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‘Chuck and Nancy,’ Washington’s New Power Couple, Set Sights on Health Care

It will not be easy. Mr. Trump is pressing Congress to adopt the health care legislation, which would cut deeply into Medicaid and dismantle the programs and prescriptions of the Affordable Care Act.

But if the bill can be stopped, the Democratic leaders have already begun nudging the president toward another about-face: setting aside the mantra of “repeal and replace” and adopting modest measures to make his predecessor’s signature domestic achievement work better.

During a recent White House dinner, the pair pushed Mr. Trump to make permanent the subsidies, known as cost-sharing reductions, paid to insurers under the health law to help low-income customers pay for out-of-pocket health expenses like co-payments and deductibles. Mr. Trump has threatened to end such payments, raising uncertainty in insurance markets and increasing premiums for 2018.

In separate interviews, both leaders said that the president was noncommittal and that their future dealings with him would depend on whether he followed through on his pledge to protect young undocumented immigrants brought here as children — beneficiaries of the Obama-era program Mr. Trump is winding down, known as Deferred Action for Childhood Arrivals, or DACA.

“Whether he pivots or not will be one of the most fundamental questions of this administration,” Mr. Schumer said. “It’s the $64,000 question. The only way it can happen is if we have a successful negotiation on DACA, and secondly whether we get health care.”

In some respects, Ms. Pelosi and Mr. Schumer are an unlikely pair. She represents San Francisco and for years has been the subject of harsh attacks from Republicans, who caricature her as affluent, elitist and permissive. He is from Brooklyn and far more attuned to the needs of big business and Wall Street. She is button-down and always on message — at least in public. (In private, she calls Mr. Schumer “Chuckles.”) He is more freewheeling and off the cuff.

When she was House speaker, her real Senate partner was the majority leader at the time, Harry Reid, with whom she helped pass some of the biggest legislative achievements of a generation: the Affordable Care Act, the Dodd-Frank Wall Street regulatory law, the 2009 economic stimulus and President George W. Bush’s Wall Street rescue.


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But Ms. Pelosi’s former chief of staff, John Lawrence, said what while she and Mr. Reid worked well together, “I don’t have the sense it was the same instinctual harmonic relationship that she has with Chuck.”

Ms. Pelosi said she and Mr. Schumer know each other so well that “we speak in shorthand to each other.”


Ms. Pelosi said she and Mr. Schumer were still assessing whether they could trust Mr. Trump.

Tom Brenner/The New York Times

Ms. Pelosi said she and Mr. Schumer were still assessing whether they could trust Mr. Trump. “We will trust each other as long as we can,” she said, adding, “It’s one issue at a time.”

Meanwhile, some Democrats are watching with a skeptical eye.

“I hope and pray that Pelosi and Schumer are more sophisticated and smarter than everyone else that’s been duped by Donald Trump,” said Representative Luis V. Gutiérrez, Democrat of Illinois, after the Democratic leaders announced their tentative deal with Mr. Trump to pursue legislation allowing the young immigrants known as Dreamers to stay in the United States.

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Others see cause for optimism. Several Democratic senators, including Heidi Heitkamp of North Dakota and Richard Blumenthal of Connecticut, said they could foresee Ms. Pelosi and Mr. Schumer reaching an agreement with Mr. Trump on legislation to repair the nation’s crumbling infrastructure, an interest of all three of them.

Senator Richard J. Durbin of Illinois, the No. 2 Democrat in the Senate, went one step further, suggesting possible bipartisan cooperation on the budget.

“I think it’s encouraging; some people don’t,” Mr. Durbin said. “But look what we achieved with the first level of agreement. Without delay, without debate, without histrionics, we sent Hurricane Harvey relief out, we didn’t close down the government, and we extended the debt ceiling of the United States on a bipartisan basis. Pretty good work.”

In working with a president so despised by Democratic voters, especially those on the far left, the two Democrats must tread carefully. Ms. Pelosi got a taste of that this week in San Francisco, when she was shouted down by protesters during a news conference where she had intended to talk about the Dream Act, legislation to offer legal status and a path to citizenship for young unauthorized immigrants brought to the United States as children.

But some Democratic strategists say the leaders have little to lose.

“I think they are in position to make deals that are good for Democratic priorities and that have the support of the Democratic caucus,” said Geoff Garin, Mr. Schumer’s pollster. “And if the deals don’t do those things, then it’s easy for them to walk away.”


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Ms. Pelosi and Mr. Schumer were both traveling with their families on separate vacations in Italy this summer when, each said, they began to strategize on how to use a looming fight over the debt ceiling as leverage to negotiate with Mr. Trump. Mr. Schumer said he proposed urging the White House to extend the debt ceiling for three months, which would force a vote again in December, giving the Democrats leverage over other agenda items. Ms. Pelosi, he said, quickly agreed.

“We were in sync,” Ms. Pelosi said. The debt ceiling deal opened the door to the White House dinner, where the two leaders raised the issue of the young immigrants. Ms. Pelosi said it was important for the president to hear that Mr. Schumer — who became minority leader just this year — was as committed to their fate as she was.

“That’s the beauty of it,” she said. “I’m the usual suspect, and he’s the new leader coming in.”

The Pelosi-Schumer relationship dates to 1987, when Ms. Pelosi, a former chairwoman of the California Democratic Party, was a newly elected congresswoman. Her fellow Californian, Representative George Miller — who was then Mr. Schumer’s landlord and roommate — invited her to a dinner at an Italian restaurant near the Capitol. A collection of House members, including Mr. Schumer, gathered there each Tuesday night to bat around policy ideas.

Mr. Miller gave Ms. Pelosi an auspicious introduction: “You’re going to meet Nancy Pelosi,” Mr. Schumer recalls him saying. “She’s going to become the first woman speaker.”

Mr. Miller was proved correct 20 years later.

“The relationship is longtime,” said Mr. Miller, who retired from the House in 2015. “They’ve had their spats, they’ve had their agreements, they’ve had their strategies become successful and they’ve had their strategies fall flat on their face, and that’s why this is working.”

They have not always seen eye to eye. In 2014, Ms. Pelosi publicly criticized Mr. Schumer when he said it was a tactical mistake for Democrats to have put a health care overhaul on the top of their agenda in 2009 after Barack Obama was elected president. Many analysts believe public anger over the Affordable Care Act cost Democrats control of the House in 2010.

“We come here to do a job, not keep a job,” Ms. Pelosi said then. In a reference to those who gained insurance under the bill, she added, “There are more than 14 million reasons why that’s wrong.”

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Obama Argues Against Dark Worldview, Defends Health Care Law

Former President Barack Obama speaks Wednesday at the Goalkeepers 2017 conference, at New York City’s Jazz at Lincoln Center.

Jamie McCarthy/Getty Images

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Former President Barack Obama speaks Wednesday at the Goalkeepers 2017 conference, at New York City’s Jazz at Lincoln Center.

Jamie McCarthy/Getty Images

Former President Barack Obama delivered a rebuke of President Trump’s “America First” worldview Wednesday in New York, the same city where Trump is meeting with world leaders on the sidelines of the United Nations General Assembly.

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“You have to start with a premise and believe that multilateral institutions and efforts are important,” Obama said, “and you don’t have to cede all your sovereignty and it doesn’t make you less patriotic to believe that. You just have to have some sense — and read.”

He also offered a vigorous defense of his signature health care law, the Affordable Care Act, or Obamacare, as Senate Republicans in Washington, D.C., try to corral the final votes needed to pass their latest effort to repeal and replace it.

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“It is aggravating,” the former president said of watching yet another repeal effort, “and all of this being done without any … rationale, it frustrates. And it is certainly frustrating to have to mobilize every couple of months to prevent our leaders from imposing real human suffering on our constituents.”

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Though he did not name Trump during his speech and a question-and-answer session that followed, Obama argued against a dark and pessimistic world outlook.

“We have to reject the notion that we are suddenly gripped by forces that we cannot control,” Obama said at a Goalkeepers conference, a gathering of young, international activists sponsored by the Bill and Melinda Gates Foundation (which is among NPR’s financial supporters). “[We've] got to embrace the longer and more optimistic view of history and the role that we play in it. And if you are skeptical of such optimism, I will say something that may sound controversial. … By just about every measure, America is better and the world is better than it was 50 years ago, 30 years ago, or even 10 years ago. And I know that statement doesn’t jibe with the steady stream of bad news and cynicism that we’re fed through television and Twitter. But it’s true. Think about it: I was born at a time, for example, when women and people of color were systematically excluded from big chunks of American life. … Even if we still have miles to travel and innumerable laws and hearts and minds to change, the shift in what this country is and what it means is astonishing, remarkable and it’s happened, when you measure it against the scope of human history [snaps fingers] in an instant.”

Obama argued that crime, teen birth, dropout, poverty and uninsured rates are all down; and that the share of those with college degrees is up, as are median incomes and life expectancies. He also contended that democratic and civil rights — like the right to vote and the right to marry — have expanded for women, ethnic and racial minorities and gays and lesbians.

“All of this has happened in such a steady march that sometimes we have a tendency to take it for granted,” Obama said.

He added, “If you had to choose any moment in history in which to be born, and you didn’t know in advance whether you’re going to be male or female, what country you’re going to be from, what your status was, you’d choose right now because the world has never been healthier or wealthier or better educated or in many ways more tolerant or less violent than it is today.”

That “Yes, we can” optimism stands in stark contrast to the nostalgia signified by Trump’s “Make America Great Again” slogan. The current occupant of the White House rose to prominence and power by selling millions of Americans on a vision of America and the world now as dark and scary places.

Part of how Trump did that was by channeling their cultural anxieties. Obama hat-tipped to that rising feeling of grievance as a critical problem in the world, describing it as “the rise of nationalism and xenophobia and a politics that says it’s not ‘we’ but ‘us and them,’ a politics that threatens to turn people away from the kind of collective action that’s always driven human progress.”

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Insurers Come Out Swinging Against New Republican Health Care Bill

Senate Republicans are already under pressure from 11 governors — including five fellow Republicans and a pivotal Alaskan independent — who this week urged the Senate to reject the last-ditch repeal effort.

The two major trade groups for insurers, the Blue Cross Blue Shield Association and America’s Health Insurance Plans, announced their opposition on Wednesday to the Graham-Cassidy bill. They joined other groups fighting the bill, such as the American Medical Association, the American Hospital Association, AARP and the lobbying arm of the American Cancer Society.

“The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions,’’ said Scott P. Serota, the president and chief executive of the Blue Cross Blue Shield Association. “The legislation reduces funding for many states significantly and would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americans’ choice of health plans.”

America’s Health Insurance Plans was even more pointed. The legislation could hurt patients by “further destabilizing the individual market” and could potentially allow “government-controlled single payer health care to grow,” said Marilyn B. Tavenner, the president and chief executive of the association. Without controls, some states could simply eliminate private insurance, she warned.

Insurers had been reluctant to speak out against the Republicans’ previous proposals in hopes that the White House and Congress would agree to stabilize insurance markets by providing critical funding for subsidies aimed at low-income Americans. But with hopes of securing that money before they finalize their rates virtually extinguished, insurers have less to lose by coming out against the proposal.

And many within the industry are worried that the next two years will be chaotic, with little support for the current market while states scramble to come up with a new way for individuals to buy policies.

“It’s just basically injecting chaos in 50 state capitals for the next two years,” said Sabrina Corlette, a research professor at Georgetown University.


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At this point, Republicans have not secured the 50 votes they would need to pass the bill, with help from Vice President Mike Pence to break a tie. But President Trump, in New York for meetings with world leaders at the United Nations, said he thought the health care bill had “a very good chance’’ of passing.

It has “tremendous support from Republicans — certainly we’re at 47 or 48 already,’’ he said, and “a lot of others are looking at it very positively.’’

“A great Bill,” Mr. Trump concluded on Twitter later Wednesday.

The latest Republican drive to repeal the Affordable Care Act has created painful choices for Republican senators from states that stand to lose money under the legislation.

The bill would eliminate penalties for people who go without insurance, and it would funnel federal funds to states in the form of block grants for health care or coverage. States could decide how to spend the money, which is now being used for the expansion of Medicaid and for subsidies to help low- and middle-income people buy private insurance.

State officials were racing to try to figure out the impact, looking to experts to help them do the calculations.

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“States such as Alaska, Connecticut, Delaware, New Hampshire, New Mexico, New York, Oregon, Vermont and Washington would see reductions of 25 percent or more over the 2020 to 2026 period,” compared with what they would receive under current law, said a monograph issued on Wednesday by Manatt Health, a unit of Manatt, Phelps Phillips, a national law firm that advises many states on health care issues.

Among the Republicans agonizing over how to vote is Ms. Murkowski, who has said the bill’s effect on her state will be her paramount consideration.

Becky Hultberg, the president and chief executive of the Alaska State Hospital and Nursing Home Association, said on Wednesday that the cuts in the bill could have a “huge impact” on Alaska.

“The cuts could be devastating to our health care system, including rural and frontier hospitals that operate on razor-thin margins,” Ms. Hultberg said in an interview. “These hospitals are often accessible only by airplane or ferry, so the loss of a hospital means an expensive and disruptive medical evacuation out of the community.”


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“Ultimately,” Ms. Hultberg said, “patients will bear the consequences, through reduced access to health care and lost insurance coverage.”

The authors of the new repeal bill, Mr. Graham and Mr. Cassidy, say decisions about health care are best made at the local level.

Mr. McCain is a close friend of Mr. Graham, but is still studying the bill and has not said how he would vote.

The other Republican senator from Arizona, Jeff Flake, had no such hesitation. “Given the choice between Arizona or Washington deciding how federal health care dollars are spent in the state,’’ he said, “I’ll take Arizona every day of the week.’’

The Manatt study said Arizona would lose money under the bill, and a study by Avalere, a health policy consulting company, reached a similar conclusion. Both studies indicated that Tennessee would gain money.

Senator Bob Corker, Republican of Tennessee, said he liked the latest repeal bill. “I’d be ecstatic if we could finally make something happen on health care’’ by passing it, he said, adding: “I’m a states’ rights kind of guy. Our state has been well run for a long time. To know that our state would have the flexibility to carry out the program with more money than it now has could be a real win for us.’’

The studies by Manatt and Avalere suggest that West Virginia would lose money under the bill. Ms. Capito “is still evaluating the proposal,” said her spokeswoman, Ashley Berrang.

But the state’s senior senator, Joe Manchin III, a Democrat, said, “The numbers do not work at all for West Virginia, with an older, sicker population and an opioid addiction problem.”

“As a former governor, I like the concept of block grants because they give you flexibility,” Mr. Manchin said. “But the cuts are deeper than the needs we have, and our needs are greater than the money we would have under the bill.”

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Now is the time to be bullish about digital health, according to this investor

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Proteus Digital Health

Earlier this month, my friend and industry colleague Rob Coppedge wrote a thoughtful post on the death of digital health, a space associated with too much hype and too little substance.

We agree that health care is really broken. It bankrupts our families, exhausts government discretionary spending, and leaves American industry at a global disadvantage.

However, here are a few divergent reasons for digital health’s (seeming) underperformance, which explains why early-stage investors aren’t getting the kind of returns they’re looking for:

  • Incrementalism: Hundreds of startups produce enterprise dashboards, online symptom checkers, and evidence-light apps. Many of these are flippant and those that are worthy often offer only incremental progress. By nature of their modest impact and the barriers to scale, many expectations are not being met.
  • Invisible unicorns: An aside, but there are many quiet successes in digital health that didn’t produce PR-driven Silicon Valley exits. How about CoverMyMeds? This team in Ohio used tech, network effects, and empathy to solve a real problem, reducing dispensing time for medications requiring payer prior authorization from an average of 14 days to 30 minutes. How? By embedding tech in the pharmacy, doctor’s office and payer — all while getting pharma to foot the bill. The result: a $1.3 billion exit to McKesson. Start-up land barely noticed.
  • Late bloomers: There may be many sleeping giants, as solving certain problems with scale sometimes takes longer in health. Just look at Pear Therapeutics, which this week received FDA clearance after a years-long process for its app to help treat substance abuse. Investors will need to think very hard to discern what can scale quickly versus what will need to bake slowly for longer.
  • Poor execution: The underlying issue with many failed or struggling digital health companies is poor execution. The excitement of the mission seems to slow down the need for timely product feedback. Most CEOs suffer from wishful thinking on the imminence of product-market fit, and defensible distribution has too often been an afterthought.
  • The “O” word: Oligopoly. As providers seek local market monopoly in the name of “scale and efficiency” or to pay for expensive medical record systems, costs soar and innovation falters. Likewise, the pharma supply chain makes money because of a lack of competition and transparent data, and payers are swimming in record profits. A special team of founders should not turn back form these challenges, but they should know the treacherous waters into which they sail.
  • Lack of ambition: Where is the Elon Musk of care provision? Why hasn’t anyone actually taken on the hospital? Hundreds of medication adherence apps entered the market in recent years, but only one start-up I can find is directly taking on the pharmacy benefits manager. In other verticals, we are seeing massive incumbents falling to data-driven, disruptive companies. We need some bigger bets in health care.

Think back to the wound-licking days of 2004…

I try to imagine how investors and founders felt in 2004. The bubble had burst, forcing the posers to depart. Meanwhile, a much smaller group of entrepreneurs kept building things, believing full well that the promise of the Internet from 1997 was not a false mirage but would take two or three rapid ecosystem iterations to actualize. And I believe some VC vintages in the following years ripened quite nicely.

This is where we are with digital health. We still need better real-time informatics that surround all that touch the patient. We still need to move data, remove silos, reinvent primary care and elder care, and bring genomics to the clinic at scale. We need to do this while taking on new models for risk and improving outcomes for populations.

And here’s where I have good news

First, so many of the best ideas from the past 10 years were just too early. But with dependencies removed, lessons learned and chess boards realigned, it’s time for the bigger second acts. Napster and MySpace and AOL paved the way for some much bigger platforms.

Secondly, the quality of some entrepreneurs starting ambitious companies in health and data is breathtaking. The advances in health research, design thinking and technology stack capabilities are helping a new class of health-technology founding teams. The talent and the tools are improving.

And then there’s the data. Deep computation is transforming how we live and work, and how we make human progress in areas like space, agriculture, manufacturing, transportation and retail. This deep compute has yet to truly make its mark on how we provide health care, and one or two large organizations dressing up buzzwords as marketing doesn’t count.

Make no mistake, the advances in computational power and data science are rapidly arriving in health provision. In the next ten years, we are going to create massively-valuable companies using deep compute to improve and QA decision-making, better enable empathetic health providers, and impact systems of care to create more personalized experiences for patients at every stage of their journey.

In fact, at some point it will no longer be called “digital health” because all aspects of health care provision will be built upon and infused with data and intelligence, from the optimized patient to a “learning” system of care.

There are blueprints to monetize

In addition to jumping through the aforementioned hurdles, we also need to address the assertion that there’s no clear path to make money in digital health.

There are many models, but here are three that are proven::

  1. 50X better: Yes, you can sell into the belly of the beast of our health system, but you do so with a product that solves a very specific problem and is 10 or even 50 times better than what was offered before. You still face speed bumps in validation, regulation and adoption, but you persevere.
  2. Full-stack: Rather than convince a huge number of stakeholders to adopt your technology, you identify the one that has to say “yes”, like a large self-insured employer. And you then go “full stack” as a tech and health business. Take Virta Health, a start-up that aims to reverse Type 2 diabetes. Rather than convincing thousands of providers and other groups to adopt new software and guidelines, Virta sells to the employer to become the “full stack” for the patient and builds a holistic provider-led clinic around this patient.
  3. Network effects: Creating a virtuous cycle where your product gets more valuable to users as more people use it is incontrovertibly powerful. And yet, there have been very few network effect platforms in U.S. health care. Network effects don’t solve every problem, but in solving problems like moving data, delivering new networks of caregiver support, and deep areas of research, we need to see more of these.

In sum, we need to be more ambitious, invest more heavily in our best entrepreneurs, and rebuild every use-case with our best data and computation. The first chapter is behind us, and now is the time to be bullish.

Scott Barclay is an entrepreneur and operator who has worked in health care for 20 years and is now a Partner at Data Collective, an early-stage investment fund focused on deep tech and compute.

Health officials declare hepatitis A outbreak in LA County

Los Angeles County health officials declared a hepatitis A outbreak Tuesday, days after a public health emergency was announced in San Diego County, where at least 16 people have died of the highly contagious virus.

Case numbers are still small in L.A. County, with only 10 people infected as part of the outbreak, said Dr. Barbara Ferrer, director of the L.A. County Department of Public Health. By comparison, almost 450 people have contracted the virus in San Diego.

Ferrer said the department is ramping up prevention efforts locally so more people don’t get sick. San Diego’s outbreak has already spread to Santa Cruz, where 69 people have been diagnosed.

Officials say homeless people in California are most at risk, because the virus appears to be moving from person to person within that community. People become infected with hepatitis A, which affects the liver, by ingesting the feces of someone who’s infected, often through contaminated food or sexual contact.

Graham-Cassidy health care bill: What you need to know

If two more senators vote no the bill is dead

Republicans need 50 votes to pass and the bill and can’t afford to lose any more senators’ support. As of now, Sens. Susan Collins of Maine, John McCain of Arizona and Lisa Murkowski of Alaska are all undecided, but they voted against the GOP’s last attempt to repeal Obamacare and could vote against this bill as well.


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10 Foods That Science Suggests Really Do Contribute To Long-Term Health


A bad diet is now a leading cause of death across the globe. Much of this is due to the fact that people who had previously eaten much healthier, traditional diets are now eating more “Westernized” fare. And its effects on global health are, unfortunately, showing.

Here in the U.S., it can sometimes seem that dietary advice changes all the time. But that’s not really the case. With a couple of exceptions (like the famous fats vs. sugar debate), what we know about nutrition has been relatively stable in recent years, with new research mostly fleshing out the correlations between food and long-term health, and illuminating the underlying mechanisms. And there are some individual foods that are particularly well-studied and repeatedly linked to long-term health. Of course, it’s not possible to eat only these foods all the time, but the idea is just to cycle them into your diet as much as you can stand, both psychologically and economically.

Here are the foods that science shows are very much linked to the reduction of disease, both physical and neurological, over the long term, and for which the mechanisms are largely mapped out.

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This goes at the top of the list because it’s such an interesting food-drug. For those of us who drink it regularly, the positive research in the last 10 years has been heartening. One of coffee’s great benefits is that it seems to be linked to brain health: Not only does it keep us alert in the short-term, by blocking adenosine receptors, but coffee consumption has also been linked to reduced risk of depression, and even of Alzheimer’s and Parkinson’s diseases. And newer research suggests that coffee drinkers may have a longevity advantage over non-drinkers. In one recent study, people who drank four cups per day had a 64% reduced risk of death over the years of the study (it was 22% for two-cup-a-day drinkers). This is partly because compounds in coffee improve vascular health, help repair cellular damage and reduce inflammation, which itself is linked to most of the chronic diseases.

Some people find the side effects (namely, anxiety) too much to handle, so may want to do decaf instead, which seems to have many of the same benefits (so does green tea). But for those who already “use” the regular form of the substance, and are happy doing so, it seems to be a good idea to continue.

Salmon and other fatty fish (or algae)

There’s a misapprehension that all omega-3 fatty acids are created equal. They’re not. The long-chain omega-3 fatty acids found in fish are abbreviated EPA and DHA, and are known to be especially important for the brain and the heart over the long term, reducing the risk of dementia and of heart disease. One study found that DHA supplementation can even counteract the neuronal damage that a high-sugar diet can bring about. The omega-3 fatty acids found in plant sources — like walnuts and flaxseeds — are called ALA, which the body can convert into EPA and DHA, but pretty inefficiently. (For more on the difference, see this.) If you don’t eat seafood, supplements can be a good idea — and since DHA is also found in algae, vegetarians and those concerned about sustainability may want to supplement this way.

(NB: Omega-6s are another kind of fatty acids all together, and while generally healthy in moderate amounts, can lead to inflammation if eaten excessively. Don’t confuse your omegas. This is why a good balance of omega-3 to omega-6 is important, and a good balance of DHA/EPA to ALA equally important.)


Nuts deserve their own category, because they have, separately from other plant-based foods, been linked to all kinds of desirable outcomes, like heart health, reduced inflammation and reduced mortality. As mentioned above, some nuts, particularly walnuts, contain good amounts of omega-3s (though again they’re a slightly inferior version of the fats than are present in fish and algae). And nuts have lots of other benefits including essential vitamins, fiber and protein. Almonds were recently shown to improve “good” cholesterol levels. Another new study found that walnuts may reduce activity in areas of the brain associated with food craving, which may help explain their known effects on metabolic health.

Peanuts (although not technically a nut) have also been linked to heart health and longevity, but sadly for many, peanut butter hasn’t been shown to have the same benefits, possibly because of the often-added hydrogenated oils and sugar. So sticking with actual nuts — walnuts, pecans, almonds and even peanuts — in their natural form is probably smart.



Speaking of peanuts, legumes (beans, peas, lentils and peanuts) are also worth putting into your diet if you don’t already. They have high quantities of protein and fiber, as well as nutrients like folate, zinc, iron and magnesium. Their consumption has been linked to a number of health benefits, including reduced blood pressure, coronary heart disease, obesity and diabetes.

A recent study looking at over 135,000 participants in 18 countries across the globe found that eating legumes was associated with a lower risk of overall mortality and mortality from non-cardiovascular issues. “Eating even one serving per day decreases the risk of cardiovascular disease and death,” said study author Victoria Miller in a news release. “Legumes are not commonly consumed outside these geographic regions, so increased consumption among populations in Europe or North America may be favourable.”

Intensely colored vegetables

Experts have long been saying to “eat the rainbow” when it comes to vegetables: for example, dark leafy greens, sweet potatoes, red peppers, avocados, broccoli, tomatoes, purple onion and red cabbage. There’s no single reason that brightly colored vegetables are healthy — there are several ways in which they confer health or perhaps prevent poor health. For instance, the orange ones are high in beta-carotene; avocados are rich in unsaturated fats; tomatoes, especially cooked, and red peppers are high in lycopene; cruciferous vegetables, particularly broccoli, have phenolic compounds that are linked to reduction in cancer risk; dark leafy greens are high in folate, among many other vitamins, and fiber.

There are multiple mechanisms behind the connection between vegetables and reduced heart and cancer risk, so cycling in as many as you comfortably can is one of the cornerstones of healthy eating. Keep in mind that the nutrient level of vegetables is generally proportional to the richness of their color. For example, iceberg lettuce has relatively little nutritional value, whereas kale, spinach and collard greens have much more.


Berries (and other fruits)

Berries, especially blueberries, are often touted as “super foods,” for their high levels of antioxidants. In fact, blueberries are the only fruit that the MIND Diet specifically recommends, based on brain research. Otherwise, since fruits tend to be high in sugar, it’s a little unclear how much we should eat.

That said, fruits are generally high in vitamins and fiber, and a better go-to for snacking than many of the things we usually go to. Citrus fruits have been linked to reduced risk of blood cancer and esophageal cancer (and oddly, to increased risk of skin cancer, since a compound seems to make skin more sensitive to light). Apples have been also been linked to a reduced risk of several types of cancer. And grapes, with their high levels of resveratrol, have been linked to reduced risk of cancer and dementia. So again, while berries may be the true super food for their high antioxidant levels, other fruits are likely a good staple to have in our diets.

Fermented things

This category is fairly broad since fermented foods in general (not just the usual one that we think of: yogurt) are good for our microbiomes — the beneficial bacteria that live in our guts and have been linked to everything from depression risk to cancer risk to overweight/obesity. Yogurt is the obvious fermented food, since it contains relatively high levels of friendly bacteria like L. acidophilus. But other fermented foods like sauerkraut, kimchi, miso, tempeh and even pickles are thought to be good for the gut and its beneficial bacteria.

Whole grains

These get an entry, even though it’s not totally clear whether whole grains are really a super food (particularly given the definition of whole grain in the U.S.) or whether they’re just a better alterative to what most people eat — refined grains. Whole grains are those with the germ and the bran still present; refined grains have had those parts stripped away, which means they consist only of the starchy, low-nutrient endosperm. But during the processing of even whole grains the beneficial parts can be degraded, and there’s been some controversy about how to conceptualize and define whole grains in the food industry.

In epidemiological studies, whole grains have certainly been linked to beneficial health outcomes: reduced heart risk and a longer life, as well as reduced risks of diabetes and colon cancer. And they are sources of vitamins, minerals, antioxidants and, if it’s not processed away, fiber. Many people in the U.S. could probably eat fewer carbs in general, increasing vegetables, lean protein and healthy fats. But carbs are not evil, and they’re fine to eat in moderation. Just make sure your grains are as whole and fiber-rich as possible, with as little processing — and added sugar and chemicals — as possible.


Turmeric and other spices

A handful of spices have been linked to significant long-term health benefits, mainly in the way of better cognitive function, reduced dementia risk, reduced cancer risk and better glucose metabolism. Turmeric, a key component of curry, has been linked to reduced incidence of Alzheimer’s disease, presumably for its antioxidant and anti-inflammatory properties. It’s also been shown to have anti-tumor properties (however, it’s also been shown to inhibit some chemotherapies, so always talk with your doctor).

Other spices, like cinnamon, have been shown to reduce blood sugar levels, so may be helpful to diabetics or in diabetes prevention, or to anyone trying to control their weight. And spiciness itself, in the form of chili peppers’ capsaicin, has been linked to heart health, likely through its effects on the vascular system. Again, there are lots of mechanisms through which various spices may exert their effects, so keeping a varied array of spices in your life is likely a good idea for health, along with the obvious: they taste good.


It seems like this is a good one to end on. The catch is that the research suggests that for health benefits, the chocolate needs to be dark, rather than milk or white. Sweets in general are not good foods to keep in your diet (except on occasion). The Mediterranean diet, the MIND Diet, the DASH diet, and just about all the research that’s rolling in these days suggests that sugar be quite limited. Studies have shown that added sugar, particularly processed sugar, is linked to just about every chronic disease there is — cancer, diabetes, heart disease and dementia. Cocoa, very separate from sweets, is linked to cognition, heart health and neurological health, likely due to its high levels of polyphenols. And while many of these studies are done with high-potency cocoa drinks, there’s also evidence suggesting that dark chocolate might confer similar benefits. Again, the key is to choose a low-sugar, dark variety of chocolate (i.e., chocolate cake doesn’t count).

* * *

Again, it’s probably not possible to subside on only these foods all the time, but just to include them as much as you realistically can. Hopefully, the more we learn about the effects of foods on long-term health, the American diet will start to fade away — and so will the serious health risks it brings with it.

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UC Irvine aims to transform public health with record-breaking $200-million donation

Susan Samueli caught a cold while visiting France more than three decades ago. Instead of the usual medicines, a friend suggested aconite, a homeopathic remedy derived from a plant in the buttercup family.

She was cured — and became a lifelong advocate of homeopathy and other alternative healing methods to complement conventional medicine. Her husband, Henry — the billionaire co-founder of Broadcom, the Irvine semiconductor maker — says he was initially skeptical but found the integrative health approach helped him easily shake off colds and flus and kept their children healthy without antibiotics.

Now the couple’s passion for integrative health has led to the largest donation ever made to UC Irvine. On Monday, UC Irvine Chancellor Howard Gillman announced that the Samuelis have donated $200 million to launch what he billed as the nation’s first universitywide enterprise to embed integrative health approaches in research, teaching and patient care.

“The human body is a very complex and highly interconnected system. Therefore our healthcare needs to be looked at through a more holistic lens,” Henry Samueli, who also owns the Anaheim Ducks, said in remarks at UC Irvine. “Our genetics, our surrounding environment, our nutrition, our physical activity and our mental state all play critical roles in our well-being.”

The GOP Congress Is Rushing Wildly Ahead With A Huge Health Care Bill. Again.

Collins and Murkowski haven’t said how they’d vote, either. Both senators objected to the previous bills’ steep cuts to Medicaid, among other things, and Cassidy-Graham also slashes the budget for that program. Arguably more significantly, Collins and Murkowski oppose eliminating federal funding for Planned Parenthood, which this bill would do.

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Tillerson Says US May Close Cuba Embassy Over Health Attacks

A closing of the embassy, were it to occur, would be less a political statement than one of concern over the risks that employees face in Havana. The American Foreign Service Association reported this month that the symptoms among those affected included mild traumatic brain injury, permanent hearing loss, loss of balance, severe headaches and brain swelling.

While noting that Cuba is responsible for protecting the health of diplomats posted to the country, State Department officials have yet to suggest that the Cuban government was behind the attacks. The Associated Press reported this weekend that the initial reaction by the Cuban president, Raúl Castro, to the news — apparent concern, with none of the usual how-dare-you-accuse-us attitude — had caught American officials off guard.

The Cubans even offered to let the F.B.I. go to Havana and investigate, a rare level of openness that suggested to some American officials that the Cuban government was equally baffled about the cause. Victims told The A.P. how they walked in and out of what seemed like powerful beams of sound that hit only certain rooms or even only parts of rooms.

American officials have speculated that the problems may have resulted from some sort of sonic attack or perhaps a surveillance operation gone wrong. The attack may have been the work of a rogue government unit or another government like Russia. That a Canadian diplomat was also affected deepened the mystery. Relations between Canada and Cuba have long been warm.

While the Trump administration has moved to reinstate travel and commercial restrictions on Cuba, there has appeared to be little appetite to entirely undo measures that are broadly popular, including among Republicans. That is another reason the administration has reacted cautiously.

Still, the attacks have led to growing concern on Capitol Hill. On Friday, five Republican senators sent a letter to Mr. Tillerson asking that he expel all Cuban diplomats in the United States and, if Cuba does not take tangible action, close the American Embassy in Havana.

American and Cuban officials met in Washington that day as part of a continuing law enforcement dialogue, and the subject of the attacks was raised, according to the State Department.

“It is an aggressive investigation that continues, and we will continue doing this until we find out who or what is responsible for this,” Heather Nauert, the department’s spokeswoman, said on Thursday.

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