Rss Feed
Tweeter button
Facebook button
Webonews button

Fighting Tuberculosis: A Global Health Emergency

The world is losing the battle against tuberculosis (TB), which remains the deadliest infectious disease despite being curable. TB patients and treatment providers face an array of challenges, from diagnosis to treatment. 

Doctors Without Borders/Médecins Sans Frontières (MSF) has been fighting TB for more than 30 years and is among the biggest treatment providers. Dr. Francis Varaine, leader of the MSF working group on tuberculosis, explains what more should be done—and why the failure to make progress is, above all, a political issue.

Where are we in the fight against TB?

We’re not exactly winning. TB is still the world’s top infectious disease killer, since overtaking HIV/AIDS in 2015. 

An estimated 1.7 million people died from TB in 2016. Of the 10.4 million people who caught the disease last year, too few have been properly diagnosed or treated. 

This reflects the struggling health system in many countries—low and middle income countries account for 95 percent of deaths—and the fact that TB affects mainly the vulnerable. Its prevalence is high among neglected communities—in places like refugee camps, slums, and prisons. It’s also the major cause of death among people infected with HIV/AIDS. 

In short, it’s a global health emergency with outsized effects on the marginalized: an obvious, urgent focus for MSF. 

What has MSF been doing about it so far?

MSF finds TB in virtually all its fields of intervention. Between 15,000 and 30,000 patients are treated in MSF-supported projects every year in more than 25 countries. We have been battling TB for more than 30 years, and are one of the biggest non-governmental treatment providers in the world. 

For the past decade or so, a major focus was on treating the hardest forms of TB, called “drug-resistant TB” (DR-TB). One-tenth of our patients suffer from a drug-resistant form of the disease.

In the past five years, and after 50 years without innovation, two new drugs have been marketed. This is a truly historic moment for patients and health care providers.

These two drugs, bedaquiline and delamanid, show a lot of promise. MSF has been an early adopter and has one of the largest cohorts in the world treated by regimens containing these drugs. Our experience shows that they are a new hope for patients, in particular those with the hardest-to-treat form of the disease. In addition to the patients we treated, our experience helps inform national and World Heath Organization guidelines. 

Unfortunately, [this effort is] only a drop in the ocean. In 2017, it was estimated that, worldwide, fewer than five percent of patients who needed these drugs were getting them.

Four Years and Counting: Newer TB Drugs Out of Reach

What else is being done to help DR-TB patients?

An estimated 600,000 people every year develop a resistant form of TB that requires an arduous, poorly effective, two-year treatment that involves eight months of injections, 15,000 pills, and harsh side effects, including deafness, psychosis, and neuropathy.

Given this desperate state of affairs and at a unique moment in time with two new drugs available, MSF has taken matters into its own hands. We are currently running two clinical trials, endTB and TB-PRACTECAL, in partnership with leading medical organizations. The aim is to find simpler, shorter (six-nine months), less toxic, all oral, and more effective treatments mainly based on new and repurposed drugs. 

Beyond drug-resistance, what are the prospects for TB treatment in general?

Broadly, it’s the same problem: very limited research and innovation, and it’s still too hard or expensive to reach more patients and treat them as quickly as we would like.

Take diagnostics: the world now has rapid tests to diagnose pulmonary TB in a matter of hours, which is revolutionary. But these [rapid tests] require constant power supply, air conditioning and dedicated lab facilities with trained staff. This isn’t adapted to a typical MSF operation or the settings of most TB patients. And we still don’t have an appropriate test for children and for extra-pulmonary forms of the disease.

TB vaccines are still probably two or three decades away. 

And while we mention it less, the treatment for uncomplicated, drug-sensitive TB (DS-TB) is still difficult to implement, at six months and with four different drugs involved. 

Well-funded health services with few patients can bear this kind of burden, but not weaker ones weathering a TB emergency. 
Moreover, there’s a worrying lack of research into new drugs: just five in the current TB pipeline compared to dozens in development for hepatitis C and HIV.

In that challenging context, where does MSF go from here?
By 2025, our goal is that every patient presenting any form of TB in any MSF project should access simple and reliable diagnostics, as well as effective and well-tolerated treatment, and to act as a force for change at the global level. 

To help achieve this, MSF’s TB projects need to reflect that ambition. First, we should diversify the categories of patients we treat: for instance, our DS-TB cohort has halved in size in the past ten years; we will take on more of these patients. HIV co-infected patients are a group with specific needs—as are children, who represent one in ten new TB patients worldwide. They will need dedicated attention in our programs.  We also should address the issue of latent TB infection in our projects. 

In parallel, we plan to stimulate and promote research for better treatments and better diagnostic tools. 
For instance, we remain engaged in research through our DR-TB clinical trials. Beyond these, we will push for innovation on better-adapted diagnostic tests. In the mid-term, we want diagnoses to be possible at the “point of care”—meaning wherever we see patients, even in rural and remote settings—and on the spot.

Following diagnosis, DS-TB should to be treatable in two months, and any drug-resistant strand in six months. 

And because the issue of drug-resistance is unavoidable when antibiotics are involved, we want to see a healthy pipeline of new drugs, diagnoses, and approaches for the future. 

But let us not forget that this is first, and above all, a political issue. New tools already exist that should be scaled up, and research, which is today shockingly limited, must be developed and accelerated with the necessary funds. It’s about ramping up the resources to bring them to where TB still prevails and kills.

The TB crisis shows no sign of slowing down, neither can we. We will keep using our medical experience and commitment to fight for TB patients.

Tell Health Leaders to #StepUpforTB 


Article source:

Meet Trump’s New, Homophobic Public Health Quack

The extraordinarily disruptive turnover in the Trump administration’s senior staff has officially reached the Centers for Disease Control and Prevention. The White House, having already cycled through one CDC director, has named its second: Robert Redfield, a retired U.S. Army lieutenant colonel and former University of Maryland opioids and AIDS researcher.

He is exactly the wrong person for the job. Amid an exploding influenza epidemic across the United States, an opioids crisis that has decreased the statistical life expectancy of Americans, and a budget crisis that twice compelled closure of critical laboratory and disease-fighting services, the CDC desperately needs a leader who can promise stability and expertise. Redfield represents the opposite; he is someone whose track record in HIV research and public health policy has been a scientific and moral failure.

The White House, in all likelihood, has carefully scrutinized Redfield’s financial history, especially after it was criticized for failing to adequately vet Trump’s first CDC director, Brenda Fitzgerald, who was forced to resign in January after revelations of multiple conflicts of interest involving stocks and other investments. But Redfield has failed to pass political vetting before — just not for economic reasons. In 2002, President George W. Bush considered but rejected Redfield for the top CDC job because his work on AIDS was deemed excessively controversial. Redfield’s record remains disqualifying today.

Forced testing, forced discharge

From the early 1980s to the early 1990s, when the AIDS epidemic was claiming a staggering death toll, and no treatment for HIV existed, Redfield was a U.S. Army major and vaccine researcher at the Walter Reed Army Institute of Research in Maryland. During President Ronald Reagan’s administration, Redfield guided the military’s public health response to HIV infections within the armed forces and also its pursuit of a vaccine against the virus. In both tasks, Redfield proved extremely controversial.

Among the Defense Department policies that Redfield helped design was mandatory testing of all troops for HIV, without confidentiality, beginning in October 1985. Any soldier, sailor, pilot, or marine who proved to be infected would quickly learn that his entire chain of command was aware of his status, often before he was informed. Recruits were screened, and those whose tests were positive were barred from service.

Active-duty personnel were also tested and if positive would face degrading mistreatment, as I discovered in 1989, when I reported in and around Fort Hood, the Army’s largest training and staging area, located in Texas. Terrified 18- and 19-year-old soldiers found to be infected with HIV would be isolated to a special barracks wing, known on the base as the “HIV hotel” or “the leper colony,” where they were treated like prisoners until they either developed full-blown AIDS or were discharged dishonorably.

The military seemed intent on administratively punishing infected soldiers for their HIV status. Soldiers described being summoned to meet with a chaplain, who would inform them that they had tested positive for HIV, and counsel them while military police rifled through their barracks searching for evidence of homosexuality and the names of possible sex partners. “You go through the Article 15 [disciplinary actions] list and see how many are HIVs,” one discharged soldier told me in 1989. “They are giving out seven or eight Article 15s a day over there. There’s no morale over there.”

About 5 million soldiers and recruits were tested by 1989, with 6,000 of them proving HIV positive. Anecdotally, many of these young men committed suicide, and most were drummed out of the military without medical coverage, dying impoverished from their AIDS disease. If the Defense Department kept score of the tragedy, the eventual, post-discharge outcomes for thousands of HIV-positive military personnel were never publicly documented.

Then-Maj. Redfield defended the Defense Department’s policies, which he largely created. “The reason we have done what we have done,” he told me at the time, “is that we think it’s good medicine — and it’s medicine that might work in the civilian sector, as well.”

Outside of his work with the military, Redfield, a devout Roman Catholic, was associated with Americans for a Sound AIDS/HIV Policy (ASAP), a Christian organization headed by W. Shepherd Smith Jr. ASAP backed the idea of mandatory testing for HIV and isolation or identification of those infected with HIV. Redfield also wrote the introduction to Smith’s 1990 book, Christians in the Age of AIDS. “It is time to reject the temptation of denial of the AIDS/HIV crisis; to reject false prophets who preach the quick-fix strategies of condoms and free needles; to reject those who preach prejudice; and to reject those who try to replace God as judge. The time has come for the Christian community — members and leaders alike — to confront the epidemic,” he wrote. Redfield named the breakdown of family values and increasing number of single-parent households as key factors responsible for the spread of AIDS.

In his book, Smith argued that AIDS was “God’s judgment” against gay people. In 1988, Redfield wrote a 32-page booklet for teenagers, AIDS and Young People, in which he advised delaying sexual activity until marriage to stave off infection.

ASAP and Redfield also backed Kimberly Bergalis, a Florida college student who was infected via a dental visit with David Acer, a dentist who died of AIDS after exposing six of his patients to the virus. Bergalis, who died of AIDS in 1991 at age 23, and her family demanded Congress pass legislation mandating HIV testing of health care workers and removal of licenses to practice for those testing positive. H.R. 2788, sponsored by arch-conservative Rep. William Dannemeyer (R-Calif.), would have revised many aspects of the Public Health Service Act, allowing for testing, loss of licensing, and quarantine of HIV-infected individuals. It ultimately failed to pass but only despite Redfield’s advocacy. “Remember, most Americans don’t feel they have a real risk from AIDS,” he told the New York Times in 1991. “This case worries them, for the only real risk of getting AIDS is from their physician.”

The vaccine hunt that wasn’t

Redfield’s scientific research has been as dubious as his public health work. In the late 1980s and early 1990s, Redfield headed up an AIDS vaccine research effort at Walter Reed that focused on gp160, a protein projection from the type of HIV most commonly found in North America. The military researchers worked together with a Connecticut-based company called MicroGeneSys to develop and test the gp160 vaccine.

The MicroGeneSys product, which the Army dubbed VaxSyn, never proved effective in doing the real job of a vaccine — blocking infection. But Redfield announced at the International AIDS Conference in Amsterdam in 1992 that VaxSyn prevented HIV from destroying key elements of patients’ immune systems, called CD4 cells. It was the first good treatment news a desperate HIV-positive community and their doctors had heard, and it caused an uproar of excitement — I know, because I was there.

But it wasn’t true. Redfield had grossly overstated the Army results, prompting a Defense Department investigation. The department decided Redfield’s “overstatement” of the effectiveness of VaxSyn was an innocent error, but the U.S. Food and Drug Administration was less than impressed with the product and declined to approve continued human testing. Unfazed, MicroGeneSys recruited former Sen. Russell Long to lobby fellow Republicans with the hope of getting Congress to back further testing. In House hearings, Redfield insisted that VaxSyn was within 12 months of being ready for a large-scale human test that would prove the gp160 concoction could stop the disease process. With Smith and ASAP chiming in, Congress was bowled over and approved $20 million for further human experiments. Also in the chorus of VaxSyn backers was then-Secretary of Defense Dick Cheney.

The VaxSyn product never worked, and its elevation to top dog status, despite lack of scientific support, was denounced in the Washington Post as “pork-barrel research.” The “MicroGeneSys soap opera,” as Science reporter Jon Cohen dubbed it, dragged on through investigations and scandal into 1994. Eventually, the Army tried the concoction on more than 600 HIV-positive military personnel, concluding they showed “no clinical improvement.” In his 2001 book, Shots in the Dark, Cohen detailed the Redfield saga and showed that he continued promoting VaxSyn and using it on human volunteers with the financial support of Smith’s ASAP long after the Army had concluded it didn’t work.

Redfield, who had been under consideration for the position of surgeon general, lost his Walter Reed job in June 1994 and was placed on clinical duty in an Army hospital in Washington. Public Citizen cried “whitewash,” insisting Redfield and MicroGeneSys were let off easy. Some of those who were involved in the investigation of Redfield’s activities have started a petition campaign denouncing Trump’s consideration of him for the CDC position.

After the fall

Redfield eventually teamed up with another controversial figure, Robert Gallo, joining his Institute of Human Virology at the University of Maryland in 1996 and has run HIV clinical care programs there ever since. Gallo, who once claimed to have discovered HIV, lost that moniker after years of dispute with French researchers, two of whom were awarded the Nobel Prize. During the Bush administration, which rolled out the enormous President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003, the Gallo group enjoyed strong funding support, and Redfield became a top advocate for the so-called “ABCs of AIDS” in Africa, pressing to prevent HIV infection through abstinence, monogamy, and, if in violation of the first two principles, using condoms.

It’s worth noting here that the entire Institute of Human Virology budget in 2016 was $105 million, a small piece of which was under Redfield’s control. He has never managed anything on the scale of the CDC, with its multibillion-dollar budget and 12,000 employees.

Meanwhile, whoever takes the reins at the CDC will likely oversee massive budget cuts. The White House has called for an overall 10 percent — nearly $1 billion — excision of the agency’s funding. The CDC’s AIDS programs would be reduced along with a range of infectious diseases efforts. Moreover, HIV/AIDS programs such as PEPFAR and programs aimed at tackling malaria, tuberculosis, and epidemic preparedness across the government are slated for major reductions. Global health programs are on the line, as are a variety of women’s health, family planning, gun violence monitoring, and other domestic health efforts.

The CDC will not thrive with Redfield as its leader. He will not serve as a powerful advocate for strong science, expansion of global health and domestic HIV efforts, or separation of religious and empirical perspectives in decision-making. He may not be in possession of hundreds of thousands of dollars’ worth of conflict of interest investments, as was Fitzgerald. But it’s clear that Redfield has plenty of ethical conflicts at the intersection of his religious and scientific views.

Article source:

American Adults Just Keep Getting Fatter

The latest data from the National Health and Nutrition Examination Survey comes at a time when the food industry is pushing back against stronger public health measures aimed at combating obesity.

In recent NAFTA negotiations, the Trump administration has proposed rules favored by major food companies that would limit the ability of the United States, Mexico and Canada to require prominent labels on packaged foods warning about the health risks of foods high in sugar and fat.

While the latest survey data doesn’t explain why Americans continue to get heavier, nutritionists and other experts cite lifestyle, genetics, and, most importantly, a poor diet as factors. Fast food sales in the United States rose 22.7 percent from 2012 to 2017, according to Euromonitor, while packaged food sales rose 8.8 percent.

The latest survey data found that American youth are faring somewhat better than adults. Among Americans ages 2 to 19, 18.5 percent were obese in the 2015 and 2016, while 5.6 percent were severely obese. (A severely obese youth is defined as being 120 percent above the 95th percentile of body-mass-index for age and gender.)

Newsletter Sign Up

Continue reading the main story

The study found that the percentage of youths who are obese and severely obese rose slightly from the 2007-2008 time frame, but not enough to be statistically significant.

Dr. Craig Hales, co-author of the survey research, said the small increase in childhood obesity “could be due to sampling error,” and that the upshot was “no increasing or decreasing trends over the last 10 years.”

“Something different is happening with adults and youth,” he said, adding that he wasn’t able to explain the reasons.

One group of youths that has seen statistically significant weight gain are the youngest children, ages 2 to 5. Obesity rates in this group rose to 13.9 percent in 2015 and 2016 from 10.1 percent in 2007 and 2008.


Continue reading the main story

Scholars who study childhood obesity disagree about whether childhood obesity has plateaued or is increasing.

“We haven’t turned the tide. If anything, rates are continuing to climb upwards.” said Dr. David Ludwig, a nutrition professor at the Harvard T.H. Chan School of Public Health. The 18.5 percent youth obesity rate in 2015-2016 marked an uptick following earlier years dating back to 2007 and 2008 when it had held steady at about 17 percent.

Dr. William Dietz, director of the Stop Obesity Alliance at George Washington University, said that it is premature to reach any conclusions about the trend in childhood obesity.

“I’m worried about it for sure, but we need two more years of data,” he said. Still, he called the overall report “dismal,” given that the high rates of obesity mean high rates of disease and premature death.

Continue reading the main story

Article source:

Here’s the real reason health care costs so much more in the US

<!– –>



15 Hours Ago

A registered nurse hangs an I.V. bag for a patient at the University of Miami Hospital's Emergency Department.

The U.S. is famous for over-spending on health care. The nation spent 17.8 percent of its GDP on health care in 2016. Meanwhile, the average spending of 11 high-income countries assessed in a new report published in the Journal of the American Medical Association — Canada, Germany, Australia, the U.K,. Japan, Sweden, France, the Netherlands, Switzerland, Denmark and the U.S. — was only 11.5 percent.

Per capita, the U.S. spent $9,403. That’s nearly double what the others spent.

This finding offers a new explanation as to why America’s spending is so excessive. According to the researchers at the Harvard Chan School, what sets the U.S. apart may be inflated prices across the board.

In the U.S., they point out, drugs are more expensive. Doctors get paid more. Hospital services and diagnostic tests cost more. And a lot more money goes to planning, regulating and managing medical services at the administrative level.

In other areas, despite conventional wisdom, there seems to be less discrepancy between the U.S. and other countries than commonly thought.

The report challenges popular beliefs about why health care spending is so high

Experts have previously suggested high utilization rates could explain high spending in the U.S. But looking at hospital discharge rates for various procedures, such as knee and hip replacements and different types of heart surgeries, the researchers found that use of care services in the U.S. is not so different compared to other countries.

In fact, compared to the average of all the nations, Americans appear to go to the doctor less often and spend fewer days in the hospital after being admitted.

Think tanks such as the Brookings Institute have suggested that low social spending might also partly be to blame, since funding programs to assist low-income families, the elderly and the disabled would mitigate the demand for medical care. But, again, researchers did not find a substantial difference in U.S. spending on social programs.

The U.S. spends less than average but not by much.

We asked 3 couples about their emergency financial plan and no one was on the same page

Another popular argument is that the American system has an unnecessarily high number of specialists, who typically earn more than general physicians, and that ramps up spending. But, according to this report, “the ratio of primary care physicians to specialists was similar between the United States and other high-income countries.”

“These data suggest that many of the policy efforts in the U.S. have not been truly evidence-based,” said author Ashish Jha, a professor of global health and director of the Harvard Global Health Institute, in a press release.

The U.S. has much higher prices across a range of services

The real difference between the American health care system and systems abroad is pricing.

Specialists, nurses and primary care doctors all earn significantly more in the U.S. compared to other countries. General physicians in America made an average of $218,173 in 2016, the report notes, which was double the average of generalists in the other countries, where pay ranged from $86,607 in Sweden to $154,126 in Germany.

Administrative costs, meanwhile, accounted for 8 percent of the GDP in the U.S. For the other countries, they ranged from 1 percent to 3 percent. Health care professionals in America also reported a higher level of “administrative burden.” A survey showed that a significant portion of doctors call the time they lose to issues surrounding insurance claims and reporting clinical data a major problem.

As for the drug market, the U.S. spent $1,443 per capita on pharmaceuticals. The average pharmaceutical spending of all 11 countries came to $749 per capita. Switzerland followed closest behind the U.S. at $939.

Billionaire Googler shares his top 3 tricks to build wealth

Individual services cost a lot more, too. In 2013, “the average cost in the U.S. was $75,345 for a coronary artery bypass graft surgery, whereas the costs in the Netherlands and Switzerland were $15,742 and $36,509, respectively,” the report states. “Computed tomography was also much higher in the United States, with an average payment of $896 per scan compared with $97 in Canada, $279 in the Netherlands, $432 in Switzerland and $500 in Australia in 2013.

“Similarly, the mean payment for an MRI in the United States was $1,145 compared with $350 in Australia and $461 in the Netherlands.”

Higher spending in some areas could make sense. Investing in pharmaceuticals, for instance, is believed to lead to innovation. Indeed, in 2016 “the U.S. accounted for 57 percent of total global production of new chemical entities,” the report states.

Still, they conclude, “whether innovation justifies high levels of spending is not clear.”

As for salaries, high income may boost performance, and studies have suggested that some countries don’t pay their health care professionals enough. What’s more, high wages in the U.S. may reflect the time and higher amounts of money American health professionals must invest in their education and training.

“Taking this investment into account, however, does not explain the more than $200,000 difference in compensation observed for physicians between countries,” the researchers assert.

Overall, the researchers believe prices in these areas should be analyzed and cut where possible. “As the U.S. continues to struggle with high health-care spending, it is critical that we make progress on curtailing these costs,” said author Irene Papanicolas, visiting assistant professor in the Department of Health Policy and Management at Harvard Chan School.

Quality of care isn’t that bad, but care still doesn’t reach everyone

One of the more notable findings in this report is that, at least in some areas, the quality of health care in the U.S. fared comparably to other countries. Long wait times for treatment, for example, are not as much of an issue for Americans as they are elsewhere. In treating heart attacks and strokes, the U.S. actually had the best record of any country.

So, contrary to past findings, the quality of care may not be much worse in the U.S. than elsewhere. But the nation’s was still shown to be the least accessible health care system.

This paramedic built a 7-figure company

An estimated 22 percent of the population has missed a consultation because they could not afford it, found the report, compared an average of 11 percent between all eleven countries.

Americans also had the lowest rate of coverage. About 10 percent of the population did not have health insurance in 2016. In the other countries studied, nearly everyone was covered.

The percentage of the population with health insurance has increased since the Affordable Care Act was passed, the report states. “Still, a substantial proportion of people would benefit from coverage but remain uninsured in the U.S., and increasing coverage for these individuals remains a policy priority.”

The report sheds new insight on how the U.S. health care system compares to its peers, and the fact that the cost of labor, pharmaceuticals and administrative organization seems to be driving spending. It also points out that, despite that level of spending, too many of its citizens remain uninsured and uncovered.

“As patients, physicians, policy makers, and legislators actively debate the future of the US health system,” the researchers urge, “data such as these are needed to inform policy decisions.”

Like this story? Like CNBC Make It on Facebook!

Don’t miss: Australians may pay more taxes than Americans, but here’s what they get for their money

Canadians may pay more taxes than Americans, but here's what they get for their money

Jonathan Blumberg

a:after {content: “203A”;font-size:1.25em;margin-left:1px;font-family:”Gotham Narrow Ssm 4r”}
@media screen and (max-width: 600px){
.video-wrapper {display: inline-block;width: 47%;}
@media screen and (max-width: 530px){
.wildcard .prime_promo_module {margin: 20px 10px!important;}
.wildcard .prime_promo_module a {font-size: 14px;}
.video-wrapper { display: inline-block;width: 100%;}
.poster-wrapper {max-width: 100%;}
.video-info {margin-left: 0px;width: 100%;max-width: 530px;}
.prime_promo_module i.fa.fa-video {font-size: 3.5em;margin: 55px 105px;}
.prime_promo_module .top{margin:0px;}
body[id*=makeit] a {font-size: 14px;}
h3.content-title {font-size: 22px;line-height: 26px;}
.immersive article .tuneIn p {font-size: 15px;}


Share this video…

Watch Next…

University of Montana receives $1 million for health and medicine efforts

Whenever Keila Szpaller posts new content, you’ll get an email delivered to your inbox with a link.

Email notifications are only sent once a day, and only if there are new matching items.

Article source:

Can fermented foods and drinks boost your health?

It’s hard to imagine how food left out to fester could possibly be good for you. But research has shown how some fermented foods contain bacteria that can help preserve the sanctity of what’s referred to as your “gut biome,” or existing colonies of beneficial bacteria, that live in digestive system.

As a result, many fermented foods and drinks have come to occupy marquee space in your local market. Kombuchas (or fermented teas) in various formations line the shelves, emblazoned with health-promoting promises. Other naturally fermented foods, like yogurt and kefir, kimchi, sauerkraut and tempeh, also now seem to be surging in newfound popularity.

So how do fermented foods help you be healthy?

“Fermentation was a way to prolong the shelf-life of foods back in ancient times. It was an accidental discovery, which augmented the symbiotic relationship with bacteria that we evolved with over hundreds of years,” explains Vincent Pedre, MD., board-certified internist, clinical instructor in medicine at the Mount Sinai School of Medicine, and author of “Happy Gut: The Cleansing Program to Help You Lose Weight, Gain Energy and Eliminate Pain.”

The “good” bacteria some foods acquire during fermentation may potentially have a positive impact on your overall health while keeping “bad” bacteria at bay. “Fermented foods can produce compounds that prevent and destroy the growth of harmful bacteria in the gut, assist in the production of neurotransmitters, acetylcholine (a chemical released by nerve cells to send signals to other cells) and serotonin (a feel-good chemical produced by nerve cells in your gut), aids in the production of stomach acid, boosts your immune system and improves your mood,” says Sandra Allonen, MEd, RD, LDN, outpatient ambulatory dietitian at Beth Israel Deaconess Medical Center in Boston, MA.

Why gut health is so important

“Basically, the gut is the foundation of health upon which every organ in your body is dependent, including your brain,” Pedre explains. “If you can’t absorb nutrients properly, then your body can’t heal. If the gut is so permeable, as in leaky gut syndrome, this has been associated with whole body inflammation, increased risk for metabolic syndrome, glucose intolerance, obesity, dementia and diabetes. Food allergies and sensitivities may be seen on the surface as skin issues, like hives, eczema, and dermatitis, but also internally as migraines, allergies, and asthma. Thus, the gut is strongly connected to every organ system, including the brain, and is a major player in the evolution of systemic, chronic disease,” he explains.

Pedre says fermented foods produce vitamins B12 and K2, which impacts the nervous system to the cardiovascular system to the bones; helping the body to eliminate toxins, fending off harmful bacteria, yeast, and parasites, adding what he calls “friendly flora” to the gut lining — even boosting the immune system.

“Seventy percent of the immune system exists all along the digestive tract,” Pedre explains. “Favorable bacteria has a regulatory effect on the immune system, keeping inflammation down and promoting cells that control the immune response.”

Rising awareness of gut health has driven the sale of probiotics (and related fermented drinks like kombucha) into big business. An article that questions the efficacy of probiotics in Scientific American cites statistics from San Francisco–based business consulting firm Grand View Research, estimating the global probiotics market exceeded $35 billion in 2015 and that it will reach $66 billion by 2024.

But probiotic supplements don’t have plant fibers that contribute to a healthier gut microbiome, says Pedre. So, if you’d rather get your probiotics through fermented foods, where do you start?

Keep an eye out for fermented foods that require refrigeration — Allonen says most fermented foods in supermarket jars or cans have been pasteurized and cooked at high heat, killing any friendly bacteria. She also recommends introducing fermented foods into your diet gradually — they can be problematic if you have yeast overgrowth, like candida. “In this case, eating fermented foods may cause headaches, malaise, fatigue, muscle aches and sometimes even low-grade fevers,” warns Pedre.

Ready to give fermented foods a try? Here are four to add to your diet:

1. Yogurt/Kefir

Pedre recommends homemade kefir as a solid source of good bacteria. “Homemade kefir can achieve probiotic concentrations in the trillions. This can be very beneficial for chronic gut issues of all types, including colitis.” Be super careful though — Allonen warns homemade fermented food that isn’t prepared or handled properly can lead to food poisoning. If you aren’t industrious, seek out plain yogurts and kefirs in the supermarket with live, active cultures and without added sugars or artificial flavors.

2. Sauerkraut

Traced back to ancient times, a tablespoon of sauerkraut, or preserved cabbage, is a great way to take in some good bacteria, says Pedre. However, as this study and Pedre warns, fermentation can increase its histamine content, so those who are histamine sensitive may have a negative reaction to them, like allergies, skin rashes — even hives. “You know if you’re histamine-sensitive if you tend to flush when you drink a glass of wine,” says Pedre.

 Kimchi is a traditional Korean dish made from salted fermented vegetables like cabbage and radishes and spices. Nungning20 / Shutterstock / Nungning20

3. Kimchi

This tasty concoction of fermented vegetables and seasonings is the cornerstone of Korean cuisine. It’s also full of fiber, live cultures and probiotics to keep your gut in check. Try it as a condiment with meat and vegetables in a lettuce wrap or taco, in scrambled eggs or in a salad or rice bowl.

4. Tempeh

This traditional Indonesian food made from soaked and cooked soybeans gets moldy during fermentation, infusing it with nutrients. This vegetarian staple can be used in place of meat in salads, soups, stews and more.

Article source:

Health insurers’ business is booming, White House says

(Story updated at 2:47 p.m. ET)

The White House on Wednesday said health insurers have reaped greater profits since the Affordable Care Act was implemented, despite initial stumbles on the public exchanges.

Individual market premium increases, government-funded tax credits and Medicaid expansion have been a boon to health insurers’ bottom lines, the White House Council of Economic Advisors said in the report, which serves to undermine some lawmakers’ push to secure funding for cost-sharing reduction subsidies and a reinsurance program to prevent further premium hikes on the ACA exchanges next year.

Congress must pass an omnibus spending bill by Friday to avert a government shutdown. The House dropped a measure to fund the cost-sharing reductions for three years and authorize a $30 billion reinsurance from the spending bill earlier this week. Lawmakers Sen. Susan Collins (R-Maine) and Sen. Lamar Alexander (R-Tenn.) are still working to pass a market stabilization measure but chances are slim.

The White House report noted that while some large insurers have exited the individual and small group markets, the plans that remain have raised premiums to account for ACA regulations and older, sicker patients. Those premiums increases have been covered by federal premium subsidies, which go to 85% of exchange enrollees, it said.

“Stable year-over-year enrollment, despite large premium increases suggests a distorted market that involves large transfers from taxpayers to insurers,” the report stated.

Meanwhile, insurers that have exited the individual market because of financial losses have increased their revenues in the Medicare and Medicaid markets, the report said.

The White House said insurers’ stock prices rose 272% from January 2014 to 2018, outperforming the SP 500 index since Jan. 1, 2014, by 106%, and with the recent corporate tax reform, insurers are set to become even more profitable.

America’s Health Insurance Plans, the insurance industry’s dominant lobbying group, commented that health insurers’ profit margins for commercial plans hover in the low- to mid-single digits, and they record even lower margins for Medicare Advantage and Medicaid plans.

“The fact that it has taken so long to achieve some level of profitability speaks to the challenges that have long existed in the individual market,” an AHIP spokeswoman said in response to the White House report.

The report isn’t revelatory. Many health reform experts have said the ACA exchanges are becoming more stable with each passing year, despite the Trump administration’s efforts to undercut the exchanges. While some major insurers, including UnitedHealth, Aetna and Humana, exited or scaled back their participation in the individual market, others such as Centene Corp. and Oscar Health have expanded their footprints.

Many regional Blue Cross and Blue Shield health plans are turning a profit or approaching profitably, as the White House noted. Highmark Health, a Blues-affiliated plan in Pittsburgh, this week said it recorded a profit on the ACA individual market for the first time in 2017.

The White House report, however, did not mention the Trump administration’s continued efforts to undermine the ACA, such as slashing the open enrollment period to 45 days, cutting funding for outreach and advertising, and ending the cost-sharing reduction payments that help reduce out-of-pocket costs for low income enrollees. Health insurers last year cited the absence of cost-sharing subsidies and the pervasive uncertainty in the future of the individual market as major reasons they hiked premiums by more than 30% on average, several analyses have shown.

Article source:

UK Lifts National Health Service Pay Cap, Ending Austerity

U.K. Prime Minister Theresa May’s government lifted the cap on pay for staff in the National Health Service, signaling an end of austerity that has shrunk the real income of nurses over the past eight years.

Under the new deal reached Wednesday, health workers will see their pay rise by 6.5 percent on average over the next three years. Officials from unions representing NHS staff met on Wednesday to sign off on the agreement, which will cost the government about 4.2 billion pounds ($5.9 billion) over three years and cover more than one 1 million people — but exclude doctors.

“We have put money aside specifically for this purpose,” Chief Secretary to the Treasury Liz Truss said in an interview with BBC Radio 5 Live. “We’re able to fund that extra pay from the money that we have found from within the public spending envelope. So we are not increasing public spending beyond our existing plans.”

The fate of the state-funded health service has become a battleground in U.K. politics with Jeremy Corbyn’s opposition Labour Party accusing May of failing patients and nurses and calling for an emergency budget amid what Health Secretary Jeremy Hunt has called the service’s “worst ever” winter crisis.

Related: European Doctors Are Giving Up on the U.K.

Flu season is not over, Stanislaus County health officials say

The flu season is not over and Stanislaus County health officials want to remind people to continue taking precautions.

Even though there has been some decrease in Influenza A, there is another strain causing concern.

Health officials said children are two times as likely to die from Influenza B than A.

This year is considered one of the worst seasons in years. There were 232 flu-related deaths in California and nine deaths in Stanislaus County.

Get the full story in the video above.

Article source:

Patients abused and dying in NHS mental health care

Mental health patients are being failed by “appalling” care daily, the NHS ombudsman has said.

Patients died because their symptoms were dismissed, a baby was taken from its mother with no explanation and a woman who had been sectioned was forced to menstruate into a plastic cup, Rob Behrens said in examples of mistreatment.

Britain should be shocked at how vulnerable patients were routinely stripped of their dignity by a system that did not have enough skilled staff, an overview of 200 cases concluded.

Bosses must start learning from repeated mistakes rather than succumbing to a “nothing I can do, guv” attitude and ministers must realise that fine words are not enough, Mr Behrens said. “This report shows the harrowing impact that failings in mental…

Article source: