://www.sciencealert.com/cuddling-lemurs-show-physical-contact-is-good-for-your-health