JustCare

Tag: Nutrition

  • Five reasons to eat avocados

    Five reasons to eat avocados

    Avocados are in season and there’s every reason to eat them. CNN reports on five health benefits of avocados that you likely did not know. And, there are so many great ways to enjoy them.

    Here are some nutritional benefits of eating avocados

    • Omega-3: You can get a good amount of omega-3 fatty acids from an avocado. Omega-3 is great for reducing your LDL cholesterol level. LDL cholesterol can cause your arteries to harden and restrict your blood flow, which in turn can lead to blood clots.
    • Potassium: Potassium is a mineral that is good for regulating nerve function. It allows for nutrients to go into cells and removes waste, including sodium. In the process, it helps fight high blood pressure.
    • Monounsaturated fats: These fats also help reduce your LDL cholesterol and does not touch your good HDL cholesterol.
    • Fiber: You don’t need to eat Grape Nuts for your fiber. Avocados deliver lots of fiber without the sugar. And, the fiber helps to fill you up, reducing your hunger level and keeping you from overeating if you’re on a diet. That said, a 3.5 ounce avocado portion is 160 calories!
    • Folate: Skip the vitamin B supplement and get the vitamin naturally from your avocado. It helps with good brain function.

    How might you enjoy the health benefits of an avocado? Slice one in half, top it with lemon juice and a little salt and pepper, then eat it straight from the skin. No muss, no fuss! Or, scoop it out and mash with a little garlic, a little lime juice, salt and some red onion for quick and easy guacamole. Use it as a mayo substitute. Dip slices in egg and breadcrumbs and fry them up. Or, add an avocado to a smoothie for a creamy healthy drink.  Avocados can also go in a soup or a dessert for extra creaminess.

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  • How you sleep could turn on what you eat

    How you sleep could turn on what you eat

    Trouble sleeping? Typically, people who exercise and stay away from computer screens sleep better at night. Anahad O’Connor writes for the New York Times that recent studies show that how well you sleep could turn on what you eat.

    Research reveals that unhealthy eating habits–such as eating a lot of sugary foods, saturated fats and processed foods–might mean poor sleep. Not surprisingly, healthy eating habits–such as eating fish, plants, fiber and foods that have lots of unsaturated fat–can help to promote a good night’s sleep.

    The research is based on observational studies, which can never show causal effects. But, these studies can find relationships between diet and sleep. Some research involves asking people to eat particular foods and then measuring their sleep as compared to other people who do not eat those foods.

    Many of these studies cannot be trusted. For example, a banana company might fund a study on the value of bananas, much like Medicare Advantage plans might fund a study on the value of Medicare Advantage plans.  Whoever is being paid has an interest in pleasing the funder and delivering the results the funder is looking for.

    Some researchers studying the relationship between diet and sleep believe that the relationship might not be between eating particular foods and a good sleep but about eating a healthy diet and a good night’s sleep.

    Some researchers have found that eating a diet rich in carbohydrates can help people fall asleep more quickly than if they eat a high fat or high protein diet. In this case, the kind of carbohydrates could affect sleep. People who eat a lot of white bread and pasta tend not to sleep soundly through the night. To sleep soundly, you want to eat complex carbohydrates with fiber, which can keep your blood-sugar level stable.

    Researchers recommend a Mediterranean diet for sound sleep.

    All this said, researchers also believe that people who sleep poorly are often hungrier than people who sleep soundly. And, they might be more inclined to eat an unhealthy diet, including lots of sugary and processed foods.

    There’s more. Researchers have found that people who sleep well often have greater will power not to eat junk food. So, if you want to sleep well, try eating a healthy diet. And, if you eat a healthy diet, you might find that you sleep better. For sure, the research is not definitive, but what’s there to lose?

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  • Snack bars are not as healthy as you might think

    Snack bars are not as healthy as you might think

    Did you know that eating snack bars may not be good for your health? They are generally marketed as “granola,” “protein,” “energy,” or “nutrition” bars, but most of them are more like candy bars. The nonprofit Cornucopia Institute reports that snack bars are generally not as healthy as their manufacturers would like you to believe.

    Except for the certified organic bars, most snack bars contain unfamiliar chemical ingredients. Beware of bars labeled “natural,” which means nothing. Any company can put a “natural” claim on a product regardless of its ingredients. Natural bars can contain harmful chemicals. Many “natural” bars contain “soy protein isolate,” which should be avoided.

    In addition, the “non-GMO” label is meaningless, unless accompanied by the USDA organic label.

    The only regulated labels are “made with” organic ingredients and “USDA organic.” Bars labeled “USDA organic” have at least 95 percent of their ingredients, by weight, certified as organic. There are no toxic pesticides, insecticides, herbicides or harmful chemicals involved in their manufacture. They are always verified as non-GMO. You can be relatively sure that the ingredients are not dangerous.

    Bars labeled “made with” organic ingredients have at least 70 percent of their ingredients, by weight, certified as organic. They are not as heavily regulated as “USDA organic.” They may have fewer health benefits than “USDA organic” bars and should be avoided in favor of USDA organic bars.

    If you want to ensure you are eating a healthy snack bar, buy USDA organic bars containing nuts, seeds and fruit as their primary ingredients. The Cornucopia Institute says “Simple Squares” have it all, seven whole organic ingredients in each bar. Avoid bars with added sweeteners, particularly sugar, and added flavors and colors, even “natural” flavors and colors.

    Cornucopia Institute has a scorecard showing the relative nutritional value of different snack bars, which you can find here.

    This post was originally published on December 19, 2017.

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  • If you need nutrition counseling, Medicare may cover it in full

    If you need nutrition counseling, Medicare may cover it in full

    As we all know, what we eat can affect our health in all kinds of ways. And, for the 15 million people with Medicare who have diabetes or kidney conditions, this is all the more true. To help people with diabetes or kidney disease learn to eat right, Medicare covers nutrition counseling in full. (Medicare also covers weight counseling.)

    If you have diabetes, chronic renal disease or have had a kidney transplant and want medical nutrition counseling, so long as you see a doctor, registered dietician, or other Medicare-qualified nutrition professional who “takes assignment”–accepts Medicare’s approved amount as payment in full–you will have no out-of-pocket costs. And, if you’re in a Medicare Advantage plan, so long as you see an in-network provider—you will have no copays, coinsurance or other out-of-pocket costs either.

    Few people with Medicare or their physicians appear to know about the nutrition-counseling benefit even though the benefit has been available since 2002. Only a small fraction of people with Medicare take advantage of it. Kaiser Health News reports that just 100,000 people with traditional Medicare received nutrition counseling in 2017. There’s no data as to whether any of the 20 million people enrolled in Medicare Advantage plans are getting this benefit.

    To benefit from Medicare coverage of dietary counseling, speak with your doctor. You will need a referral from your doctor to a registered dietician or qualified nutrition specialist. Medicare generally pays for three hours of dietary counseling during the first year you receive counseling. Medicare pays for an additional two hours of counseling every year afterwards.

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  • Eat better, spend less on health care

    Eat better, spend less on health care

    So long as the US population is aging, health care costs will continue to increase no matter what happens with health care reform. An op-ed in the New York Times, by Dariush Mozzafarian and Dan Glickman, argues that the food we eat drives up health care costs. If Americans ate better and became healthier, we would spend far less on health care.

    Today, tens of millions of Americans suffer from one or more chronic conditions. Close to one third of the US population, more than 100 million adults, have pre-diabetes or diabetes. More than one third of the population, more than 120 million adults, have cardiovascular disease. And three quarters of the adult population is obese. These chronic conditions are responsible for hundreds of billions of dollars in health care spending, as well as lost productivity. (Note: Medicare covers a diabetes prevention program, weight-loss counseling and nutrition counseling.)

    We know that people who eat healthy diets feel better and have lower health care costs. But, that’s different from knowing how to change people’s diets so that they eat better, especially when the food industry giants invest heavily in getting people to eat unhealthy diets. What would it take to improve population health through better nutrition?

    The authors suggest a number of ways to improve people’s diets. They propose that electronic health records include nutrition; health care providers could focus more on eating well and prescribe people fruits and vegetables; health care providers also could design healthy meals for people in poor health. One recent study shows that, for each person in poor health, these healthy meals alone would save $9,000 a year in health care costs.

    Of course, behavior change, whether for a health care provider or a patient, is challenging. And, the food industry will do what it can to make change in people’s eating habits difficult. The food industry has done a great job of keeping sugary beverages and junk food from being taxed more, even though these foods have no health benefits and drive up health costs.

    The authors also suggest that the government subsidize the cost of healthy foods, such as vegetables, fruits, nuts, beans, whole grains and fish. They suggest government regulatory safety standards for processed foods to reduce sugar, sodium and transfats, if not voluntary action by industry. And, SNAP, which helps about 12 percent of Americans with the cost of food, could focus more on a healthy diet.

    Government has a big role to play in helping people to eat healthy diets. But, no presidential candidates are talking about food policy and few journalists are asking about it.  Government action in this area may be a long time coming.

    Here’s more from Just Care:

  • Dietary changes may help fight allergies

    Dietary changes may help fight allergies

    What’s on your plate has a significant effect on allergies, including on how well allergy meds work for you, says says Vincent Pedre, MD, a board-certified internist and integrative physician in New York City, author of the book Happy Gut, and a former seasonal allergy sufferer himself. Nutrition is Dr. Pedre’s preferred approach to treating his allergies, in order to avoid possible drug side effects such as fatigue, sleepiness, and “feeling mentally slow,” he says.

    A dietary strategy against allergies might include subtracting some foods and nutrients and adding or increasing others. Eliminating or reducing foods such as wheat, dairy and sugar can make a difference, Dr. Pedre says. “We change the diet — a lot of times taking out dairy, for example — and spring allergy symptoms become pretty much nonexistent,” he observes. “There can be a huge improvement with the right dietary changes.”

    On the add-to-your-diet list, Dr. Pedre recommends foods rich in vitamin C (a natural antihistamine, antioxidant and immune booster), quercetin (an antihistamine and anti-inflammatory), and omega-3 fatty acids (anti-inflammatories). Foods high in vitamin C include broccoli, kale, cauliflower, bell peppers, mangoes, strawberries, oranges, pineapples, cantaloupes and peaches. Dietary sources of quercetin are apples, citrus fruits, onions, garlic, tomatoes, legumes, dark berries, green and black teas and red wine. “Vitamin C and quercetin stabilize the mast cells, which release histamine,” so you’re left with fewer allergy symptoms such as a runny nose or sneezing, Dr. Pedre explains. . . . Meanwhile, omega-3 fatty acids can be found in  . . . almonds, walnuts, avocado, ground flax and chia seeds.

    Although there are no studies to support its effectiveness, locally sourced honey — a teaspoon per day, taken for a couple of months before allergy season begins — is theoretically a natural form of immunotherapy, Dr. Pedre adds. The idea is that it delivers a small dose of pollens from the local area, the same ones that would trigger an allergic response if your body were not accustomed to them.

    This post is excerpted from Medshadow.org.

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  • Home-delivered meals, more than good nutrition

    Home-delivered meals, more than good nutrition

    As we and the people we love age, it’s important to keep in mind the importance of both good nutrition and social interactions. Eating alone often leads to poor nutrition and can be particularly depressing. A study by Kali S. Thomas, Brown University, shows the value of home-delivered meals for people’s physical and emotional health.
    Thomas’ research shows increased levels of depression, anxiety and loneliness, and poorer quality of life for people who are on waitlists for Meals on Wheels or who receive weekly shipments of frozen meals, as compared with people who get daily meal deliveries. People who get daily meal deliveries get to socialize with the people delivering those meals.
    Home-delivered meals not only help older adults remain in their homes longer, but they have mental and physical health benefits. Based on answers to survey questions, Thomas’ study found that older adults receiving daily meals showed improved mental health and fewer falls and hospitalizations. They felt less isolated and safer, perhaps because of the sense they were being checked on by the people delivering their home-delivered meals.
    Many older adults lack any social interactions. which are critical to quality of life. They live alone and have no family or friends to help them over an extended period of time.  Thomas’ study found that those on waiting lists for home-delivered meals rated their health less well than others living in the community. And, they worried about their ability to continue to live in their homes.
    If you’re interested in learning more about home-delivered meals for yourself or someone you love, contact your local area agency on agency at 1-800-677-1116. Area Agencies on Aging are located in communities across the US and provide free assistance and resources for older adults. You can learn more about them and the services they offer here. For additional information from Just Care about free and low-cost resources for older adults, including friendly visiting programs, click here.
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  • The danger of letting Medicare Advantage plans divert money away from medical care

    The danger of letting Medicare Advantage plans divert money away from medical care

    The 2018 Chronic Care Act allows Medicare Advantage plans to offer enrollees non-medical services that may improve health and patient safety. However, the danger of letting Medicare Advantage plans divert money away from medical care is serious.  As a rule, Medicare Advantage plans already shift costs to their sickest enrollees, often steering them back to traditional Medicare or into poor quality nursing homes. If they can spend more money on non-medical care, it could easily mean they spend less money on complex care, jeopardizing access to needed care for enrollees in poor health.

    Contrary to what PBS suggests in its story on this new policy, Medicare Advantage plans generally do not manage medical care or, if they do, they manage it poorly. A Commonwealth Fund report argues for providing better incentives to these plans to deliver better care. But is that possible? Their shareholder returns depend upon their spending less on care, which generally means delaying or denying care to people in poor health.

    An article in the NEJM by Amber Willink and Eva DuGoff highlights the risks of changing Medicare Advantage policy to allow these commercial plans to provide non-medical care. These plans design their benefits to attract healthier people and steer clear of people with costly conditions. In the authors’ words, “It will be critical for CMS to oversee the design and marketing of supplemental benefits.” But, exactly how will they do that and how many people with costly needs will be hurt in the meantime?

    In its report about the new Medicare policy, PBS buried the lede: Medicare Advantage plans tend to do everything in their power to deter people with costly needs from enrolling and to encourage enrollees to disenroll if they need costly care. If they are allowed to shift even more costs onto people who need complex care and spend money on non-medical benefits that attract lower-cost enrollees, they may put their enrollees at serious risk.

    Moreover, where’s the data to show that Medicare Advantage plans tie services to health outcomes as PBS asserts? Medicare Advantage plans do not tend to share their data. Indeed, they rarely if ever allow researchers to tie their services to health outcomes and report on their findings.

    To be clear, government investment in the non-medical social determinants of health, including good housing, nutrition, transportation and the like is smart and helps promote good health outcomes. But, that is not what this new policy is doing. Rather, it is appears to allow Medicare Advantage plans to play fast and loose with taxpayer money. It is not at all clear they will be accountable for their spending.

    We should not blame Medicare Advantage plans for their behavior. Their shareholders would be up in arms if they did not discourage people with costly conditions from enrolling. And, these commercial plans would lose money if too many people with cancer and heart disease and stroke enrolled in their plans.  But, that’s the reason you should avoid them if you can afford the supplemental coverage you need to protect yourself with traditional Medicare. And, it is the reason the government should not trust them with taxpayer money to decide how to invest in non-medical care.

    People in Medicare Advantage plans, particularly for-profit plans, take a gamble. They risk not being able to see the specialists and use the specialty hospitals they know and trust if they get sick in their communities. What’s worse, they may lose access to centers of excellence. They risk tremendous out-of-pocket costs if they develop complex conditions. And, they risk having to pay out of pocket for their care if they get care out of their area.

    Deductibles and copays in a Medicare Advantage plan can be as high as $6,700 a year, which the federal government, many educators and journalists fail to highlight. And, if you need care in December and January, you can be talking nearly $14,000 out of pocket.

    By design, Medicare Advantage plans cannot deliver the high-value care that people with Medicare need.  If a bunch of well-intentioned people decided to open the best Medicare Advantage plan for older people with stroke, heart disease and cancer, it would be out of business before it opened its doors. Everyone with these conditions would flock to it, and it would have to raise premiums to cover its costs. People who were healthy would leave for a plan with lower premiums, which would drive up the good health plan’s premiums further.

    Medicare Advantage plans could not survive if traditional Medicare, like Medicare Advantage, had a catastrophic cap. That’s likely why traditional Medicare does not have a catastrophic cap. Policymakers either want traditional Medicare to die, or they do not understand the risks Medicare Advantage plans pose.  In part, it is because they have little clue how Medicare Advantage plans are performing. Let’s not pretend otherwise.

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  • Five ways to feel at your best

    Five ways to feel at your best

    If you focus on birthdays, we are all getting older.  But, many of us who may be “getting up there” in age find ways to stay young at heart–fit, mentally active, and purposeful.  Here are five ways to feel at your best:

    1. Be active: Walk, run, jump rope. Get your heart rate up.  Countless studies show the value of aerobic exercise for your gut, your memory, your immune system, your cardiovascular health, your strength, your stress level, your mood, your cholesterol levels. It may be the best medicine for your body and brain. Also, do balancing exercises and use weights to strengthen your muscles. That is key to good health, including bone health, lowering risk of stroke and even spousal health
    2. Eat well and keep a healthy weight: Sense of smell and taste can change as you age; it’s still important to eat healthy foods. Eat lots of fruits, vegetables, beans, nuts, seeds, lean meats and fish. Avoid, fats, pasta and sugared drinks. And if you need help losing weight or eating better, talk to your doctor; in some cases, Medicare covers weight-loss counseling and nutrition counseling.
    3. Get the sleep you need. Here are seven tips for getting a good night’s sleep.
    4. Keep in touch with family and friends you enjoy. And make one of them your health care buddy, someone to go with you to the doctor, take notes and be a second set of eyes and ears.
    5. And, perhaps, take up bowling: Watch this video from the Atlantic on how one older adult has stayed young and met his life partner bowling.

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    If you’d like to learn more about what you can do to feel at your best, click here for the National Institutes of Health booklet, Young at Heart.

  • Are fish oil supplements just another red herring?

    Are fish oil supplements just another red herring?

    There appears to be precious little evidence of the benefits  to individuals of fish oil supplements, according to research out of the University of Auckland in New Zealand and, more recently, a US study published in the New England Journal of Medicine.

    The researchers at the University of Auckland found that if you’re hoping to help your heart by consuming fish oil supplements, you might want to stop hoping and switch to eating fish rich in omega-3 fatty acids. But, you should do so in moderation. Researchers analyzed the results of 18 randomized clinical trials between 2005 and 2012 and found essentially no basis for recommending people take fish oil supplements.

    The US researchers tested whether fish oil supplements help people with dry eye, a common condition in which the eye is inflamed, causing vision problems and pain. In their study 500 people received either fish oil supplements or a dummy pill every day over a year.  They found that people who took the supplements had the same symptoms at the end of the year as people who took the dummy pill.

    So, instead of taking fish oil supplements, eat mackerel, herring, tuna, halibut and salmon, which all provide omega-3 fatty acids, otherwise known as fish oil. Eating broiled or baked fish could reduce your risk of cardiac death. But, beware, if you eat fried fish, you likely increase your risk of heart disease.

    Eating fish also may increase your exposure to methylmercury. Swordfish, king mackerel, shark, or tilefish have high levels of methylmercury. Higher mercury consumption is associated with a higher risk of cardiovascular disease; however results are mixed. As always, the key is moderation and a balanced diet.

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