Chart of the Day: Health Spending and Life Expectancy of Selected OECD Countries

Source: The Economist

Advertisements

Bison Lasagna

Ingredients

1/2 lb ground bison
1 onion,chopped
8 garlic cloves, peeled and minced large tomatoes, peeled, seeded and chopped
1/4 cup reduced sodium beef broth or beef stock
2 tablespoons chopped fresh oregano
2 tablespoons chopped fresh rosemary
1/4 teaspoon ground black pepper
2 cups nonfat ricotta cheese
1 cup chopped fresh basil
1/2 cup chopped sun-dried tomatoes, packed without oil
2 tablespoons grated Parmesan cheese
24 cups water
9 dried lasagna noodles
1-1/2 cups grated mozzarella cheese

Method

  1. Preheat an oven to 350°F (180°C). Coat a 13-by-9-inch baking dish with nonstick cooking spray.
  2. Coat a large nonstick frying pan with nonstick cooking spray and set over medium heat. Add the bison, the onion and half of the garlic and saute until the meat is browned and no longer pink, about 5 minutes.
  3. Stir in the chopped tomatoes, broth or stock, oregano, rosemary and pepper. Bring to a boil, reduce the heat to low and simmer, uncovered, until the sauce has thickened, about 10 minutes. Remove from the heat.
  4. In a food processor with the metal blade or in a blender, combine the ricotta cheese, basil, sun-dried tomatoes, Parmesan cheese and remaining garlic. Process until smooth.
  5. In large pot over high heat, bring the water to a boil. Add the noodles and cook according to the package directions or until al dente, about 10 minutes. Drain.
  6. In the prepared pan, layer 3 noodles, half of the ricotta mixture, one-third of the meat sauce and one-third of the mozzarella.
  7. Repeat the layers, using 3 noodles, the remaining ricotta mixture, half of the remaining meat sauce and half of the remaining mozzarella.
  8. Top with the remaining noodles, the remaining meat sauce and the remaining mozzarella.
  9. Bake, uncovered, until bubbly and golden on top, 35-45 minutes. Cool for 10 minutes before slicing.
  10. To serve, divide among 6 individual plates.

Makes 6 servings.

Source: Cooking for Healthy Living

How to Make Toast Even Better: Fry It

Marian Bull wrote . . . . . . . . .

You know how to make toast. Your 6 year old cousin knows how to make toast. You just pop the thing in the toaster, you are saying to me in your brain right now. And yes, you’re right: that’s a completely viable way to make toast! It’s perhaps the easiest task you can accomplish in a kitchen without a microwave. You can even do it under a broiler if you’re lacking in counter space for single-use devices.

But that is not, unfortunately, the best way to make toast. That is not the most delicious way to make toast! That is not the way to make yourself yearn for your toast the way you yearn for a stupid pair of expensive sneakers or an all-expenses-paid trip to Tulum. For that kind of toast, you’re going to need a bottle of good olive oil, and a pan—yes, a pan! Like the one you use to make eggs!—on the stove. Because the best, tastiest, most perfect toast is toast that is fried.

Anyone who does things like crossfit or counting calories will probably stop trusting me at this point, and I understand that. There are people who don’t want to go adding a tablespoon or two of (“good”) fat to their diets. Toast that has been fried until glossy and golden in a pan full of hot oil is not the basis of a “low-cal breakfast”. It’s not going to give you the same effect as, say, a smoothie. But it is fucking delicious.

Here’s what happens: When you fry a thick slab of bread in olive oil, the insides get soft—for this reason it’s a great way to use up a loaf that’s almost stale—and the outsides get golden and crunchy. (My former boss, who is the person who exposed me to fried toast, likens it to a “[very large crouton].”) It is the perfect base for a cooked egg, or some vegetables, or beans, or even something like sliced fruit—anything that’s not too, too fatty. (Avocado is pushing it.)

And the process is easy, albeit slightly more laborious than your standard toast production. Get yourself a thick slice of crusty bread. Heat up a tablespoon or two of olive oil in a pan, until it’s shimmering but not smoking. Then add the bread, and flip when it’s golden, and cook the other side until it looks good too. Sprinkle the thing with salt, and then eat it plain, or underneath whatever leftovers are sitting in your fridge. You will not necessarily feel virtuous, but you will feel happy, and that is important, too.

Source: GQ Magazine

The Startling Link Between Sugar and Alzheimer’s

Olga Khazan wrote . . . . . . . . .

In recent years, Alzheimer’s disease has occasionally been referred to as “type 3” diabetes, though that moniker doesn’t make much sense. After all, though they share a problem with insulin, type 1 diabetes is an autoimmune disease, and type 2 diabetes is a chronic disease caused by diet. Instead of another type of diabetes, it’s increasingly looking like Alzheimer’s is another potential side effect of a sugary, Western-style diet.

In some cases, the path from sugar to Alzheimer’s leads through type 2 diabetes, but as a new study and others show, that’s not always the case.

A longitudinal study, published Thursday in the journal Diabetologia, followed 5,189 people over 10 years and found that people with high blood sugar had a faster rate of cognitive decline than those with normal blood sugar—whether or not their blood-sugar level technically made them diabetic. In other words, the higher the blood sugar, the faster the cognitive decline.

“Dementia is one of the most prevalent psychiatric conditions strongly associated with poor quality of later life,” said the lead author, Wuxiang Xie at Imperial College London, via email. “Currently, dementia is not curable, which makes it very important to study risk factors.”

Melissa Schilling, a professor at New York University, performed her own review of studies connecting diabetes to Alzheimer’s in 2016. She sought to reconcile two confusing trends. People who have type 2 diabetes are about twice as likely to get Alzheimer’s, and people who have diabetes and are treated with insulin are also more likely to get Alzheimer’s, suggesting elevated insulin plays a role in Alzheimer’s. In fact, many studies have found that elevated insulin, or “hyperinsulinemia,” significantly increases your risk of Alzheimer’s. On the other hand, people with type 1 diabetes, who don’t make insulin at all, are also thought to have a higher risk of Alzheimer’s. How could these both be true?

Schilling posits this happens because of the insulin-degrading enzyme, a product of insulin that breaks down both insulin and amyloid proteins in the brain—the same proteins that clump up and lead to Alzheimer’s disease. People who don’t have enough insulin, like those whose bodies’ ability to produce insulin has been tapped out by diabetes, aren’t going to make enough of this enzyme to break up those brain clumps. Meanwhile, in people who use insulin to treat their diabetes and end up with a surplus of insulin, most of this enzyme gets used up breaking that insulin down, leaving not enough enzyme to address those amyloid brain clumps.

According to Schilling, this can happen even in people who don’t have diabetes yet—who are in a state known as “prediabetes.” It simply means your blood sugar is higher than normal, and it’s something that affects roughly 86 million Americans.

Schilling is not primarily a medical researcher; she’s just interested in the topic. But Rosebud Roberts, a professor of epidemiology and neurology at the Mayo Clinic, agreed with her interpretation.

In a 2012 study, Roberts broke nearly 1,000 people down into four groups based on how much of their diet came from carbohydrates. The group that ate the most carbs had an 80 percent higher chance of developing mild cognitive impairment—a pit stop on the way to dementia—than those who ate the smallest amount of carbs. People with mild cognitive impairment, or MCI, can dress and feed themselves, but they have trouble with more complex tasks. Intervening in MCI can help prevent dementia.

Rebecca Gottesman, a professor of neurology at Johns Hopkins, cautions that the findings on carbs aren’t as well-established as those on diabetes. “It’s hard to be sure at this stage, what an ‘ideal’ diet would look like,” she said. “There’s a suggestion that a Mediterranean diet, for example, may be good for brain health.”

But she says there are several theories out there to explain the connection between high blood sugar and dementia. Diabetes can also weaken the blood vessels, which increases the likelihood that you’ll have ministrokes in the brain, causing various forms of dementia. A high intake of simple sugars can make cells, including those in the brain, insulin resistant, which could cause the brain cells to die. Meanwhile, eating too much in general can cause obesity. The extra fat in obese people releases cytokines, or inflammatory proteins that can also contribute to cognitive deterioration, Roberts said. In one study by Gottesman, obesity doubled a person’s risk of having elevated amyloid proteins in their brains later in life.

Roberts said that people with type 1 diabetes are mainly only at risk if their insulin is so poorly controlled that they have hypoglycemic episodes. But even people who don’t have any kind of diabetes should watch their sugar intake, she said.

“Just because you don’t have type 2 diabetes doesn’t mean you can eat whatever carbs you want,” she said. “Especially if you’re not active.” What we eat, she added, is “a big factor in maintaining control of our destiny.” Roberts said this new study by Xie is interesting because it also shows an association between prediabetes and cognitive decline.

That’s an important point that often gets forgotten in discussions of Alzheimer’s. It’s such a horrible disease that it can be tempting to dismiss it as inevitable. And, of course, there are genetic and other, non-nutritional factors that contribute to its progression. But, as these and other researchers point out, decisions we make about food are one risk factor we can control. And it’s starting to look like decisions we make while we’re still relatively young can affect our future cognitive health.

“Alzheimer’s is like a slow-burning fire that you don’t see when it starts,” Schilling said. It takes time for clumps to form and for cognition to begin to deteriorate. “By the time you see the signs, it’s way too late to put out the fire.”

Source: The Atlantic

The ‘Bottom’ Blood Pressure Number Matters, Too

Amy Norton wrote . . . . . . . . .

When it comes to blood pressure readings, the “top” number seems to grab all the attention.

But a large, new study confirms that both numbers are, in fact, critical in determining the risk of heart attack and stroke.

Blood pressure measurements are given as a “top” and “bottom” number. The first reflects systolic blood pressure, the amount of pressure in the arteries as the heart contracts. The second reflects diastolic blood pressure, the pressure in the arteries between heart muscle contractions.

For years, systolic blood pressure has been seen as the one that really matters. That’s based on studies — including the famous Framingham Heart Study — showing that high systolic blood pressure is a stronger predictor of heart disease and stroke.

At the same time, though, doctors measure both systolic and diastolic blood pressure, and treatment guidelines are based on both. So just how important is that diastolic number?

“The idea behind this new study was to address the confusion,” said lead researcher Dr. Alexander Flint, an investigator with Kaiser Permanente Northern California’s division of research.

Using medical records from 1.3 million patients, his team confirmed that, yes, high systolic blood pressure was a stronger risk factor for heart attack and stroke. But those risks also climbed in tandem with diastolic pressure; and people with normal systolic readings were still at risk if their diastolic pressure was high.

“There’s been a common belief that systolic blood pressure is the only one that matters,” Flint said. “But diastolic definitely matters.”

He and his colleagues reported the findings in the New England Journal of Medicine.

The definition of high blood pressure has gotten a revamp in recent years. Guidelines issued in 2017 by the American College of Cardiology (ACC) and other heart groups lowered the threshold for diagnosing the condition — from the traditional 140/90 mm Hg to 130/80.

The fact that treatment guidelines include a diastolic pressure threshold implies that it’s important. And indeed it is, said Dr. Karol Watson, a member of the ACC’s prevention section and leadership council.

In fact, she said, doctors once thought that diastolic blood pressure was the more important one — based on research at the time. Then came the studies showing that systolic pressure was generally a better predictor of people’s risk of heart disease and stroke.

In addition, Watson said, high systolic blood pressure is more prevalent, because of natural changes in blood pressure as people age.

“As we get older, systolic blood pressure keeps marching up,” she explained. Diastolic blood pressure, on the other hand, generally peaks when people are in their 40s to 60s — and then it declines.

But it’s clear, Watson said, that while systolic and diastolic blood pressure are different, they both deserve attention.

In the latest study, cardiovascular risks rose with each “unit increase” in systolic pressure above 140, by about 18% on average. Meanwhile, each increase in diastolic blood pressure above 90 was tied to a 6% increase in heart disease and stroke risk.

The researchers saw a similar pattern when they looked at blood pressure increases above the 130/80 threshold. That, Flint said, supports the 2017 guideline shift.

The findings are based on over 1.3 million patients in the Kaiser Permanente health system who had roughly 36.8 million blood pressure readings taken from 2007 through 2016. Over eight years, more than 44,000 patients had a heart attack or stroke.

According to Flint, it’s the largest study of its kind to date.

The bottom line for patients, Watson said, is that they should care about both blood pressure numbers. In her experience, she noted, patients often point to the number that’s in the normal range and say, “But look how good this is.”

Flint agreed, saying that no one should “ignore” the diastolic number. “It’s important not only in blood pressure treatment, but on the side of diagnosis, too,” he said.

Source: HealthDay


Today’s Comic