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Friday, February 15, 2013

Beshear endorses statewide smoking ban as bill moves to the House floor; Williamsburg adopts its own ban

Gov. Steve Beshear endorsed a statewide smoking ban yesterday at a Frankfort rally to push the bill that would enact the ban.

"Beshear, who later acknowledged that he smoked in college but quit soon afterwards, said Kentucky ranks No. 1 in the nation in smoking and lung cancer," reports Jack Brammer of the Lexington Herald-Leader.

Noting that Kentucky leads the nation in smoking, Beshear said, "Our addiction hurts productivity, jacks up health care costs and literally kills our people. Yet we've never instituted a statewide law to protect Kentuckians from secondhand smoke." Noting that over one-third of Kentuckians live in jurisdictions with smoking bans, he said, "It's time that we extend that protection to all Kentuckians. . . . Years from now, people will wonder why we waited so long."

Republican Rep. Julie Raque Adams  of Louisville, a co-sponsor of the bill, noted at the rally that Williamsburg this week became the 23rd Kentucky locality to adopt a smoking ban.

The statewide measure, House Bill 190, was posted for passage in the House today but is not expected to be called for a vote unless supporters show Speaker Greg Stumbo that they have the votes to pass it.


Read more here: http://www.kentucky.com/2013/02/14/2517025/former-kentucky-basketball-star.html#storylink=cpy
Gov. Steve Beshear endorsed a statewide smoking ban yesterday at a Frankfort rally to push the bill that would enact the ban.

"Beshear, who later acknowledged that he smoked in college but quit soon afterwards, said Kentucky ranks No. 1 in the nation in smoking and lung cancer," reports Jack Brammer of the Lexington Herald-Leader.

Noting that Kentucky leads the nation in smoking, Beshear said, "Our addiction hurts productivity, jacks up health care costs and literally kills our people. Yet we've never instituted a statewide law to protect Kentuckians from secondhand smoke." Noting that over one-third of Kentuckians live in jurisdictions with smoking bans, he said, "It's time that we extend that protection to all Kentuckians. . . . Years from now, people will wonder why we waited so long."

Republican Rep. Julie Raque Adams  of Louisville, a co-sponsor of the bill, noted at the rally that Williamsburg this week became the 23rd Kentucky locality to adopt a smoking ban.

The statewide measure, House Bill 190, was posted for passage in the House today but is not expected to be called for a vote unless supporters show Speaker Greg Stumbo that they have the votes to pass it.


Read more here: http://www.kentucky.com/2013/02/14/2517025/former-kentucky-basketball-star.html#storylink=cpy
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Thursday, February 14, 2013

Value of tests to diagnose FIP

Jeffery U, Deitz K and Hostetter S. Positive predictive value of albumin: globulin ratio for feline infectious peritonitis in a mid-western referral hospital population. J Feline Med Surg. 2012; 14: 903-5
 
The definitive method to diagnose feline infectious peritonitis (FIP) is biopsy and histopathology. A previous report has indicated that a low serum albumin to globulin (A:G) ratio has a high positive predicative value for FIP in cats with clinical signs highly suggestive of the disease. Yet, FIP can present with more vague clinical signs. Predictive values (positive and negative) depend significantly on the prevalence of the disease in the tested population. The positive predictive value is the probability that an animal with a positive test truly has the target disease. When prevalence of the disease is high, the positive predictive value of a test will be greater than when prevalence is low. The authors of this retrospective study investigated the performance of low A:G ratio as a diagnostic test for cats with vague signs of illness consistent with a possible diagnosis of FIP. They wanted to establish the positive predictive value of A:G less than 0.8 and less than 0.6 for FIP in a referral hospital in a mid-west population of cats with one or more clinical signs compatible with FIP (lethargy and inappetance, along with weight loss, pyrexia, effusion, neurological signs, diarrhea, mild upper respiratory tract signs, ocular lesions, and jaundice).

The findings of this study show the importance of determining diagnostic test performance in relation to the population in which the test will be performed. In this study’s results, a cat with an A:G of 0.6 or more was highly unlikely to have FIP. Also, in this population of cats (those visiting a referral hospital in mid-west United States) where the prevalence of FIP is low, a low A:G is of little value in confirming FIP. Therefore, using an A:G of less than 0.8 or less than 0.6 to support a diagnosis of FIP in a patient from a population where FIP would be one of several differential diagnoses carries a high risk of a false-positive diagnosis. [VT]

See also: Fischer Y, Sauter-Louis C and Hartmann K. Diagnostic accuracy of the Rivalta test for feline infectious peritonitis. Vet Clin Pathol. 2012; 41: 558-67

Related blog posts:
Diagnosis of FIP (May 2011)
Development of new therapies for FIP (March 2012)
Jeffery U, Deitz K and Hostetter S. Positive predictive value of albumin: globulin ratio for feline infectious peritonitis in a mid-western referral hospital population. J Feline Med Surg. 2012; 14: 903-5
 
The definitive method to diagnose feline infectious peritonitis (FIP) is biopsy and histopathology. A previous report has indicated that a low serum albumin to globulin (A:G) ratio has a high positive predicative value for FIP in cats with clinical signs highly suggestive of the disease. Yet, FIP can present with more vague clinical signs. Predictive values (positive and negative) depend significantly on the prevalence of the disease in the tested population. The positive predictive value is the probability that an animal with a positive test truly has the target disease. When prevalence of the disease is high, the positive predictive value of a test will be greater than when prevalence is low. The authors of this retrospective study investigated the performance of low A:G ratio as a diagnostic test for cats with vague signs of illness consistent with a possible diagnosis of FIP. They wanted to establish the positive predictive value of A:G less than 0.8 and less than 0.6 for FIP in a referral hospital in a mid-west population of cats with one or more clinical signs compatible with FIP (lethargy and inappetance, along with weight loss, pyrexia, effusion, neurological signs, diarrhea, mild upper respiratory tract signs, ocular lesions, and jaundice).

The findings of this study show the importance of determining diagnostic test performance in relation to the population in which the test will be performed. In this study’s results, a cat with an A:G of 0.6 or more was highly unlikely to have FIP. Also, in this population of cats (those visiting a referral hospital in mid-west United States) where the prevalence of FIP is low, a low A:G is of little value in confirming FIP. Therefore, using an A:G of less than 0.8 or less than 0.6 to support a diagnosis of FIP in a patient from a population where FIP would be one of several differential diagnoses carries a high risk of a false-positive diagnosis. [VT]

See also: Fischer Y, Sauter-Louis C and Hartmann K. Diagnostic accuracy of the Rivalta test for feline infectious peritonitis. Vet Clin Pathol. 2012; 41: 558-67

Related blog posts:
Diagnosis of FIP (May 2011)
Development of new therapies for FIP (March 2012)
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Wednesday, February 13, 2013

Frontier Nursing University in Hyden helps bring better family health care to rural America with distance learning

Midwives and nurse practitioners who recently graduated from Frontier Nursing University in Hyden address the unique challenges of rural areas, including shortages of health care providers, by bringing local health care to rural communities across the country. FNU was featured in a recent report from the Robert Wood Johnson Foundation.

FNU, a graduate program that offers distance education to nurses with an interest in nurse-midwifery and family nurse practitioner and women’s health specialties, aims to build a pipeline of highly educated nurses serving in rural or underserved areas, reports RWJF, one of its funders.  Many scholars and grantees sponsored by RWJF go on to spearhead projects to improve access to high quality nursing care in remote areas, the foundation says.

“We’re trying to introduce primary care providers into rural areas in such a way that they can provide high quality care and preventive services too,” says Suzan Ulrich, associate dean of midwifery and women’s health at FNU and an RWJF executive nurse fellow.

Demand for health care is rising nationwide because of an aging population that is living longer, but sicker, with multiple chronic conditions. The need for health care providers will intensify next year, when millions of new patients will become eligible for health insurance under the health-reform law.

Rural parts of the country face unique challenges and shortages of health providers, including nurses, can be particularly acute in rural areas, said Alan Morgan, CEO of the National Rural Health Association. These nurses and other providers have less access to education programs, which tend to be located in more densely populated areas. Programs that offer advanced degrees, from the baccalaureate to the doctorate, can be especially difficult to access for students living in rural areas, according to RWJF.

Identifying and educating nurses from rural areas is a key goal of FNU, which offers distance education programs that enable students to remain in their home communities and a “bridge” program that allows nurses with associate’s degrees to move more easily into master’s and doctorate programs. “These students really love where they live,” Ulrich said. “If we can educate them to stay within their communities, then those communities are going to have a provider who’s going to be there a long time." (Read more)
Midwives and nurse practitioners who recently graduated from Frontier Nursing University in Hyden address the unique challenges of rural areas, including shortages of health care providers, by bringing local health care to rural communities across the country. FNU was featured in a recent report from the Robert Wood Johnson Foundation.

FNU, a graduate program that offers distance education to nurses with an interest in nurse-midwifery and family nurse practitioner and women’s health specialties, aims to build a pipeline of highly educated nurses serving in rural or underserved areas, reports RWJF, one of its funders.  Many scholars and grantees sponsored by RWJF go on to spearhead projects to improve access to high quality nursing care in remote areas, the foundation says.

“We’re trying to introduce primary care providers into rural areas in such a way that they can provide high quality care and preventive services too,” says Suzan Ulrich, associate dean of midwifery and women’s health at FNU and an RWJF executive nurse fellow.

Demand for health care is rising nationwide because of an aging population that is living longer, but sicker, with multiple chronic conditions. The need for health care providers will intensify next year, when millions of new patients will become eligible for health insurance under the health-reform law.

Rural parts of the country face unique challenges and shortages of health providers, including nurses, can be particularly acute in rural areas, said Alan Morgan, CEO of the National Rural Health Association. These nurses and other providers have less access to education programs, which tend to be located in more densely populated areas. Programs that offer advanced degrees, from the baccalaureate to the doctorate, can be especially difficult to access for students living in rural areas, according to RWJF.

Identifying and educating nurses from rural areas is a key goal of FNU, which offers distance education programs that enable students to remain in their home communities and a “bridge” program that allows nurses with associate’s degrees to move more easily into master’s and doctorate programs. “These students really love where they live,” Ulrich said. “If we can educate them to stay within their communities, then those communities are going to have a provider who’s going to be there a long time." (Read more)
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Senate advances bill to allow Christian heath coverage cooperative back into Kentucky

Without dissent, the state Senate approved a bill Wednesday, Feb. 13, that would grant Christian health cost-sharing organization Medi-Share an exemption from the state's insurance laws and enable it to resume operation in Kentucky.

The Florida-based health care ministry was forced out of Kentucky last year by Franklin Circuit Judge Thomas Wingate, who ordered Medi-Share to stop operating in Kentucky. He acted at the request of the state Department of Insurance, which said the organization didn't comply with insurance regulations.

Sen. Tom Buford, R-Nicholasville, chairman of the 
Banking and Insurance Committee and sponsor of the bill, said the legislation would allow about 800 Kentuckians to rejoin Medi-Share. It would remove Medi-Share and two similar ministries operating in Kentucky out from oversight of the insurance department.

"The Department of Insurance regulates insurance companies. This is not an insurance company," Buford told the committee. Medi-Share does not include any contractual agreement to pay medical bills, but users are matched with each other to help pay for medical expenses through community giving, according to its website.

Medi-Share's plans resembles secular insurance in some ways but only allows participation by people who pledge to live Christian lives with no smoking, drinking, using drugs or engaging in sex outside of marriage, reports Beth Musgrave of the Lexington Herald-Leader.


The bill would require Medi-Share to tell members it's not an insurance company and does not guarantee that all medical bills would be paid, notes Roger Alford of The Associated Press.

The Rev. Dewayne Walker, pastor of Mount Olivet Baptist Church in Lexington, told the committee Medi-Share paid about $250,000 in medical bills for his wife, who had cancer. Medi-Share President Tony Meggs testified in court last year that the group has helped arrange to pay for some $25 million in medical bills for Kentuckians over the past 10 years, Alford reports.


Without dissent, the state Senate approved a bill Wednesday, Feb. 13, that would grant Christian health cost-sharing organization Medi-Share an exemption from the state's insurance laws and enable it to resume operation in Kentucky.

The Florida-based health care ministry was forced out of Kentucky last year by Franklin Circuit Judge Thomas Wingate, who ordered Medi-Share to stop operating in Kentucky. He acted at the request of the state Department of Insurance, which said the organization didn't comply with insurance regulations.

Sen. Tom Buford, R-Nicholasville, chairman of the 
Banking and Insurance Committee and sponsor of the bill, said the legislation would allow about 800 Kentuckians to rejoin Medi-Share. It would remove Medi-Share and two similar ministries operating in Kentucky out from oversight of the insurance department.

"The Department of Insurance regulates insurance companies. This is not an insurance company," Buford told the committee. Medi-Share does not include any contractual agreement to pay medical bills, but users are matched with each other to help pay for medical expenses through community giving, according to its website.

Medi-Share's plans resembles secular insurance in some ways but only allows participation by people who pledge to live Christian lives with no smoking, drinking, using drugs or engaging in sex outside of marriage, reports Beth Musgrave of the Lexington Herald-Leader.


The bill would require Medi-Share to tell members it's not an insurance company and does not guarantee that all medical bills would be paid, notes Roger Alford of The Associated Press.

The Rev. Dewayne Walker, pastor of Mount Olivet Baptist Church in Lexington, told the committee Medi-Share paid about $250,000 in medical bills for his wife, who had cancer. Medi-Share President Tony Meggs testified in court last year that the group has helped arrange to pay for some $25 million in medical bills for Kentuckians over the past 10 years, Alford reports.


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Tuesday, February 12, 2013

28% of Ky. adults 18-64 say they lack health coverage; 41% lacked it sometime in last year; employer coverage down since '08

Nearly three in 10 working-age adults in Kentucky are not covered by any form of health insurance, and the number who get health insurance from their employer, or their spouse’s employer, has plummeted since 2008, the first year of the Great Recession, according to the latest Kentucky Health Issues Poll. The decline accelerated in the last year, and was accompanied by a big jump in the percentage on public insurance.

The poll, taken Sept. 20 through Oct. 14, found that 28 percent of adults aged 18 to 64 said they had no health insurance at the time they were interviewed, and 41 percent said they had been uninsured at some point in the previous year.


The survey found that 37 percent get their insurance from an employer or spouse’s employer, well below the 55 percent figure in a similar poll in 2008. Conversely, 27 percent are now covered by some form of public insurance, way up from the 10 percent in 2008.

Medicaid in Kentucky covers households with incomes up to 70 percent of the federal poverty threshold; 43 percent of working-age adults living at or below that level reported being uninsured last fall. Among those with incomes more than double the poverty level for their size household, 15 percent said they were uninsured.

The poll was conducted for the Foundation for a Healthy Kentucky and the Health Foundation of Greater Cincinnati by the Institute for Policy Research at the University of Cincinnati. Pollsters contacted a random sample of 1,680 adults throughout Kentucky by telephone, including landlines and cell phones. The poll questioned only working-age adults about insurance because 98 percent of seniors have some form of health coverage. The poll has a margin of error of plus or minus 2.5 percentage points.
Nearly three in 10 working-age adults in Kentucky are not covered by any form of health insurance, and the number who get health insurance from their employer, or their spouse’s employer, has plummeted since 2008, the first year of the Great Recession, according to the latest Kentucky Health Issues Poll. The decline accelerated in the last year, and was accompanied by a big jump in the percentage on public insurance.

The poll, taken Sept. 20 through Oct. 14, found that 28 percent of adults aged 18 to 64 said they had no health insurance at the time they were interviewed, and 41 percent said they had been uninsured at some point in the previous year.


The survey found that 37 percent get their insurance from an employer or spouse’s employer, well below the 55 percent figure in a similar poll in 2008. Conversely, 27 percent are now covered by some form of public insurance, way up from the 10 percent in 2008.

Medicaid in Kentucky covers households with incomes up to 70 percent of the federal poverty threshold; 43 percent of working-age adults living at or below that level reported being uninsured last fall. Among those with incomes more than double the poverty level for their size household, 15 percent said they were uninsured.

The poll was conducted for the Foundation for a Healthy Kentucky and the Health Foundation of Greater Cincinnati by the Institute for Policy Research at the University of Cincinnati. Pollsters contacted a random sample of 1,680 adults throughout Kentucky by telephone, including landlines and cell phones. The poll questioned only working-age adults about insurance because 98 percent of seniors have some form of health coverage. The poll has a margin of error of plus or minus 2.5 percentage points.
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Kentucky ranks 10th in nation for injury-related deaths

Injuries are the third leading cause of death nationally, the leading cause of death for Americans between the ages of 1 and 44. Kentucky is among the nation's most problematic states, and it could take several more steps to prevent injuries, says a new state-by-state report on injury-prevention policy.

Kentucky ranks 10th in the nation for injury-related deaths, with a rate of 76.5 such deaths per 100,000 people, and the state spends about $26.8 million for injury-related medical expenses. New Mexico has the highest rate of injury-related deaths, 97.8 per 100,000 people, and New Jersey has the lowest at 36.1. The national rate is 57.9, so Kentucky's rate is almost a third higher than the nation.

Kentucky scored with only three of a set of 10 key indicators for injury prevention: its primary seat belt law, which most states also have; its prescription drug monitoring program, driven by heavy abuse of painkillers; and a strong law on youth sports concussions. Among the injury-prevention indicators that Kentucky lacks, it does not:

  • Require bicycle helmets for all children.
  • Require that children ride in a car seat or booster seat to at least the age of eight.
  • Require helmets for all motorcycle riders. (It once did, but when the law was repealed, deaths rose 50 percent, the report says.)
  • Does not require mandatory ignition interlocks for convicted drunk drivers.
  • Does not allow people in dating relationships to get protection orders.

The report by the Trust for America’s Health and the Robert Wood Johnson Foundation concludes that millions of injuries could be prevented and billions of dollars could be saved in medical costs each year if more states adopted, implemented and enforced additional research-based injury prevention policies and programs. (Read more).
Injuries are the third leading cause of death nationally, the leading cause of death for Americans between the ages of 1 and 44. Kentucky is among the nation's most problematic states, and it could take several more steps to prevent injuries, says a new state-by-state report on injury-prevention policy.

Kentucky ranks 10th in the nation for injury-related deaths, with a rate of 76.5 such deaths per 100,000 people, and the state spends about $26.8 million for injury-related medical expenses. New Mexico has the highest rate of injury-related deaths, 97.8 per 100,000 people, and New Jersey has the lowest at 36.1. The national rate is 57.9, so Kentucky's rate is almost a third higher than the nation.

Kentucky scored with only three of a set of 10 key indicators for injury prevention: its primary seat belt law, which most states also have; its prescription drug monitoring program, driven by heavy abuse of painkillers; and a strong law on youth sports concussions. Among the injury-prevention indicators that Kentucky lacks, it does not:

  • Require bicycle helmets for all children.
  • Require that children ride in a car seat or booster seat to at least the age of eight.
  • Require helmets for all motorcycle riders. (It once did, but when the law was repealed, deaths rose 50 percent, the report says.)
  • Does not require mandatory ignition interlocks for convicted drunk drivers.
  • Does not allow people in dating relationships to get protection orders.

The report by the Trust for America’s Health and the Robert Wood Johnson Foundation concludes that millions of injuries could be prevented and billions of dollars could be saved in medical costs each year if more states adopted, implemented and enforced additional research-based injury prevention policies and programs. (Read more).
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Tips to help avoid a preventable return trip to the hospital

Patients too often leave the hospital without knowing how to care for themselves, leading to a preventable return. Here are tips to improve your chances of a successful recovery at home:

Be sure you understand your illness, and the care you received in the hospital.

Ask if you will require help at home. Can you bathe yourself? Climb stairs? Will you need bandages changed or shots? If so, do you have a caregiver to help, or will you need to arrange a visiting nurse?

Repeat back your care instructions to those who give them, to be sure you understand them.

Ask for a written discharge plan that lists your medical conditions, your treatments, and the plan for your ongoing care.

Get a list of all medications, how to use them, and what to do if you experience side effects. Be sure to ask whether to continue medications you were taking before this hospitalization.

Ask what symptoms suggest you’re getting worse and what to do if that happens, especially at night or during the weekend.

What follow-up appointments will you need and when? Ask if your hospital will make the appointments for you, and send your records.

Do you have transportation home, to follow-up appointments, and to the drugstore?

If you have a regular physician, make sure the hospital sends a report of your hospital stay.

If you are uninsured or will have difficulty affording prescriptions, a hospital discharge planner or social worker may be able to link you to community resources that can help.

Get a name and number to call if questions about your hospitalization or discharge arise.

Sources: The Associated Press; Dr. Eric Coleman, University of Colorado; Robert Wood Johnson Foundation; Journal of the American Medical Association.
Patients too often leave the hospital without knowing how to care for themselves, leading to a preventable return. Here are tips to improve your chances of a successful recovery at home:

Be sure you understand your illness, and the care you received in the hospital.

Ask if you will require help at home. Can you bathe yourself? Climb stairs? Will you need bandages changed or shots? If so, do you have a caregiver to help, or will you need to arrange a visiting nurse?

Repeat back your care instructions to those who give them, to be sure you understand them.

Ask for a written discharge plan that lists your medical conditions, your treatments, and the plan for your ongoing care.

Get a list of all medications, how to use them, and what to do if you experience side effects. Be sure to ask whether to continue medications you were taking before this hospitalization.

Ask what symptoms suggest you’re getting worse and what to do if that happens, especially at night or during the weekend.

What follow-up appointments will you need and when? Ask if your hospital will make the appointments for you, and send your records.

Do you have transportation home, to follow-up appointments, and to the drugstore?

If you have a regular physician, make sure the hospital sends a report of your hospital stay.

If you are uninsured or will have difficulty affording prescriptions, a hospital discharge planner or social worker may be able to link you to community resources that can help.

Get a name and number to call if questions about your hospitalization or discharge arise.

Sources: The Associated Press; Dr. Eric Coleman, University of Colorado; Robert Wood Johnson Foundation; Journal of the American Medical Association.
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Beshear will expand Medicaid, Democrat and Republican say; D says governor believes the state can opt out if it's not affordable

State legislators in both parties say they expect Gov. Steve Beshear to expand Medicaid to cover several hundred thousand more Kentuckians who earn up to 138 percent of the federal poverty rate.

Rep. Tom Burch, chairman of the House Health and Welfare Committee, told Ryan Alessi of cn|2’s "Pure Politics" that the governor told him exactly that last week. And Sen. Tom Buford, R-Nicholasville, told Kentucky Health News that he expects Beshear to do the deed.

Burch told Alessi that Beshear has decided to move forward with the expansion because he believes the state would be able to opt out if state officials discover that Kentucky can’t afford it after 2017.

Beshear didn’t mention expansion in his State of the Commonwealth Address last week, and the governor’s office said the official decision hadn’t been made yet but didn’t dispute Burch’s statement, Alessi reports. Here is the salient part of his interview with Burch:



Buford said Beshear will be under much political pressure to expand Medicaid because it is President Obama's signature program and expansion will create jobs. However, Republican legislators generally  have opposed the expansion of Medicaid because the state can’t afford it. The federal government will cover the cost of covering the extra people from 2014 through 2016. Kentucky would have to kick in 5 percent of the costs starting in 2017 and 10 percent by 2020.  

The federal government covers roughly 70 percent of Kentucky’s $6 billion Medicaid program. It covers more than 800,000 Kentuckians and with the expansion, that number could grow to more than 1 million — or roughly a quarter of all Kentuckians, reports Alessi.

“I think it’s critical that we take a look at those to see how we achieve that. I’m not sure that this would be the way that would be best-suited to Kentucky and be fiscally responsible for the state of Kentucky,” Sen. Julie Denton, R-Louisville and chairman of the Senate Health and Welfare Committee, told Alessi in December (at 4:10 of the interview below)“Frankly, I don’t think we can afford to do it,” she said.

State legislators in both parties say they expect Gov. Steve Beshear to expand Medicaid to cover several hundred thousand more Kentuckians who earn up to 138 percent of the federal poverty rate.

Rep. Tom Burch, chairman of the House Health and Welfare Committee, told Ryan Alessi of cn|2’s "Pure Politics" that the governor told him exactly that last week. And Sen. Tom Buford, R-Nicholasville, told Kentucky Health News that he expects Beshear to do the deed.

Burch told Alessi that Beshear has decided to move forward with the expansion because he believes the state would be able to opt out if state officials discover that Kentucky can’t afford it after 2017.

Beshear didn’t mention expansion in his State of the Commonwealth Address last week, and the governor’s office said the official decision hadn’t been made yet but didn’t dispute Burch’s statement, Alessi reports. Here is the salient part of his interview with Burch:



Buford said Beshear will be under much political pressure to expand Medicaid because it is President Obama's signature program and expansion will create jobs. However, Republican legislators generally  have opposed the expansion of Medicaid because the state can’t afford it. The federal government will cover the cost of covering the extra people from 2014 through 2016. Kentucky would have to kick in 5 percent of the costs starting in 2017 and 10 percent by 2020.  

The federal government covers roughly 70 percent of Kentucky’s $6 billion Medicaid program. It covers more than 800,000 Kentuckians and with the expansion, that number could grow to more than 1 million — or roughly a quarter of all Kentuckians, reports Alessi.

“I think it’s critical that we take a look at those to see how we achieve that. I’m not sure that this would be the way that would be best-suited to Kentucky and be fiscally responsible for the state of Kentucky,” Sen. Julie Denton, R-Louisville and chairman of the Senate Health and Welfare Committee, told Alessi in December (at 4:10 of the interview below)“Frankly, I don’t think we can afford to do it,” she said.

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End of NFL? Fight withdrawal symptoms after Super Bowl effectively; Health Ranger informs public



 

The Super Bowl has created an enormous stir among the football loving people of the U.S. In a poll conducted in January 2012, this is what was found:

 

For 36 percent of the sports fans in the U.S., football is their favorite sport.

 

This is far higher than the popularity of any other sport in the country. The Super Bowl season is a time of ultimate jubilation for football fans. But as soon as the season ends, many football fans experience a withdrawal, similar to that of drug addicts, not being able to cope with the abrupt end of their favorite sport. This is a withdrawal symptom and it can be duly dealt with. 

 

Natural News reports that the withdrawal symptoms in football fans have psychological reasons. Dr. Angelos Halaris of Loyola University Medical Center is of the opinion that during merrymaking, the human brain releases dopamine, which is a pleasure producing neurotransmitter.

 

During the Super Bowl season, the brain of a football fan constantly releases dopamine and when the season ends, the brain stops releasing the substance, thus creating a sense of withdrawal in the fan’s mind. The withdrawal symptoms match those of drug addicts, but are less severe.

 

There are effective methods of coping with this. Halaris suggests that fans can watch recorded football games on television or on the internet. They can also spend their time watching other games like baseball and basketball. However, this procedure may not be effective for everyone.


 

It is important for a fan to talk about his feelings of withdrawal with his friends or family members because if this issue remains suppressed, it can usher in serious consequences. Natural News says that there is no room for self-medication and by no means should fans resort to antidepressants. It is only a matter of time before the withdrawal symptoms fade away completely and naturally, leaving the fans with ample time to prepare for next season, with positivity and enthusiasm that is devoid of the ill effects of antidepressants.


 

The Super Bowl has created an enormous stir among the football loving people of the U.S. In a poll conducted in January 2012, this is what was found:

 

For 36 percent of the sports fans in the U.S., football is their favorite sport.

 

This is far higher than the popularity of any other sport in the country. The Super Bowl season is a time of ultimate jubilation for football fans. But as soon as the season ends, many football fans experience a withdrawal, similar to that of drug addicts, not being able to cope with the abrupt end of their favorite sport. This is a withdrawal symptom and it can be duly dealt with. 

 

Natural News reports that the withdrawal symptoms in football fans have psychological reasons. Dr. Angelos Halaris of Loyola University Medical Center is of the opinion that during merrymaking, the human brain releases dopamine, which is a pleasure producing neurotransmitter.

 

During the Super Bowl season, the brain of a football fan constantly releases dopamine and when the season ends, the brain stops releasing the substance, thus creating a sense of withdrawal in the fan’s mind. The withdrawal symptoms match those of drug addicts, but are less severe.

 

There are effective methods of coping with this. Halaris suggests that fans can watch recorded football games on television or on the internet. They can also spend their time watching other games like baseball and basketball. However, this procedure may not be effective for everyone.


 

It is important for a fan to talk about his feelings of withdrawal with his friends or family members because if this issue remains suppressed, it can usher in serious consequences. Natural News says that there is no room for self-medication and by no means should fans resort to antidepressants. It is only a matter of time before the withdrawal symptoms fade away completely and naturally, leaving the fans with ample time to prepare for next season, with positivity and enthusiasm that is devoid of the ill effects of antidepressants.
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Nursing homes push for lawsuit protection with fast-moving bill and broadcast ads; newspaper editorials excoriate sponsor, industry

A state Senate committee has approved a bill that would require lawsuits against nursing homes to clear a review panel before going to court, a move that has drawn very sharp criticism from the editorial pages of the state's two largest newspapers. Meanwhile, the nursing-home industry is running television and radio ads urging calls to legislators in favor of the measure, which the Senate Health and Welfare Committee approved 7-4 last Wednesday without hearing from its opponents.

"Slimy action on questionable bill" read the headline over Tuesday's Lexington Herald-Leader's editorial, which began, "Good ideas can withstand criticism. So, when lawmakers move a piece of legislation without hearing from any of its opponents, you have to wonder whether they're sneaking through a stinker."

The chairman of the committee and the bill's sponsor, Sen. Julie Denton, R-Louisville, said some members had to leave for other meetings. "But somehow they had time to listen to industry spokesmen before voting," the Herald-Leader noted. "The nursing home industry claims that it is under siege from frivolous lawsuits drummed up by attorneys advertising for clients and that this legal threat pushes up nursing homes' insurance and legal costs, taking money that otherwise could go into patient care." (Read more)

The Courier-Journal editorial, which first reported the committee's action, accused Denton of "a brazen abuse of her power as committee chairman" and said sarcastically that she was "humane" to spare members of he committee "the ugly details of nursing home neglect and abuse. . . . Why should members, before lunch, have to consider graphic testimony about bedsores, near-starvation, dehydration and bowel obstructions suffered by elderly, helpless people? But for members of the General Assembly who are interested in the facts, here are some:

• Kentucky currently has about 23,000, mostly frail, elderly people who are residents in about 280 nursing homes. About half the homes have been cited by federal inspectors for a serious deficiency since 2009.
• 40 percent of the homes are rated at below average by the U.S. Center for Medicare and Medicaid Services when it comes to basic health and safety.
• In 2012, Kentucky ranked first in overall federal fines for violations and one Kentucky nursing home racked up the nation’s highest fines for the year.
• Kentucky ranks first in serious nursing home deficiencies that threaten the safety of residents. (Read more)

Sen. Ray Jones, D-Pikeville, who called Denton's move "blatantly wrong." has filed several floor amendments to the bill, which remained in the Senate Rules Committee Monday.

The Kentucky Association of Health Care Facilities is pushing the bill with TV and radio commercials urging calls to legislators. It placed $9,464 worth of ads on Lexington TV stations through Feb. 14.
A state Senate committee has approved a bill that would require lawsuits against nursing homes to clear a review panel before going to court, a move that has drawn very sharp criticism from the editorial pages of the state's two largest newspapers. Meanwhile, the nursing-home industry is running television and radio ads urging calls to legislators in favor of the measure, which the Senate Health and Welfare Committee approved 7-4 last Wednesday without hearing from its opponents.

"Slimy action on questionable bill" read the headline over Tuesday's Lexington Herald-Leader's editorial, which began, "Good ideas can withstand criticism. So, when lawmakers move a piece of legislation without hearing from any of its opponents, you have to wonder whether they're sneaking through a stinker."

The chairman of the committee and the bill's sponsor, Sen. Julie Denton, R-Louisville, said some members had to leave for other meetings. "But somehow they had time to listen to industry spokesmen before voting," the Herald-Leader noted. "The nursing home industry claims that it is under siege from frivolous lawsuits drummed up by attorneys advertising for clients and that this legal threat pushes up nursing homes' insurance and legal costs, taking money that otherwise could go into patient care." (Read more)

The Courier-Journal editorial, which first reported the committee's action, accused Denton of "a brazen abuse of her power as committee chairman" and said sarcastically that she was "humane" to spare members of he committee "the ugly details of nursing home neglect and abuse. . . . Why should members, before lunch, have to consider graphic testimony about bedsores, near-starvation, dehydration and bowel obstructions suffered by elderly, helpless people? But for members of the General Assembly who are interested in the facts, here are some:

• Kentucky currently has about 23,000, mostly frail, elderly people who are residents in about 280 nursing homes. About half the homes have been cited by federal inspectors for a serious deficiency since 2009.
• 40 percent of the homes are rated at below average by the U.S. Center for Medicare and Medicaid Services when it comes to basic health and safety.
• In 2012, Kentucky ranked first in overall federal fines for violations and one Kentucky nursing home racked up the nation’s highest fines for the year.
• Kentucky ranks first in serious nursing home deficiencies that threaten the safety of residents. (Read more)

Sen. Ray Jones, D-Pikeville, who called Denton's move "blatantly wrong." has filed several floor amendments to the bill, which remained in the Senate Rules Committee Monday.

The Kentucky Association of Health Care Facilities is pushing the bill with TV and radio commercials urging calls to legislators. It placed $9,464 worth of ads on Lexington TV stations through Feb. 14.
Read More


Monday, February 11, 2013

First major study of diet and strokes links fried, sugary Southern diet, low on fruits and vegetables, to increased risk

Genuine Kentucky fried platter:
Cornbread, fried catfish, fried green
tomatoes, fried apples and fried okra
(Photo from Ramsey's, Lexington)
By Molly Burchett
Kentucky Health News

People with a Southern diet, or one heavy on fried food and sugary drinks like sweet tea and soft drinks, are more likely to suffer a stroke, a new study finds.

It's the first big look at diet and strokes, and researchers say it might help explain people in the nation's "stroke belt" or southern states suffer more of them, reports Marilynn Marchione of The Associated Press.

These findings have important implications for Kentuckians because stroke accounts for 5.5 percent of Kentucky deaths each year and more than 81 percent of Kentucky adults eat fruit and vegetables fewer than 5 times a day, which is a indicator of risk for stroke:

Heart Disease and Stroke Risk Factors
from federal Behavioral Risk Factor Surveillance System national survey
Ky.
U.S.
Eat fruits and vegetables less than 5 times/day81.675.6
Overweight or obese69.162.9
No moderate or vigorous physical activity55.850.5
High total blood cholesterol38.537.6
High blood pressure30.027.8
Cigarette smoking28.219.8
Diabetes9.98.0

"We're talking about fried foods, french fries, hamburgers, processed meats, hot dogs," bacon, ham, liver, gizzards and sugary drinks, said the study's leader, Suzanne Judd of the University of Alabama in Birmingham.  For the study, a southern diet also included jerky, red meat, eggs, and whole milk.

Fried foods tend to be eaten with lots of salt, which raises blood pressure and sweet drinks increases risk for diabetes- both are known stroke risk factors, Judd said.

People who ate about six meals a week featuring these sorts of "Southern" foods had a 41 percent higher stroke risk than people who ate that way about once a month, researchers found.
In contrast, people whose diets were high in fruits, vegetables, whole grains and fish had a 29 percent lower stroke risk, reports Marchione.
"It's a very big difference," Judd said. "The message for people in the middle is there's a graded risk" — the likelihood of suffering a stroke rises in proportion to each Southern meal in a week. 
These findings were reported last week at the American Stroke Association conference. The study was launched in 2002 to explore regional variations in stroke risks and reasons for them.

Stroke death rates in Kentucky vary widely among counties. Here's a county map of the rates, from KentuckyHealthFacts.org, which has a county-by county list:
The map shows stroke rates in ranges per 100,000 population from 2003 through 2007. Purple counties had rates above 69; blue counties ranged from 52 to 69; turquoise were 44 to 52; light blue were 31 to 44 (the number that is about the national average), and tan were 18 to 31.
Genuine Kentucky fried platter:
Cornbread, fried catfish, fried green
tomatoes, fried apples and fried okra
(Photo from Ramsey's, Lexington)
By Molly Burchett
Kentucky Health News

People with a Southern diet, or one heavy on fried food and sugary drinks like sweet tea and soft drinks, are more likely to suffer a stroke, a new study finds.

It's the first big look at diet and strokes, and researchers say it might help explain people in the nation's "stroke belt" or southern states suffer more of them, reports Marilynn Marchione of The Associated Press.

These findings have important implications for Kentuckians because stroke accounts for 5.5 percent of Kentucky deaths each year and more than 81 percent of Kentucky adults eat fruit and vegetables fewer than 5 times a day, which is a indicator of risk for stroke:

Heart Disease and Stroke Risk Factors
from federal Behavioral Risk Factor Surveillance System national survey
Ky.
U.S.
Eat fruits and vegetables less than 5 times/day81.675.6
Overweight or obese69.162.9
No moderate or vigorous physical activity55.850.5
High total blood cholesterol38.537.6
High blood pressure30.027.8
Cigarette smoking28.219.8
Diabetes9.98.0

"We're talking about fried foods, french fries, hamburgers, processed meats, hot dogs," bacon, ham, liver, gizzards and sugary drinks, said the study's leader, Suzanne Judd of the University of Alabama in Birmingham.  For the study, a southern diet also included jerky, red meat, eggs, and whole milk.

Fried foods tend to be eaten with lots of salt, which raises blood pressure and sweet drinks increases risk for diabetes- both are known stroke risk factors, Judd said.

People who ate about six meals a week featuring these sorts of "Southern" foods had a 41 percent higher stroke risk than people who ate that way about once a month, researchers found.
In contrast, people whose diets were high in fruits, vegetables, whole grains and fish had a 29 percent lower stroke risk, reports Marchione.
"It's a very big difference," Judd said. "The message for people in the middle is there's a graded risk" — the likelihood of suffering a stroke rises in proportion to each Southern meal in a week. 
These findings were reported last week at the American Stroke Association conference. The study was launched in 2002 to explore regional variations in stroke risks and reasons for them.

Stroke death rates in Kentucky vary widely among counties. Here's a county map of the rates, from KentuckyHealthFacts.org, which has a county-by county list:
The map shows stroke rates in ranges per 100,000 population from 2003 through 2007. Purple counties had rates above 69; blue counties ranged from 52 to 69; turquoise were 44 to 52; light blue were 31 to 44 (the number that is about the national average), and tan were 18 to 31.
Read More


Some Christian Co. health board members balk at director's idea of using $100,000 of $2.4 million reserve for recreational trail

The director of the Christian County Health Department urged its board to give $100,000 from reserves to fund a rail-to-trail project to provide residents with new opportunities for exercise.

Coverting old railroad beds to recreation trails could help improve Christian County's infrastructure to promote healthy living, which is needed because a study last year ranked Christian County 116th out of Kentucky's 120 counties in this area, said Health Department Director Mark Pyle.

The department has $2.4 million in reserve, but several board members opposed the idea, citing a budget shortfall this fiscal year, financial troubles with the school-nurse program and delays in Medicaid reimbursements, reports Nick Tabor of the Kentucky New Era.

The City of Hopkinsville hopes to raise $400,000 for the first phase of the trail project. A recreational trail would initiate a culture change and residents should have public resources equal to those of other regions, Mayor Dan Kemp told Taylor.

Pyle told Tabor the trail would help the health department accomplish its goal of advancing public health, and the reserve money isn't there for sitting on. He said he believes the board will agree to using the money for the project at its next meeting, April 22, after considering funding priorities.

The New Era endorsed the health department's contribution as a good investment in local health, which by law is the health board's responsibility. For a PDF of the editorial and the news story, click here.
The director of the Christian County Health Department urged its board to give $100,000 from reserves to fund a rail-to-trail project to provide residents with new opportunities for exercise.

Coverting old railroad beds to recreation trails could help improve Christian County's infrastructure to promote healthy living, which is needed because a study last year ranked Christian County 116th out of Kentucky's 120 counties in this area, said Health Department Director Mark Pyle.

The department has $2.4 million in reserve, but several board members opposed the idea, citing a budget shortfall this fiscal year, financial troubles with the school-nurse program and delays in Medicaid reimbursements, reports Nick Tabor of the Kentucky New Era.

The City of Hopkinsville hopes to raise $400,000 for the first phase of the trail project. A recreational trail would initiate a culture change and residents should have public resources equal to those of other regions, Mayor Dan Kemp told Taylor.

Pyle told Tabor the trail would help the health department accomplish its goal of advancing public health, and the reserve money isn't there for sitting on. He said he believes the board will agree to using the money for the project at its next meeting, April 22, after considering funding priorities.

The New Era endorsed the health department's contribution as a good investment in local health, which by law is the health board's responsibility. For a PDF of the editorial and the news story, click here.
Read More


Diagnosis of arthritis in cats

Klinck MP, Frank D, Guillot M and Troncy E. Owner-perceived signs and veterinary diagnosis in 50 cases of feline osteoarthritis. Can Vet J. 2012; 53: 1181-6.

Osteoarthritis (OA) is common in older cats and the associated chronic pain and functional limitations are a serious animal welfare concern. In this study from the University of Montreal, owners of 50 cats were interviewed to collect information on specific osteoarthritis signs observed in the home. Information was collected on signs relating to mobility, self-maintenance, social and exploratory behavior, and activity and habits at diagnosis and after treatment. The mean age at diagnosis of OA was 12 years and many cats (44%) had concurrent diseases. Owner-reported abnormalities led to OA diagnosis in most cases; either as the primary finding (30%), or combined with abnormal physical examination or radiographic findings (64%). Owners frequently reported changes in mobility, particularly gait, jumping, and use of stairs. It was rare for a diagnosis of OA to be based on physical examination findings alone. 

The most common treatments were glucosamine and polysulfated glycosaminoglycan products. Feline OA diagnosis and therapeutic monitoring remains challenging for veterinary practitioners and it appears to rely heavily on owner-perceived signs. Questioning of owners with cats at risk for OA revealed various observable signs potentially useful in detection and monitoring. [MK]

See also: Bennett D, Zainal Ariffin SM and Johnston P. Osteoarthritis in the cat: 1. how common is it and how easy to recognise? J Feline Med Surg. 2012; 14: 65-75

Related blog articles:
Improving treatment of chronic pain in cats (April 2012)
Osteoarthritis in cats (August 2010)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Klinck MP, Frank D, Guillot M and Troncy E. Owner-perceived signs and veterinary diagnosis in 50 cases of feline osteoarthritis. Can Vet J. 2012; 53: 1181-6.

Osteoarthritis (OA) is common in older cats and the associated chronic pain and functional limitations are a serious animal welfare concern. In this study from the University of Montreal, owners of 50 cats were interviewed to collect information on specific osteoarthritis signs observed in the home. Information was collected on signs relating to mobility, self-maintenance, social and exploratory behavior, and activity and habits at diagnosis and after treatment. The mean age at diagnosis of OA was 12 years and many cats (44%) had concurrent diseases. Owner-reported abnormalities led to OA diagnosis in most cases; either as the primary finding (30%), or combined with abnormal physical examination or radiographic findings (64%). Owners frequently reported changes in mobility, particularly gait, jumping, and use of stairs. It was rare for a diagnosis of OA to be based on physical examination findings alone. 

The most common treatments were glucosamine and polysulfated glycosaminoglycan products. Feline OA diagnosis and therapeutic monitoring remains challenging for veterinary practitioners and it appears to rely heavily on owner-perceived signs. Questioning of owners with cats at risk for OA revealed various observable signs potentially useful in detection and monitoring. [MK]

See also: Bennett D, Zainal Ariffin SM and Johnston P. Osteoarthritis in the cat: 1. how common is it and how easy to recognise? J Feline Med Surg. 2012; 14: 65-75

Related blog articles:
Improving treatment of chronic pain in cats (April 2012)
Osteoarthritis in cats (August 2010)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Read More


How Whole Body Vibration Exercises Can Help Improve Fitness in the Elderly


By Dr. Mercola
Exercise is a critical part of a healthy lifestyle, and it can be a part of your life no matter what your age. In fact, staying active becomes increasingly important as you get older.
Even frail seniors of advanced age can improve muscle strength and agility with exercise, which is important for preventing falls and injuries.
For seniors who have a hard time performing aerobic exercise, using a Whole Body Vibration (WBV) platform (such as The Power Plate) can help them improve performance, allowing them to become stronger, faster and more agile, according to recent research1.
As explained by Dr. Keith DeOrio, M.D2., WBV stimulation affects your entire body musculature, as well as your internal organs and glands. 
Your muscle spindles fire secondary to the mechanical stimulation produced by the vibrating plate, and this rapid firing of the muscle spindle causes a neuromuscular response that leads to physiological changes in your brain as well as your entire body.  

How Whole Body Vibration Can Improve Fitness in Those Over 65

The featured study was funded by the Spanish government, and while small in scale, it suggests Whole Body Vibration (WBV) training can stimulate muscle growth and improve overall fitness in the elderly. As reported by Reuters:
“Twenty-four men and women over 65 performed 10 squats held for 45 seconds on the vibrating platform, with a minute rest in between, three times per week for 11 weeks. The study also included 25 people who did not take part in the vibration exercises.
... Those who did the exercises were, on average, able to do two more reps of upper and lower body strength exercises, had almost half an inch more lower body flexibility, and walked 33 yards one second faster than before the vibration training...”
Other studies have also demonstrated significant gains in most measures of muscle performance in sedentary and elderly individuals when using WBV. It has also been shown to provide a number of additional health benefits in the elderly. For example, one study, performed by the University of Liege in Belgium3, investigated the effects of controlled whole body vibrations exercises on overall health in elderly patients and found that after six weeks (performing 4 one-minute sessions, 3 times a week), the participants experienced:  
143 percent improvement in physical function57 percent improvement in the quality of walking
77 percent improvement in equilibrium41 percent reduction in pain
60 percent improvement in vitality23 percent improvement in general health

Reduce Bone Loss with Whole Body Vibration

Loss of bone mass is one of the common signs of aging, because as you age your existing bone is absorbed by your body while new bone is created to replace it. In the case of osteoporosis, the formation of new bone falls behind the rate of bone absorption, leading to weakened, thinner and more brittle bones.
A thinning hipbone is a major concern if you are elderly, because any fall increases the risk of a broken hip, which always carries a great risk of complications and usually requires prolonged specialized care for recovery. It's estimated that 25 percent of elderly people suffering a hip fracture die as a direct result4.
Weight-bearing exercise, like resistance- or strength training, can go a long way to prevent brittle bone formation, and can help reverse the damage already done. WBV training can also be helpful here, especially in the elderly.
In a study5 by Medical College of Georgia researchers, using vibration therapy 30 minutes daily for 12 weeks improved bone density in mice, a finding that adds support for their use in humans, especially the elderly. It's thought that the vibrations prompt movement of the cell nucleus, which may trigger the release of osteoblasts to build bone. Previous studies have also found that WBV training increases bone density in the hip and inhibits bone loss in the spine and hip areas.

Vitamin D and K2 Are Also Critical Factors for Bone Health Throughout Life

For optimal bone health you also need to optimize your vitamin D levels, and make sure you’re getting enough vitamin K2. Both of these nutrients are essential for healthy bone formation and maintenance, and they work in tandem. This is why, if you take high doses of vitamin D3, you also need to take extra vitamin K2.
The biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove calcium from areas where it shouldn’t be, such as in your arteries and soft tissues. Vitamin K2 deficiency is actually what produces the symptoms of vitamin D toxicity, which includes inappropriate calcification that can lead to hardening of your arteries.
So remember, if you take supplemental vitamin D, you're creating an increased demand for K2. Together, these two nutrients help strengthen your bones and improve your heart health.
While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Dr. Kate Rheaume-Bleue, author ofVitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life, suggests that for every 1,000 IU's of vitamin D you take, you may benefit from about 100 micrograms of K2, and perhaps as much as 150-200 micrograms (mcg). So, if you take 8,000 IU's of vitamin D3 per day, that means you'd need in the neighborhood of 800 to 1,000 micrograms (0.8 to 1 milligram/mg) of vitamin K2.

Insulin Resistance and Age-Related Muscle Loss

In related news, the International Osteoporosis Foundation (IOF) Nutrition Working Group has released a scientific review6 that examines the role of nutrition in the development of sarcopenia (age-related loss of muscle mass).
Sarcopenia affects about 10 percent of those over 60, with higher rates as age advances. It may seem like common sense that if you don't use your muscles, they'll eventually atrophy away, yet so many people fail to apply this information. The older you get, the faster your muscles atrophy if you're not regularly engaging in appropriate exercise. However, dietary factors are also at play. According to the authors:
“A loss of fast twitch fibers, glycation of proteins, and insulin resistance may play an important role in the loss of muscle strength and development of sarcopenia.”
As I keep repeating, insulin resistance caused by excessive sugar consumption is at the root of virtually every disease and health ailment you can think of, and that includes age-related muscle loss. In fact, if your insulin receptors are insensitive, the mTOR mechanism, which is part of the insulin pathway and builds protein in your muscles, remains inactivated, making muscle wasting more or less inevitable. So, needless to say, it's very important to keep your insulin levels low to avoid becoming insulin resistant — not just for your overall health, but also to maintain healthy muscle.

Nutritional Factors that help Preserve Muscle Mass, Strength and Performance in Seniors

The IOF review identified a number of important dietary factors shown to have a beneficial impact on the maintenance of muscle mass with advancing age, as well as the treatment of sarcopenia. These include:
  • Protein: The authors suggest an intake of 1.0-1.2 grams of protein per kilo of body weight per day to maintain optimal muscle and bone health in seniors who do not have severely impaired renal function.
  • This is  more than the recommendations issued by Dr. Ron Rosedale, who believes one gram of protein per kilo of leanbody weight is sufficient for muscle maintenance and repair without detrimentally triggering the mTor pathway, which he believes ma play a role in the development of cancer.  
    So if you are really lean, the recommendation is close but if you are obese you could be consuming far too much protein based on the IOF recommendation. However if your goal is to increase muscle mass, then the extra protein would make sense.
    Whey protein is an excellent choice of protein for a number of reasons, but in part because it increases GLP-1, a satiety peptide that promotes healthy insulin secretion, and helps your insulin work more effectively.  Just use the dose of protein you feel is appropriate for your needs. 20 grams if you want to follow lower protein Dr. Rosedale approach and double that if you want to increase muscle growth.
  • Vitamin D: The authors recommend optimizing vitamin D levels through exposure to sunlight and/or supplementation if required.
  • Avoiding dietary acid loads: Acid-producing foods such as meats and grains can have a detrimental impact on musculoscletal health when consumed in excess, and especially in combination with insufficient intake of vegetables and fruits, which have an alkalinizing effect. The authors recommend increasing consumption of vegetables to help prevent sarcopenia
  • Vitamin B12 and/or folic acid
According to Dr. Ambrish Mithal, co-author and Chair and Head of Endocrinology and Diabetes division at Medanta, New Delhi7:
"Strategies to reduce the numbers of falls and fractures within our ageing populations must include measures to prevent sarcopenia. At present, the available evidence suggests that combining resistance training with optimal nutritional status has a synergistic effect in preventing and treating sarcopenia.”

Other Beneficial Supplements for Optimal Muscle Performance

Two additional supplements that can help optimize muscle performance, regardless of your age, are:
  1. Carnosine in the form of beta-alanine:  Carnosine is a pluripotent dipeptide composed of two amino acids (beta-alanine and histadine), found most notably in your muscles, where it helps buffer lactic acids and serves as a potent antioxidant that can help quell muscle inflammation. Most studies find that if you want to increase athletic performance with carnosine, your best bet is to use beta-alanine instead, since beta-alanine appears to be the rate limiting amino acid in the formation of carnosine.
  2. While you can easily purchase these as supplements, I do NOT recommend doing that. It is far better to get them from whole foods. The foods with the highest amount of useful dietary dipeptides like carnosine would be animal proteins, like eggs, whey protein, poultry and beef.
  3. Astaxanthin: A phenomenally potent antioxidant that has been shown to help improve muscle endurance, workout performance and recovery. It also reduces inflammation from all causes, including workout injuries, and even enhances your ability to metabolize fat.

How Whole Body Vibration Training Prevents Muscle-Wasting

Jumping back to where we started, by stimulating your fast- and super-fast muscle fibers, Whole Body Vibration training using a Power Plate appears to be very helpful for preventing and/or reversing age-related muscle wasting. It will also kick-start your pituitary gland into making more human growth hormone (HGH), which plays an important part in promoting overall health and longevity.
WBV is a truly revolutionary approach to fitness because it addresses your neuromuscular system as a whole, rather than one limb or muscle group at a time. Not to mention it's time efficient, allowing you to trim off several precious hours per week from your workout time. When used together with my Peak Fitness program, which includes high intensity interval training; a series of powerful high-intensity burst-type exercises, you can complete your entire workout a fraction of the time you'd have to spend on traditional workouts.
WBV training using the Power Plate is really the perfect complement to high intensity interval training to build strength, shed excess fat, and improve athletic performance. Both of these techniques also help you produce growth hormone (HGH) naturally. To learn more, please see this previous article.

It’s Never Too Late to Start Exercising

As you can see, age-related muscle wasting and bone loss doesn't have to happen to you... Following the advice detailed above can go a long way toward maintaining healthy bones and muscle mass as you age.
The earlier you start, the better, but remember, you are never too old to start exercising. Research shows that, no matter your age, you stand to gain significant improvements in strength, range of motion, balance, bone density and mental clarity through exercise. My mom didn't start working out until she was 74 and now, at the age of 78, she has gained significant improvements in strength, range of motion, balance, bone density and mental clarity.
And, if you’re presently incapable of engaging in aerobic exercise, using Whole Body Vibration training may be just the thing to help you get more active...  If you're still on the fence about starting an exercise program, there's no time like the present. I guarantee it will make a major difference in your energy level, self-esteem and probably your entire outlook on life. It is really THAT powerful, whether you're 18 years old or 80!



About Dr Kevin Lau


Dr Kevin Lau DC is a Singapore chiropractor and the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.

By Dr. Mercola
Exercise is a critical part of a healthy lifestyle, and it can be a part of your life no matter what your age. In fact, staying active becomes increasingly important as you get older.
Even frail seniors of advanced age can improve muscle strength and agility with exercise, which is important for preventing falls and injuries.
For seniors who have a hard time performing aerobic exercise, using a Whole Body Vibration (WBV) platform (such as The Power Plate) can help them improve performance, allowing them to become stronger, faster and more agile, according to recent research1.
As explained by Dr. Keith DeOrio, M.D2., WBV stimulation affects your entire body musculature, as well as your internal organs and glands. 
Your muscle spindles fire secondary to the mechanical stimulation produced by the vibrating plate, and this rapid firing of the muscle spindle causes a neuromuscular response that leads to physiological changes in your brain as well as your entire body.  

How Whole Body Vibration Can Improve Fitness in Those Over 65

The featured study was funded by the Spanish government, and while small in scale, it suggests Whole Body Vibration (WBV) training can stimulate muscle growth and improve overall fitness in the elderly. As reported by Reuters:
“Twenty-four men and women over 65 performed 10 squats held for 45 seconds on the vibrating platform, with a minute rest in between, three times per week for 11 weeks. The study also included 25 people who did not take part in the vibration exercises.
... Those who did the exercises were, on average, able to do two more reps of upper and lower body strength exercises, had almost half an inch more lower body flexibility, and walked 33 yards one second faster than before the vibration training...”
Other studies have also demonstrated significant gains in most measures of muscle performance in sedentary and elderly individuals when using WBV. It has also been shown to provide a number of additional health benefits in the elderly. For example, one study, performed by the University of Liege in Belgium3, investigated the effects of controlled whole body vibrations exercises on overall health in elderly patients and found that after six weeks (performing 4 one-minute sessions, 3 times a week), the participants experienced:  
143 percent improvement in physical function57 percent improvement in the quality of walking
77 percent improvement in equilibrium41 percent reduction in pain
60 percent improvement in vitality23 percent improvement in general health

Reduce Bone Loss with Whole Body Vibration

Loss of bone mass is one of the common signs of aging, because as you age your existing bone is absorbed by your body while new bone is created to replace it. In the case of osteoporosis, the formation of new bone falls behind the rate of bone absorption, leading to weakened, thinner and more brittle bones.
A thinning hipbone is a major concern if you are elderly, because any fall increases the risk of a broken hip, which always carries a great risk of complications and usually requires prolonged specialized care for recovery. It's estimated that 25 percent of elderly people suffering a hip fracture die as a direct result4.
Weight-bearing exercise, like resistance- or strength training, can go a long way to prevent brittle bone formation, and can help reverse the damage already done. WBV training can also be helpful here, especially in the elderly.
In a study5 by Medical College of Georgia researchers, using vibration therapy 30 minutes daily for 12 weeks improved bone density in mice, a finding that adds support for their use in humans, especially the elderly. It's thought that the vibrations prompt movement of the cell nucleus, which may trigger the release of osteoblasts to build bone. Previous studies have also found that WBV training increases bone density in the hip and inhibits bone loss in the spine and hip areas.

Vitamin D and K2 Are Also Critical Factors for Bone Health Throughout Life

For optimal bone health you also need to optimize your vitamin D levels, and make sure you’re getting enough vitamin K2. Both of these nutrients are essential for healthy bone formation and maintenance, and they work in tandem. This is why, if you take high doses of vitamin D3, you also need to take extra vitamin K2.
The biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove calcium from areas where it shouldn’t be, such as in your arteries and soft tissues. Vitamin K2 deficiency is actually what produces the symptoms of vitamin D toxicity, which includes inappropriate calcification that can lead to hardening of your arteries.
So remember, if you take supplemental vitamin D, you're creating an increased demand for K2. Together, these two nutrients help strengthen your bones and improve your heart health.
While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Dr. Kate Rheaume-Bleue, author ofVitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life, suggests that for every 1,000 IU's of vitamin D you take, you may benefit from about 100 micrograms of K2, and perhaps as much as 150-200 micrograms (mcg). So, if you take 8,000 IU's of vitamin D3 per day, that means you'd need in the neighborhood of 800 to 1,000 micrograms (0.8 to 1 milligram/mg) of vitamin K2.

Insulin Resistance and Age-Related Muscle Loss

In related news, the International Osteoporosis Foundation (IOF) Nutrition Working Group has released a scientific review6 that examines the role of nutrition in the development of sarcopenia (age-related loss of muscle mass).
Sarcopenia affects about 10 percent of those over 60, with higher rates as age advances. It may seem like common sense that if you don't use your muscles, they'll eventually atrophy away, yet so many people fail to apply this information. The older you get, the faster your muscles atrophy if you're not regularly engaging in appropriate exercise. However, dietary factors are also at play. According to the authors:
“A loss of fast twitch fibers, glycation of proteins, and insulin resistance may play an important role in the loss of muscle strength and development of sarcopenia.”
As I keep repeating, insulin resistance caused by excessive sugar consumption is at the root of virtually every disease and health ailment you can think of, and that includes age-related muscle loss. In fact, if your insulin receptors are insensitive, the mTOR mechanism, which is part of the insulin pathway and builds protein in your muscles, remains inactivated, making muscle wasting more or less inevitable. So, needless to say, it's very important to keep your insulin levels low to avoid becoming insulin resistant — not just for your overall health, but also to maintain healthy muscle.

Nutritional Factors that help Preserve Muscle Mass, Strength and Performance in Seniors

The IOF review identified a number of important dietary factors shown to have a beneficial impact on the maintenance of muscle mass with advancing age, as well as the treatment of sarcopenia. These include:
  • Protein: The authors suggest an intake of 1.0-1.2 grams of protein per kilo of body weight per day to maintain optimal muscle and bone health in seniors who do not have severely impaired renal function.
  • This is  more than the recommendations issued by Dr. Ron Rosedale, who believes one gram of protein per kilo of leanbody weight is sufficient for muscle maintenance and repair without detrimentally triggering the mTor pathway, which he believes ma play a role in the development of cancer.  
    So if you are really lean, the recommendation is close but if you are obese you could be consuming far too much protein based on the IOF recommendation. However if your goal is to increase muscle mass, then the extra protein would make sense.
    Whey protein is an excellent choice of protein for a number of reasons, but in part because it increases GLP-1, a satiety peptide that promotes healthy insulin secretion, and helps your insulin work more effectively.  Just use the dose of protein you feel is appropriate for your needs. 20 grams if you want to follow lower protein Dr. Rosedale approach and double that if you want to increase muscle growth.
  • Vitamin D: The authors recommend optimizing vitamin D levels through exposure to sunlight and/or supplementation if required.
  • Avoiding dietary acid loads: Acid-producing foods such as meats and grains can have a detrimental impact on musculoscletal health when consumed in excess, and especially in combination with insufficient intake of vegetables and fruits, which have an alkalinizing effect. The authors recommend increasing consumption of vegetables to help prevent sarcopenia
  • Vitamin B12 and/or folic acid
According to Dr. Ambrish Mithal, co-author and Chair and Head of Endocrinology and Diabetes division at Medanta, New Delhi7:
"Strategies to reduce the numbers of falls and fractures within our ageing populations must include measures to prevent sarcopenia. At present, the available evidence suggests that combining resistance training with optimal nutritional status has a synergistic effect in preventing and treating sarcopenia.”

Other Beneficial Supplements for Optimal Muscle Performance

Two additional supplements that can help optimize muscle performance, regardless of your age, are:
  1. Carnosine in the form of beta-alanine:  Carnosine is a pluripotent dipeptide composed of two amino acids (beta-alanine and histadine), found most notably in your muscles, where it helps buffer lactic acids and serves as a potent antioxidant that can help quell muscle inflammation. Most studies find that if you want to increase athletic performance with carnosine, your best bet is to use beta-alanine instead, since beta-alanine appears to be the rate limiting amino acid in the formation of carnosine.
  2. While you can easily purchase these as supplements, I do NOT recommend doing that. It is far better to get them from whole foods. The foods with the highest amount of useful dietary dipeptides like carnosine would be animal proteins, like eggs, whey protein, poultry and beef.
  3. Astaxanthin: A phenomenally potent antioxidant that has been shown to help improve muscle endurance, workout performance and recovery. It also reduces inflammation from all causes, including workout injuries, and even enhances your ability to metabolize fat.

How Whole Body Vibration Training Prevents Muscle-Wasting

Jumping back to where we started, by stimulating your fast- and super-fast muscle fibers, Whole Body Vibration training using a Power Plate appears to be very helpful for preventing and/or reversing age-related muscle wasting. It will also kick-start your pituitary gland into making more human growth hormone (HGH), which plays an important part in promoting overall health and longevity.
WBV is a truly revolutionary approach to fitness because it addresses your neuromuscular system as a whole, rather than one limb or muscle group at a time. Not to mention it's time efficient, allowing you to trim off several precious hours per week from your workout time. When used together with my Peak Fitness program, which includes high intensity interval training; a series of powerful high-intensity burst-type exercises, you can complete your entire workout a fraction of the time you'd have to spend on traditional workouts.
WBV training using the Power Plate is really the perfect complement to high intensity interval training to build strength, shed excess fat, and improve athletic performance. Both of these techniques also help you produce growth hormone (HGH) naturally. To learn more, please see this previous article.

It’s Never Too Late to Start Exercising

As you can see, age-related muscle wasting and bone loss doesn't have to happen to you... Following the advice detailed above can go a long way toward maintaining healthy bones and muscle mass as you age.
The earlier you start, the better, but remember, you are never too old to start exercising. Research shows that, no matter your age, you stand to gain significant improvements in strength, range of motion, balance, bone density and mental clarity through exercise. My mom didn't start working out until she was 74 and now, at the age of 78, she has gained significant improvements in strength, range of motion, balance, bone density and mental clarity.
And, if you’re presently incapable of engaging in aerobic exercise, using Whole Body Vibration training may be just the thing to help you get more active...  If you're still on the fence about starting an exercise program, there's no time like the present. I guarantee it will make a major difference in your energy level, self-esteem and probably your entire outlook on life. It is really THAT powerful, whether you're 18 years old or 80!



About Dr Kevin Lau


Dr Kevin Lau DC is a Singapore chiropractor and the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.
Read More


Surprising Health Hazards Associated with All-Fruit Diet


By Dr. Mercola
Fruits are loaded with healthy antioxidants, vitamins and minerals, which is why eating them in moderation is fine for healthy people. However, many benefit by restricting their fruit intake.
Fructose, a simple sugar found in fruit, is preferentially metabolized to fat in your liver, and eating large amounts has been linked to negative metabolic and endocrine effects. So eating very large amounts – or worse, nothing but fruit – can logically increase your risk of a number of health conditions, from insulin and leptin resistance to cancer.
For example, research has shown that pancreatic tumor cells use fructose, specifically, to divide and proliferate, thus speeding up the growth and spread of the cancer.
As a general health rule, I recommend limiting your total fructose consumption to about 25 grams per day on average, and that includes fructose from fruit. However, if you have insulin resistance, heart disease, cancer or high blood pressure, you may want to cut it down to 15 grams or less.

Kutcher Lands in Hospital After Adopting All-Fruit Diet

Actor Ashton Kutcher recently disclosed health issues brought on by following an all-fruit diet,1 adopted in preparation to play the character of Steve Jobs in the upcoming film “Jobs,” due out April 19.
Jobs had adopted an all-fruit diet in his younger days, and even the brand he co-founded – Apple – was a nod to his dietary obsession. Kutcher recently told USA Today:2
"First of all, the fruitarian diet can lead to like severe issues. I went to the hospital like two days before we started shooting the movie. I was like doubled over in pain. My pancreas levels were completely out of whack. It was really terrifying ... considering everything."
The “everything” is likely a reference to pancreatic cancer – the disease that killedSteve Jobs on October 5, 2011, at the age of 56. Even though Jobs consumed a fruitarian diet years before he contracted his pancreatic cancer, there could be some relationship.

Why Large Amounts of Fruit May Not Be Healthy

While people are becoming increasingly aware of the connection between excessive fructose consumption and obesity and chronic disease, many forget that fruit is a source of fructose as well. Many tend to believe that as long as fruit is natural and raw they can have unlimited quantities without experiencing any adverse metabolic effects.
Eliminating processed foods and soda – which are loaded with high fructose corn syrup – and replacing it with an all-fruit diet is likely not going to improve your health. As Marisa Moore, registered dietician and spokeswoman for the Academy of Nutrition and Dietetics told CNN Health:3
When you only eat fruit, you're excluding a lot of valuable nutrients from your diet. Protein is one of the main ones that comes to mind... Protein acts like a building block for your muscles and skin and organs. The same goes for fats. Although they often get demonized, fats play an important role in our hormone levels and brain function.”
It’s important to consider ALL sources of fructose, and to try to limit your total consumption if you want to optimize your health. Granted, fruits contain beneficial dietary fibers, antioxidants, vitamins and minerals, which is why they’re an important part of a healthy diet – as long as they’re eaten in moderation. I believe most people would benefit by replacing the fruit with 50-70 percent of their calories from healthy fat. You also need moderate amounts of high quality protein.
An all-fruit diet is essentially an all-fructose diet, and this is bound to spell disaster for your health, at least long-term. Studies have shown that fructose can induce:
Impaired glucose tolerance, insulin resistance, and diabetesElevated triglyceridesAbdominal obesity
Leptin resistanceInflammation and oxidative stressEndothelial dysfunction
Microvascular diseaseHyperuricemiaRenal (kidney) damage
Fatty liver diseaseHigh blood pressureMetabolic syndrome

The Fructose Pancreatic Cancer Connection

Pancreatic cancer is one of the faster spreading cancers; only about four percent of patients can expect to survive five years after their diagnosis. Each year, about 44,000 new cases are diagnosed in the U.S., and 37,000 people die of the disease. Cancer of the pancreas has a terrible prognosis--half of all patients with locally advanced pancreatic cancer die within 10 months of the diagnosis; half of those in whom it has metastasized die within six months.
Your pancreas contains two types of glands: exocrine glands that produce enzymes that break down fats and proteins, and endocrine glands that make hormones like insulin that regulate sugar in your blood.
Steve Jobs died of tumors originating in the endocrine glands, which are among the rarer forms of pancreatic cancer. His cancer was detected during an abdominal scan in October 2003, as Fortune magazine reported in a 2008 cover story.4 He reportedly spent nine months on "alternative therapies," including what Fortune called "a special diet,” although there was no mention of what type of diet this might have been. In 2004, after the cancer had spread, Jobs opted for surgery. Unfortunately, it did not cure him.
Five years later, he underwent an experimental procedure called peptide receptor radionuclide therapy (PRRT), which involves delivering radiation to tumor cells by attaching one of two radioactive isotopes to a drug that mimics somatostatin, the hormone that regulates the entire endocrine system and the secretion of other hormones. This treatment also failed. After having a liver transplant, Jobs succumbed to the cancer in 2011.
Interestingly enough, research published in 20105 suggests fructose may have a particularly significant impact on pancreatic cancer.
Insulin production is one of your pancreas’ main functions, used by your body to process blood sugar, and, in the laboratory, insulin promotes the growth of pancreatic cancer cells. However, there’s more to it than that. The research in question showed that the way the different sugars are metabolized (using different metabolic pathways) is of MAJOR consequence when it comes to feeding pancreatic cancer cells and making them proliferate. According to the authors:
"Importantly, fructose and glucose metabolism are quite different... These findings show that cancer cells can readily metabolize fructose to increase proliferation."
The study confirms the old adage that sugar feeds cancer – a finding that Dr. Warburg received a Nobel Prize for over 90 years ago. Tumor cells do thrive on glucose and do not possess the metabolic machinery to burn fat. However, the cells used fructosefor cell division, speeding up the growth and spread of the cancer. If this difference isn't of major consequence, then I don't know what is. Whether you're simply interested in preventing cancer, or have cancer and want to live longer, you ignore these facts at your own risk.
There’s reasonable cause to suspect that if your body maintains high levels of insulin, you increase the pancreatic cancer's ability to survive and grow. In fact, researchers now believe that up to a third of all types of cancers may be caused by diet and lifestyle. So if you want to prevent cancer, or want to treat cancer, it is imperative that you keep your insulin levels as low as possible.

Should You Eliminate Fruit from Your Diet?

Short answer, no, it wouldn’t be wise to eliminate fruit entirely. Fruit is definitely a source of fructose, and one that can harm your health if you eat it in vast quantities, but eating small amounts of whole fruits is fine if you are healthy.
In vegetables and fruits, the fructose is mixed in with fiber, vitamins, minerals, enzymes, and beneficial phytonutrients, all of which help moderate the negative metabolic effects. However, if you suffer with any fructose-related health issues, such as insulin resistance, metabolic syndrome, heart disease, obesity or cancer, you would be wise to limit your total fructose consumption to 15 grams of fructose per day. This includes fructose from ALL sources, including whole fruit.
If you are not insulin resistant, you may increase this to 25 grams of total fructose per day on average.
If you received your fructose only from vegetables and fruits (where it originates) as most people did a century ago, you'd consume about 15 grams per day. Today the average is 73 grams per day which is nearly 500 percent higher a dose and our bodies simply can't tolerate that type of biochemical abuse. So please, carefully add your fruits based on the following table to keep your total fructose below 15-25 grams per day, depending on your current health status.
FruitServing SizeGrams of Fructose
Limes1 medium0
Lemons1 medium0.6
Cranberries1 cup0.7
Passion fruit1 medium0.9
Prune1 medium1.2
Guava2 medium2.2
Date (Deglet Noor style)1 medium2.6
Cantaloupe1/8 of med. melon2.8
Raspberries1 cup3.0
Clementine1 medium3.4
Kiwifruit1 medium3.4
Blackberries1 cup3.5
Star fruit1 medium3.6
Cherries, sweet103.8
Strawberries1 cup3.8
Cherries, sour1 cup4.0
Pineapple1 slice (3.5" x .75")4.0
Grapefruit, pink or red1/2 medium4.3
 
FruitServing SizeGrams of Fructose
Boysenberries1 cup4.6
Tangerine/mandarin orange1 medium4.8
Nectarine1 medium5.4
Peach1 medium5.9
Orange (navel)1 medium6.1
Papaya1/2 medium6.3
Honeydew1/8 of med. melon6.7
Banana1 medium7.1
Blueberries1 cup7.4
Date (Medjool)1 medium7.7
Apple (composite)1 medium9.5
Persimmon1 medium10.6
Watermelon1/16 med. melon11.3
Pear1 medium11.8
Raisins1/4 cup12.3
Grapes, seedless (green or red)1 cup12.4
Mango1/2 medium16.2
Apricots, dried1 cup16.4
Figs, dried1 cup23.0

How to Determine Your Individual Susceptibility to Fructose Damage

As already stated, those who need to be careful about their fruit intake are people with high insulin levels. You can measure your fasting insulin level to find out for sure, but if you have any of the following problems it is highly likely you have insulin resistance syndrome:
  • Overweight
  • High Cholesterol
  • High Blood Pressure
  • Diabetes
  • Yeast Infections
Besides that, you can also use your uric acid levels as a marker for your susceptibility to fructose damage, as some people may be able to process fructose more efficiently than others. The higher your uric acid, the more sensitive you are to the effects of fructose. The safest range of uric acid appears to be between 3 and 5.5 milligrams per deciliter (mg/dl), and there appears to be a steady relationship between uric acid levels and blood pressure and cardiovascular risk, even down to the range of 3 to 4 mg/dl.
According to Dr. Richard Johnson, the ideal uric acid level is probably around 4 mg/dl for men and 3.5 mg/dl for women.
If you are one of those who believes that fruit is healthy no matter how much you eat, I would strongly encourage you to have your uric acid level checked to find out how sensitive you are to fructose. Eat the amount of fruit you feel is right for you for a few weeks and then check your uric acid level and see if your levels are healthy. If they are elevated you might try reducing the fruit to recommended levels and rechecking your uric acid level. Many who are overweight likely have uric acid levels well above 5.5. Some may even be closer to 10 or above. Measuring your uric acid levels is a very practical way to determine just how strict you need to be when it comes to your fructose – and fruit -- consumption.

Is there Such a Thing as an Ideal Diet for Everyone?

Nutritional requirements can vary wildly from one person to the next, which is why I’ve been a longtime proponent of eating in accordance with your nutritional type. For example, if you’re a protein type, fruits are generally not beneficial for you with the exception of coconut, which has a higher fat content that is beneficial for protein types. On the other hand, carbohydrate types tend to fare well with fruit and can safely consume moderate amounts. This is an important distinction, and everyone should try to eat primarily the specific fruits that are best for their unique biochemistry.
However, many find nutritional typing to be too complex. So to simplify matters, while still allowing for a fully personalized program, I recently updated and revised my Nutritional Plan. It consists of three levels, from beginners to advanced, and covers the basic requirements of a healthy diet.
Keep in mind that emerging evidence suggests your diet should be at least half healthy fat, and possibly as high as 70 percent. My personal diet is about 60-70 percent healthy fat, and both Paul Jaminet, PhD., author of Perfect Health Diet, and Dr. Ron Rosedale, M.D., an expert on treating diabetes through diet, agree that the ideal diet includes somewhere between 50-70 percent fat. It's important to understand that your body requires saturated fats from animal and vegetable sources (such as meat, dairy, certain oils, and tropical plants like coconut) for optimal functioning.
When you take this into account, it’s easy to see that an all-fruit diet could wreak absolute havoc with your health.
Keep in mind that frequent hunger may be a major clue that you're not eating correctly. Not only is it an indication that you're consuming the wrong types of food, but it's also a sign that you're likely consuming them in lopsided ratios for your individual biochemistry. Fat is far more satiating than carbs, so if you have cut down on carbs and feel ravenous, remember this is a sign that you haven't replaced them with sufficient amounts of fat. You do want to make sure you're adding the correct types of fat though, such as:
Olives and Olive oilCoconuts and coconut oilButter made from raw grass-fed organic milk
Raw nuts, such as, almonds or pecansOrganic pastured egg yolksAvocados
Grass-fed meatsPalm oilUnheated organic nut oils

If You Seek Optimal Health, Pay Careful Attention to Your Insulin Levels

Three lifestyle issues keep popping up on the radar when you look at what’s contributing to pancreatic cancer: sugar intake, lack of exercise, and vitamin D deficiency. Obesity and physical inactivity makes your body less sensitive to the glucose-lowering effects of insulin. Diminished sensitivity to insulin leads to higher blood levels of insulin, which in turn can increase your risk of pancreatic cancer.
It’s a no-brainer that an all-fruit diet can seriously jeopardize your insulin sensitivity, thereby raising your risk of any number of health problems, including pancreatic problems. It’s simply FAR too much fructose for most people. I personally developed diabetes when I tried the "Eat Right for Your Blood Type" diet, which included eating large amounts of fruit for breakfast. So please, be careful of any diet that seems to extreme, and remember the human body NEEDS healthful fats and high quality protein for proper functioning.
Remember to listen to your body over the long term to guide you as to the best food selections. If your energy level deceases, you have a difficult time maintaining your ideal weight or are hungry all the time, there is a good chance that you have yet to find the optimal fuel for your body. As for fruits, use caution if you have any kind of insulin related health issues, as discussed above, and limit your total fructose consumption to 15-25 grams of fructose per day, depending on your health status.



About Dr Kevin Lau


Dr Kevin Lau DC is a Singapore chiropractor and the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.

By Dr. Mercola
Fruits are loaded with healthy antioxidants, vitamins and minerals, which is why eating them in moderation is fine for healthy people. However, many benefit by restricting their fruit intake.
Fructose, a simple sugar found in fruit, is preferentially metabolized to fat in your liver, and eating large amounts has been linked to negative metabolic and endocrine effects. So eating very large amounts – or worse, nothing but fruit – can logically increase your risk of a number of health conditions, from insulin and leptin resistance to cancer.
For example, research has shown that pancreatic tumor cells use fructose, specifically, to divide and proliferate, thus speeding up the growth and spread of the cancer.
As a general health rule, I recommend limiting your total fructose consumption to about 25 grams per day on average, and that includes fructose from fruit. However, if you have insulin resistance, heart disease, cancer or high blood pressure, you may want to cut it down to 15 grams or less.

Kutcher Lands in Hospital After Adopting All-Fruit Diet

Actor Ashton Kutcher recently disclosed health issues brought on by following an all-fruit diet,1 adopted in preparation to play the character of Steve Jobs in the upcoming film “Jobs,” due out April 19.
Jobs had adopted an all-fruit diet in his younger days, and even the brand he co-founded – Apple – was a nod to his dietary obsession. Kutcher recently told USA Today:2
"First of all, the fruitarian diet can lead to like severe issues. I went to the hospital like two days before we started shooting the movie. I was like doubled over in pain. My pancreas levels were completely out of whack. It was really terrifying ... considering everything."
The “everything” is likely a reference to pancreatic cancer – the disease that killedSteve Jobs on October 5, 2011, at the age of 56. Even though Jobs consumed a fruitarian diet years before he contracted his pancreatic cancer, there could be some relationship.

Why Large Amounts of Fruit May Not Be Healthy

While people are becoming increasingly aware of the connection between excessive fructose consumption and obesity and chronic disease, many forget that fruit is a source of fructose as well. Many tend to believe that as long as fruit is natural and raw they can have unlimited quantities without experiencing any adverse metabolic effects.
Eliminating processed foods and soda – which are loaded with high fructose corn syrup – and replacing it with an all-fruit diet is likely not going to improve your health. As Marisa Moore, registered dietician and spokeswoman for the Academy of Nutrition and Dietetics told CNN Health:3
When you only eat fruit, you're excluding a lot of valuable nutrients from your diet. Protein is one of the main ones that comes to mind... Protein acts like a building block for your muscles and skin and organs. The same goes for fats. Although they often get demonized, fats play an important role in our hormone levels and brain function.”
It’s important to consider ALL sources of fructose, and to try to limit your total consumption if you want to optimize your health. Granted, fruits contain beneficial dietary fibers, antioxidants, vitamins and minerals, which is why they’re an important part of a healthy diet – as long as they’re eaten in moderation. I believe most people would benefit by replacing the fruit with 50-70 percent of their calories from healthy fat. You also need moderate amounts of high quality protein.
An all-fruit diet is essentially an all-fructose diet, and this is bound to spell disaster for your health, at least long-term. Studies have shown that fructose can induce:
Impaired glucose tolerance, insulin resistance, and diabetesElevated triglyceridesAbdominal obesity
Leptin resistanceInflammation and oxidative stressEndothelial dysfunction
Microvascular diseaseHyperuricemiaRenal (kidney) damage
Fatty liver diseaseHigh blood pressureMetabolic syndrome

The Fructose Pancreatic Cancer Connection

Pancreatic cancer is one of the faster spreading cancers; only about four percent of patients can expect to survive five years after their diagnosis. Each year, about 44,000 new cases are diagnosed in the U.S., and 37,000 people die of the disease. Cancer of the pancreas has a terrible prognosis--half of all patients with locally advanced pancreatic cancer die within 10 months of the diagnosis; half of those in whom it has metastasized die within six months.
Your pancreas contains two types of glands: exocrine glands that produce enzymes that break down fats and proteins, and endocrine glands that make hormones like insulin that regulate sugar in your blood.
Steve Jobs died of tumors originating in the endocrine glands, which are among the rarer forms of pancreatic cancer. His cancer was detected during an abdominal scan in October 2003, as Fortune magazine reported in a 2008 cover story.4 He reportedly spent nine months on "alternative therapies," including what Fortune called "a special diet,” although there was no mention of what type of diet this might have been. In 2004, after the cancer had spread, Jobs opted for surgery. Unfortunately, it did not cure him.
Five years later, he underwent an experimental procedure called peptide receptor radionuclide therapy (PRRT), which involves delivering radiation to tumor cells by attaching one of two radioactive isotopes to a drug that mimics somatostatin, the hormone that regulates the entire endocrine system and the secretion of other hormones. This treatment also failed. After having a liver transplant, Jobs succumbed to the cancer in 2011.
Interestingly enough, research published in 20105 suggests fructose may have a particularly significant impact on pancreatic cancer.
Insulin production is one of your pancreas’ main functions, used by your body to process blood sugar, and, in the laboratory, insulin promotes the growth of pancreatic cancer cells. However, there’s more to it than that. The research in question showed that the way the different sugars are metabolized (using different metabolic pathways) is of MAJOR consequence when it comes to feeding pancreatic cancer cells and making them proliferate. According to the authors:
"Importantly, fructose and glucose metabolism are quite different... These findings show that cancer cells can readily metabolize fructose to increase proliferation."
The study confirms the old adage that sugar feeds cancer – a finding that Dr. Warburg received a Nobel Prize for over 90 years ago. Tumor cells do thrive on glucose and do not possess the metabolic machinery to burn fat. However, the cells used fructosefor cell division, speeding up the growth and spread of the cancer. If this difference isn't of major consequence, then I don't know what is. Whether you're simply interested in preventing cancer, or have cancer and want to live longer, you ignore these facts at your own risk.
There’s reasonable cause to suspect that if your body maintains high levels of insulin, you increase the pancreatic cancer's ability to survive and grow. In fact, researchers now believe that up to a third of all types of cancers may be caused by diet and lifestyle. So if you want to prevent cancer, or want to treat cancer, it is imperative that you keep your insulin levels as low as possible.

Should You Eliminate Fruit from Your Diet?

Short answer, no, it wouldn’t be wise to eliminate fruit entirely. Fruit is definitely a source of fructose, and one that can harm your health if you eat it in vast quantities, but eating small amounts of whole fruits is fine if you are healthy.
In vegetables and fruits, the fructose is mixed in with fiber, vitamins, minerals, enzymes, and beneficial phytonutrients, all of which help moderate the negative metabolic effects. However, if you suffer with any fructose-related health issues, such as insulin resistance, metabolic syndrome, heart disease, obesity or cancer, you would be wise to limit your total fructose consumption to 15 grams of fructose per day. This includes fructose from ALL sources, including whole fruit.
If you are not insulin resistant, you may increase this to 25 grams of total fructose per day on average.
If you received your fructose only from vegetables and fruits (where it originates) as most people did a century ago, you'd consume about 15 grams per day. Today the average is 73 grams per day which is nearly 500 percent higher a dose and our bodies simply can't tolerate that type of biochemical abuse. So please, carefully add your fruits based on the following table to keep your total fructose below 15-25 grams per day, depending on your current health status.
FruitServing SizeGrams of Fructose
Limes1 medium0
Lemons1 medium0.6
Cranberries1 cup0.7
Passion fruit1 medium0.9
Prune1 medium1.2
Guava2 medium2.2
Date (Deglet Noor style)1 medium2.6
Cantaloupe1/8 of med. melon2.8
Raspberries1 cup3.0
Clementine1 medium3.4
Kiwifruit1 medium3.4
Blackberries1 cup3.5
Star fruit1 medium3.6
Cherries, sweet103.8
Strawberries1 cup3.8
Cherries, sour1 cup4.0
Pineapple1 slice (3.5" x .75")4.0
Grapefruit, pink or red1/2 medium4.3
 
FruitServing SizeGrams of Fructose
Boysenberries1 cup4.6
Tangerine/mandarin orange1 medium4.8
Nectarine1 medium5.4
Peach1 medium5.9
Orange (navel)1 medium6.1
Papaya1/2 medium6.3
Honeydew1/8 of med. melon6.7
Banana1 medium7.1
Blueberries1 cup7.4
Date (Medjool)1 medium7.7
Apple (composite)1 medium9.5
Persimmon1 medium10.6
Watermelon1/16 med. melon11.3
Pear1 medium11.8
Raisins1/4 cup12.3
Grapes, seedless (green or red)1 cup12.4
Mango1/2 medium16.2
Apricots, dried1 cup16.4
Figs, dried1 cup23.0

How to Determine Your Individual Susceptibility to Fructose Damage

As already stated, those who need to be careful about their fruit intake are people with high insulin levels. You can measure your fasting insulin level to find out for sure, but if you have any of the following problems it is highly likely you have insulin resistance syndrome:
  • Overweight
  • High Cholesterol
  • High Blood Pressure
  • Diabetes
  • Yeast Infections
Besides that, you can also use your uric acid levels as a marker for your susceptibility to fructose damage, as some people may be able to process fructose more efficiently than others. The higher your uric acid, the more sensitive you are to the effects of fructose. The safest range of uric acid appears to be between 3 and 5.5 milligrams per deciliter (mg/dl), and there appears to be a steady relationship between uric acid levels and blood pressure and cardiovascular risk, even down to the range of 3 to 4 mg/dl.
According to Dr. Richard Johnson, the ideal uric acid level is probably around 4 mg/dl for men and 3.5 mg/dl for women.
If you are one of those who believes that fruit is healthy no matter how much you eat, I would strongly encourage you to have your uric acid level checked to find out how sensitive you are to fructose. Eat the amount of fruit you feel is right for you for a few weeks and then check your uric acid level and see if your levels are healthy. If they are elevated you might try reducing the fruit to recommended levels and rechecking your uric acid level. Many who are overweight likely have uric acid levels well above 5.5. Some may even be closer to 10 or above. Measuring your uric acid levels is a very practical way to determine just how strict you need to be when it comes to your fructose – and fruit -- consumption.

Is there Such a Thing as an Ideal Diet for Everyone?

Nutritional requirements can vary wildly from one person to the next, which is why I’ve been a longtime proponent of eating in accordance with your nutritional type. For example, if you’re a protein type, fruits are generally not beneficial for you with the exception of coconut, which has a higher fat content that is beneficial for protein types. On the other hand, carbohydrate types tend to fare well with fruit and can safely consume moderate amounts. This is an important distinction, and everyone should try to eat primarily the specific fruits that are best for their unique biochemistry.
However, many find nutritional typing to be too complex. So to simplify matters, while still allowing for a fully personalized program, I recently updated and revised my Nutritional Plan. It consists of three levels, from beginners to advanced, and covers the basic requirements of a healthy diet.
Keep in mind that emerging evidence suggests your diet should be at least half healthy fat, and possibly as high as 70 percent. My personal diet is about 60-70 percent healthy fat, and both Paul Jaminet, PhD., author of Perfect Health Diet, and Dr. Ron Rosedale, M.D., an expert on treating diabetes through diet, agree that the ideal diet includes somewhere between 50-70 percent fat. It's important to understand that your body requires saturated fats from animal and vegetable sources (such as meat, dairy, certain oils, and tropical plants like coconut) for optimal functioning.
When you take this into account, it’s easy to see that an all-fruit diet could wreak absolute havoc with your health.
Keep in mind that frequent hunger may be a major clue that you're not eating correctly. Not only is it an indication that you're consuming the wrong types of food, but it's also a sign that you're likely consuming them in lopsided ratios for your individual biochemistry. Fat is far more satiating than carbs, so if you have cut down on carbs and feel ravenous, remember this is a sign that you haven't replaced them with sufficient amounts of fat. You do want to make sure you're adding the correct types of fat though, such as:
Olives and Olive oilCoconuts and coconut oilButter made from raw grass-fed organic milk
Raw nuts, such as, almonds or pecansOrganic pastured egg yolksAvocados
Grass-fed meatsPalm oilUnheated organic nut oils

If You Seek Optimal Health, Pay Careful Attention to Your Insulin Levels

Three lifestyle issues keep popping up on the radar when you look at what’s contributing to pancreatic cancer: sugar intake, lack of exercise, and vitamin D deficiency. Obesity and physical inactivity makes your body less sensitive to the glucose-lowering effects of insulin. Diminished sensitivity to insulin leads to higher blood levels of insulin, which in turn can increase your risk of pancreatic cancer.
It’s a no-brainer that an all-fruit diet can seriously jeopardize your insulin sensitivity, thereby raising your risk of any number of health problems, including pancreatic problems. It’s simply FAR too much fructose for most people. I personally developed diabetes when I tried the "Eat Right for Your Blood Type" diet, which included eating large amounts of fruit for breakfast. So please, be careful of any diet that seems to extreme, and remember the human body NEEDS healthful fats and high quality protein for proper functioning.
Remember to listen to your body over the long term to guide you as to the best food selections. If your energy level deceases, you have a difficult time maintaining your ideal weight or are hungry all the time, there is a good chance that you have yet to find the optimal fuel for your body. As for fruits, use caution if you have any kind of insulin related health issues, as discussed above, and limit your total fructose consumption to 15-25 grams of fructose per day, depending on your health status.



About Dr Kevin Lau


Dr Kevin Lau DC is a Singapore chiropractor and the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.
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