Jenna Jameson Loses 80 Pounds on Ketogenic Diet 

I hesitated to link to this story about a porn star, but decided to do it anyway. You judge her lifestyle for yourself.

Looks to me like she could use some weight training.

From Fox News:

“For dinner, Jameson, 44, says she prepares salmon in the oven with lemon, butter and dill around 5 p.m. and serves it with broccoli or asparagus.

Jameson also noted that she doesn’t mix meat and dairy because she eats Kosher, but says her followers should feel welcome to do so.The blonde bombshell, who welcomed daughter Batel Lu in April 2017, says that when she’s hungry, she eats, particularly because she’s breastfeeding — but that she makes it a point to avoid keto breads and snacks and focus solely on whole, organic foods.

The “How to Make Love Like a Porn Star” author has shared her weight loss progress for months.”

Source: Jenna Jameson shares keto diet tips after 80-pound weight loss | Fox News

Is this the diet she used?

Drug Therapy For Alzheimer’s Dementia Is Worse Than No Drug

dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“Honey, let’s talk to doc about stopping those drugs.”

I commonly admit patients to the hospital who happen to be taking either Aricept or memantine (or both) in an effort to slow the cognitive decline of dementia. Aricept is a cholinesterase inhibitor, abbreviated ChEI below.

A meta-analysis published in November 2018 in JAMA Network suggests that folks taking those drugs have a more rapid cognitive decline compared to those who don’t. Moreover, the rate of decline for those taking memantine, with or without ChEIs, was faster than those receiving ChEIs only or receiving neither medication.

A typical dose of Aricept (donepezil) is 10 mg/day. The average wholesale price for that pill is $20.23 (USD). One brand of memantine is called Namenda, and the usual dose is 10 mg twice daily. Average wholesale dose for that is $17.80/day.  Take both those drugs daily for one month and it’s $1,140.90. Or $13,690.80 for a year. And that’s the wholesale price.

I can think of a few better uses of that money.

Admittedly, there must be individual patients that respond better than average to these drug, and some respond worse than average. You can’t tell in advance who those are.

Click the link below for the full study. From the Abstract:

Results

Across 10 studies, of 2714 participants, the mean (SD) age was 75.0 (8.2) years, 58% were female, and 9% were racial/ethnic minorities. There were 906 participants (33.4%) receiving ChEIs, 143 (5.3%) receiving memantine, 923 (34.0%) receiving both, and 742 (27.3%) receiving neither. Meta-analysis showed those receiving ChEIs or memantine were associated with significantly greater annual rate of decline on the ADAS-cog [a test of cognition] than those receiving neither medication (1.4 points/y; 95% CI, 0.1-2.7).

Conclusions and Relevance

Similar to observational studies, many participants in AD clinical trials receiving ChEIs or memantine experience greater cognitive decline. This difference is nearly as large as the hypothesized effect sizes of the treatments investigated in the trials. Concomitant use of ChEIs or memantine may be confounded with outcomes on the ADAS-cog and should be considered in design of clinical trials of potential therapeutic agents for AD. Post hoc analyses stratifying by ChEIs or memantine must be interpreted cautiously given the potential for confounding.

Source: Association of Concomitant Use of Cholinesterase Inhibitors or Memantine With Cognitive Decline in Alzheimer Clinical Trials: A Meta-analysis | Dementia and Cognitive Impairment | JAMA Network Open | JAMA Network

Have Americans Given Up On Losing the Excess Weight?

The Truth About Low-Protein, High-Carb Diets and Brain Aging

From Dr Georgia Edes:

“A new study conducted at the University of Sydney and published in the journal Cell Reports is inspiring headlines around the world, like this one: “Low-protein, high-carb diet may help ward off dementia”

In the study, scientists compared diets containing different amounts of protein and carbohydrate to a low-calorie diet. Their results suggested that diets lower in protein and higher in carbohydrate may, in some cases, provide subtle brain benefits similar to the benefits seen with calorie restriction. The researchers concluded, “A very low-protein, high-carbohydrate diet may be a feasible nutritional intervention to delay brain aging.”

Source: The Truth About Low-Protein, High-Carb Diets and Brain Aging | Psychology Today

This is ground-breaking research if you’re a mouse.

Keeping Alzheimer’s Disease at Bay 

No surprise here:

“A review of studies that looked at the effect of the Mediterranean diet on long-term cognitive function established that people who adhered to this way of eating had less cognitive decline, had improvements in cognitive function, or were less likely to develop Alzheimer’s disease compared to people who did not stick to this diet. The Mediterranean diet emphasizes fruits, vegetables, whole grains, beans, nuts, fish and olive oil, with lesser amounts of poultry and cheese and limited amounts of red meat and sweets.”

Source: Keeping Alzheimer’s Disease at Bay – Diabetes Self-Management

ABitOfBritt on HAES: Health at Every Size

Discover a “Fair Price” For Your Upcoming Medical Procedure

…at Healthcare Bluebook.

I don’t know if the site above is legitimate or not. But I like the idea behind it. Check it out and see what you think.

 

 

Is There a Premium Increase in Your Future: Health Insurers Are Vacuuming Up Details About You

From ProPublica…

“Before the conference, I’d seen a press release announcing that the largest health actuarial firm in the world, Milliman, was now using the LexisNexis scores. I tracked down Marcos Dachary, who works in business development for Milliman. Actuaries calculate health care risks and help set the price of premiums for insurers. I asked Dachary if Milliman was using the LexisNexis scores to price health plans and he said: “There could be an opportunity.”

The scores could allow an insurance company to assess the risks posed by individual patients and make adjustments to protect themselves from losses, he said. For example, he said, the company could raise premiums, or revise contracts with providers. It’s too early to tell whether the LexisNexis scores will actually be useful for pricing, he said. But he was excited about the possibilities. “One thing about social determinants data — it piques your mind,” he said. Dachary acknowledged the scores could also be used to discriminate. Others, he said, have raised that concern. As much as there could be positive potential, he said, “there could also be negative potential.” It’s that negative potential that still bothers data analyst Erin Kaufman, who left the health insurance industry in January. The 35-year-old from Atlanta had earned her doctorate in public health because she wanted to help people, but one day at Aetna, her boss told her to work with a new data set.

To her surprise, the company had obtained personal information from a data broker on millions of Americans. The data contained each person’s habits and hobbies, like whether they owned a gun, and if so, what type, she said. It included whether they had magazine subscriptions, liked to ride bikes or run marathons. It had hundreds of personal details about each person. The Aetna data team merged the data with the information it had on patients it insured. The goal was to see how people’s personal interests and hobbies might relate to their health care costs. But Kaufman said it felt wrong: The information about the people who knitted or crocheted made her think of her grandmother. And the details about individuals who liked camping made her think of herself. What business did the insurance company have looking at this information? “It was a dataset that really dug into our clients’ lives,” she said. “No one gave anyone permission to do this.”

Source: Health Insurers Are Vacuuming Up Details About You —… — ProPublica

Why Your Health Insurer Doesn’t Care About Your Huge Healthcare Bills

Health insurers don’t care because they’re just going to pass the cost on to you and your employer via higher premiums. And the more your employer pays for health insurance fees, the less they can put into your paycheck.

Article like the one linked below make my blood boil.

“After Aetna approved the in-network payment of $70,882 [for a partial hip replacement] (not including the fees of the surgeon and anesthesiologist), Frank’s coinsurance required him to pay the hospital 10 percent of the total.

When Frank called NYU Langone [hospital] to question the charges, the hospital punted him to Aetna, which told him it paid the bill according to its negotiated rates. Neither Aetna nor the hospital would answer his questions about the charges.”

Source: Why Your Health Insurer Doesn’t Care About Your Big… — ProPublica

Here’s a comment left under the article:

I am a physician and have seen these games for years.
It is obvious that the insurers collude with the hospitals and pharmacies, to raise the patients copays.
It is a way of transferring costs onto the consumer.
Each insurance company has a different contract, with each hospital and pharmacy.
For example, I recently needed an MRI. I priced the charges in advance with my local hospital.
If I used my small group blue x policy, I would be charged about $2,200 dollars as my copay. I negotiated to pay the medicare rate in full, and not use my insurance. I paid $240 dollars as the full medicare rate. It was much cheaper for me not to use my insurance, than to use my insurance and pay an inflated copay.

Pharmacies are a little more forthcoming about their pricing, so their games are a little more obvious.
A pharmacy will tell you the price of a drug, but you have to tell them your insurance first.
The chain pharmacies will change the list price for a drug, depending on the insurance.
For example, I told a patient that the silver sulfadiazine cream I was prescribing should cost about $10. The next day they came back furious at me. The local chain pharmacy said it was $440, and their insurance supposedly paid $400, leaving them a copay of $40.

I called around and I found that the full cost at the chain pharmacy without insurance was much less ($35). Walmart had it as one of their $4 drugs. The $440 cream at the chain pharmacy and the $4 cream at Walmart were made by the same generic manufacturer.
I don’t believe that the insurance company was dumb enough to pay $400 dollars for a $4 tube of cream. I think that the list price of the drug was inflated, by mutual agreement between the chain pharmacy and the insurer. By inflating the list price, the patient paid $40 for a $4 tube of cream through their copay. I doubt the insurance company paid anything.

Recipe: Cucumber Salad

Without the avocado (as above), calorie count drops by 140, but who’s counting these days?

This makes three servings.

Ingredients

Protein

12 oz cooked boneless steak, cut into bite-sized pieces

Vinaigrette

2 Tbsp red wine vinegar

6 Tbsp extra virgin olive oil

1 tbsp lemon juice

1/4 tsp salt

pepper to taste

1 tsp celery seeds

2 tsp dried oregano

Salad

2 large cucumbers (8 inches long), peeled or not, sliced and wedged

3 medium tomatoes (4 to 4.5 oz each), diced

1 green bell pepper, diced

1/2 small red onion, thinly sliced

0.5 to 1 oz parsley (about 1/4 of a typical bunch), leaves plucked and chopped, stems discarded

2 oz parmesan cheese (good quality), shredded or shaved

1.5 avocados (California or Haas, dark skin), peeled and sliced or diced

For the lacto-vegetarians in your life (or vegans if you omit the cheese)

Instructions

Start with the vinaigrette. to a small bowl add the vinegar, olive oil, lemon juice, salt, pepper, celery seeds and oregano, then whisk together and set aside.

In a large bowel, mix the cucumber, tomatoes, bell pepper, onion, parsley, and cheese. Then add the vinaigrette and all ingredients gently but thoroughly. Enjoy the steak and avocado on the side or mixed into the salad.

A serving is three cups of salad, 4 oz steak, and 1/2 avocado.

Number of servings: 3

Nutrient Analysis Per Serving (FitDay):

826 calories

Calories from fat: 67%

Calories from protein: 22%

Calories from carbohydrate: 11%

26 carb grams

11 fiber grams

15 grams digestible carb

43 protein grams

Prominent features (70% or more of RDA): Protein, B6, B12, C, iron, phosphorus, selenium, zinc.

Options to consider:

Substitute chicken or shrimp for steak. Substitute other cheese for Parmesan. Sprinkle final product with lemon juice.

The salad alone would be a hit at any potluck dinner