Medicare

092 - Sleeping Your Way to the Top, Mellow Yellow, and The Brain Microbiome - HealthHippieMD Week In Review

May 26th is my 60th birthday. As a gift to me, please pass this newsletter on to at least one person you think might be interested. I'd love to double my readership. Thanks for reading and your ongoing support!

Forgive and Let Live

In the podcast, Feel Better, Live More with Dr Rangan Chatterjee: #448 A Proven Prescription for Health and Happiness: Why Being Able To Forgive Improves Your Physical & Mental Wellbeing Dr. Rangan Chatterjee discusses the importance of forgiveness with Dr. Fred Luskin, a clinical psychologist from Stanford University. Dr. Luskin, the director of the Stanford University Forgiveness Projects, emphasizes that forgiveness is a crucial yet often overlooked component of health. He argues that while diet, exercise, stress, and sleep are vital, the ability to forgive can significantly improve both mental and physical wellbeing. According to Dr. Luskin, forgiveness is a perspective that can lead to profound healing and a happier life. (Thanks, Megan).

Hard Facts on Stool

Michael Harrop's Human Microbes has created a controversial black market for fecal microbiota transplants (FMT), used to treat conditions like cystitis and irritable bowel syndrome. Despite the FDA only approving FMT for Clostridioides difficile, desperate patients like Alexandra seek alternative cures from this underground source. Despite lacking medical credentials, Harrop matches "super-donors" with buyers, selling stool for $1,000 per dose. While some report miraculous recoveries, medical experts warn of severe risks and unknown long-term effects, urging caution and further research. Fecal microbiota transplant: Inside the black market for human poop.

Fit or Fat

A recent study by the University of Aberdeen reveals that exercise enhances the body's ability to metabolize saturated fats. The research focused on the "athlete's paradox," which observes that endurance athletes and people with type 2 diabetes store high levels of muscle fat. Through an eight-week experiment involving 29 athletes and 30 people with diabetes, researchers discovered that exercise enables people with diabetes to store and burn saturated fat efficiently, mirroring the athletes' fat metabolism. The study underscores the importance of regular physical activity for improving fat metabolism and overall metabolic health. Exercise improves storage and burning of saturated fat, study finds.

3 M's Sticky Situation

ProPublica's exposé reveals how Kris Hansen, a chemist at 3M, discovered toxic "forever chemicals" (PFAS) in human blood. Initially tasked with verifying external lab results, Hansen confirmed that PFAS contamination was widespread, even in the general population. Despite her findings, 3M executives suppressed the information, halting her research and enforcing secrecy. Decades later, the EPA is now demanding the removal of these chemicals from drinking water. Hansen, who remained silent for years, now grapples with the environmental and health implications of her discovery and 3 M's long-held secrets. How 3M Execs Convinced a Scientist the Forever Chemicals She Found in Human Blood Were Safe — ProPublica.

A Sobering Solution?

Scientists have developed a hydrogel that may be the answer to hangover woes and alcohol-related health issues. Crafted from whey protein and enhanced with iron atoms, sugar molecules, and gold nanoparticles, this gel breaks down alcohol in the gastrointestinal tract. In mouse experiments, it significantly reduced blood alcohol levels and prevented liver damage, weight loss, and gut problems. This novel hydrogel holds promise for both social drinkers and those with chronic alcohol issues, potentially serving as a groundbreaking remedy and preventative measure against alcohol's harmful effects. Clinical trials in humans are anticipated soon. Is this the hangover cure we've been waiting for?

The Brain Microbiome

Recent research suggests that the brain might have its own microbiome, challenging the long-held belief that the brain is a sterile organ. Initial studies from 2013 found non-human genetic material in brain tissue, hinting at the presence of bacteria and viruses. More recent investigations have discovered bacteria and fungi in the brains of both healthy individuals and those with Alzheimer's disease. However, the mechanisms by which these microbes enter the brain remain unclear. This discovery could open new avenues for treating neurological diseases, but further research is needed to fully confirm and understand these findings. Wait, The Brain Has Its Own Microbiome? What New Research Tells Us.

Mellow Yellow

A recent study reveals that D-limonene, a terpene found in citrus fruits and cannabis, reduces anxiety when combined with THC, the psychoactive component in marijuana. Conducted by Johns Hopkins University, the double-blind study involved 20 participants inhaling various doses of THC and limonene. Results showed that higher doses of limonene significantly decreased anxiety and paranoia. While the exact mechanism remains unclear, the study suggests limonene's potential as an anxiolytic agent. This research highlights the need for empirical testing of terpenes' effects, challenging unverified marketing claims in the medicinal cannabis industry. A New Study Found This Molecule Is Linked to Less Anxiety While Stoned.

Sleep Your Way to the Top

In How to Buy Yourself a Longer Life - The New York Times (gift article), Frank Bruni explores Equinox's new luxury membership, "Optimize," costing $40,000 annually and featuring services like a sleep coach, nutritionist, and personal trainer. This deluxe package aims to enhance fitness and longevity, reflecting an increasing obsession among the wealthy with extended youth. Bruni critiques this trend, highlighting the growing economic segregation and the extravagant ways the affluent flaunt their wealth and seek to optimize their lives, underscoring a deepening divide in American society.

Garden Your Way to a Healthier You

Gardening offers multifaceted benefits for both mind and body. Engaging in activities such as shoveling mulch and pulling weeds counts as moderate-intensity exercise, contributing significantly to physical activity goals. Beyond the physical, gardening provides mental health perks, including stress reduction and a sense of purpose. Emilee Weaver from the North Carolina Botanical Garden highlights how nurturing plants can be deeply fulfilling. Studies support these claims, showing that gardeners are more active and enjoy better mental health than non-gardeners. The article briefly mentions exposure to the soil microbiome and its association with mental health. The Health Benefits of Gardening - The New York Times (gift article).

Prior Authorization Frustration

Medicare Advantage plans, touted for reducing waste and inappropriate care, are increasingly criticized for unnecessarily restricting coverage. This issue is starkly illustrated by Marlene Nathanson's experience, whose stroke recovery was abruptly interrupted when her plan denied further treatment coverage. Despite significant progress in therapy, she was given just 48 hours to leave her rehabilitation facility. Traditional Medicare seldom requires prior authorization, but nearly all Advantage plans do, particularly for high-cost services. With more than half of Medicare beneficiaries enrolled in these plans, such denials are becoming alarmingly common. When 'Prior Authorization' Becomes a Medical Roadblock - The New York Times (gift article).

083 - Weighty Decisions, Biting Back, and Cellular Suicide - HealthHippieMD Week In Review

Are You Doing Too Much

How can you strive for excellence without overworking yourself? Why is perfectionism on the rise? Listen to a fantastic episode of Angela Duckworth's No Stupid Questions: 184. Are You Doing Too Much? on Apple Podcasts

Bullshit Genius

In A Bullshit Genius by Oscar Schwartz, Walter Isaacson's career is scrutinized, revealing a pattern of glorifying tech moguls under the guise of neutral biographies. Once celebrated for his portrayals of historical figures like Benjamin Franklin and Albert Einstein, Isaacson shifted his focus to Silicon Valley icons, notably Steve Jobs and Elon Musk. His depiction of Jobs as a flawed yet visionary genius resonated with the public, aligning with the tech industry's self-image. However, his subsequent biography of Musk exposed the limitations of Isaacson's approach. Despite Musk's erratic behavior and questionable achievements, Isaacson attempts to fit him into the same genius narrative, ultimately failing to assess the darker aspects of Silicon Valley's influence critically. The article suggests that Isaacson's works reflect the tech industry's self-aggrandizement rather than objective analyses of true genius.

AI Coaches in the Game

The coaching industry, which focuses on professional development in critical thinking and leadership skills, is experiencing disruption from generative AI. Platforms like CoachHub are exploring AI coaching to democratize access to coaching services. Dr. Nicky Terblanche, a specialist in coaching programs, sees AI's potential in performance coaching and as a support tool for human coaches. While AI cannot yet replace human coaches in developmental coaching, it can effectively assist in structured, goal-based coaching. However, there is skepticism among coaches about AI's impact on the client-coach relationship, highlighting the need for coach education on AI benefits. Would you trust big work-life decisions to an AI coach?

Power of Prevention

"The earlier a first episode of depression begins, and the more episodes a person suffers, the more serious and disabling the condition is likely to be throughout life." Preemptive Measures highlights the importance of early intervention in preventing depression among teenagers. Esther Oladejo, an 18-year-old from Merseyside, England, shares her experience with the Blues Program, a six-week course developed by psychologist Paul Rohde to teach teens skills to manage emotions and stress. This program is part of a global movement to establish effective depression prevention strategies for young people. Research shows that early intervention can significantly reduce the onset of depression, improving life trajectories and potentially saving healthcare costs. Despite the challenges in implementing these programs widely, their success in improving mental health outcomes for at-risk teens is undeniable, as seen in Esther's story and the growing adoption of such programs in schools and communities.

The Mind's Quiet Orchestra

Your brain's "default mode" network takes the spotlight when you're not actively engaged in a task. This network, which was discovered two decades ago, comprises various brain regions that activate during restful states, offering insights into how the brain operates when not focused on external tasks. Initially thought to facilitate mind wandering or daydreaming primarily, the default mode network is now understood to play a more complex role, including memory recall, future envisioning, and self-referential thinking. This network's interactions with other brain networks, such as the salience network, are crucial in determining what to pay attention to and when to switch focus. Abnormalities in the default mode network have been explored about mental health disorders, although findings are not yet conclusive. Understanding this network and its interactions continues to challenge and refine our understanding of brain function, emphasizing the importance of internal mental activities even without overt tasks. What Your Brain Is Doing When You're Not Doing Anything | Quanta Magazine.

+see also How the Brain Creates Your Physical Sense of Self | Scientific American.

Cellular Suicide

Recent research suggests that apoptosis, a form of programmed cell death, first arose billions of years ago in bacteria. While seemingly counterintuitive, this self-destructive process is an essential and productive mechanism in complex organisms. Apoptosis can be traced back to ancient forms of cell death undertaken by single-celled organisms, which appear to have evolved as a social behavior. The origins of apoptosis might be linked to the mitochondrion, an organelle central to the process, or a long-ago interaction between our ancestors and bacteria. Studies indicate that the last common ancestor of yeast and humans already had the necessary tools for self-destruction around 2 billion years ago. This research challenges the assumption that programmed cell death is unique to multicellular organisms and suggests that it may have evolved as a way for single-celled organisms to benefit their kin or protect their colonies from disease. The discovery of bacterial genes involved in apoptosis in eukaryotic genomes points to a complex evolutionary history of this process, highlighting the interplay between survival, death, and the collective good in the natural world. Cellular Self-Destruction May Be Ancient. But Why? | Quanta Magazine.

Biting Back

Tarsus Pharmaceuticals is developing a groundbreaking pill to protect humans from Lyme disease by killing ticks before they can bite. This innovative drug, derived from the veterinary medicine lotilaner, has shown promising results in early trials, killing up to 97% of ticks within 24 hours and maintaining effectiveness for up to 30 days. The pill targets the ticks, offering potential protection against other tick-borne diseases. As Lyme disease cases continue to rise, this new form of pre-exposure prophylaxis could be a game-changer in preventing the debilitating effects of the disease. A Pill That Kills Ticks Is a Promising New Weapon Against Lyme Disease | WIRED.

Weighty Decisions

Medicare may soon cover the weight loss drug Wegovy following the FDA's approval of its use for reducing serious heart risks in obese or overweight adults. Wegovy, from the same drug class as the diabetes medication Ozempic, has shown a 20% reduction in the risk of severe heart events in clinical trials. The Centers for Medicare and Medicaid Services are reviewing the decision, with the possibility of adding Wegovy to Medicare's prescription plans. However, Novo Nordisk, the maker of Wegovy, needs help to meet the high demand for the drug, with a supply shortage ongoing since May 2023. To address this, Novo Nordisk acquired three facilities for $11 billion to increase production capacity starting from 2026. Weight loss drug Wegovy could be covered by Medicare.

Uncommon Connections

A groundbreaking study led by researchers at the National Institutes of Health has unveiled a significant link between ADHD symptoms and abnormal interactions within the brain. Analyzing over 10,000 functional brain images from youths with and without ADHD reveals enhanced connectivity between the frontal cortex and deeper brain regions responsible for learning, emotion, and behavior control. This large-scale study provides robust evidence of the neural pathways involved in ADHD, surpassing previous smaller studies. The findings not only deepen our understanding of ADHD but also open doors for developing more targeted treatments. Brain Connectivity Breakthrough Sheds New Light on ADHD - Neuroscience News (thanks, Wendy!).

057 - Blue Zones, Mini-Siestas, and Nociplastic Pain - HealthHippieMD Week In Review

The Mind Diet and Dementia

"Experts have estimated that 40 percent of dementia cases worldwide might be prevented or delayed with certain modifiable factors, such as by prioritizing exercise and sleep and addressing health conditions like hearing loss or hypertension. But a growing body of evidence suggests that diet may play a role in dementia prevention, too." What Is the MIND Diet? And Can It Prevent Dementia? - The New York Times (gift article).

An Apple a Day

Researchers examined produce prescription programs, where patients received fresh produce for free with a doctor's prescription. Blood sugar levels, blood pressure, and weight showed significant improvement. This innovative approach not only enhances health but also reduces food insecurity. As the food-is-medicine movement gains momentum, producing prescriptions could become a ripe solution to combat diet-related ailments, emphasizing that good health begins with what's on your plate. Prescriptions for fruits and vegetables can improve the health of people with diabetes and other ailments, new study finds.

Protein Paradox

Is "eating like The Rock" the key to health? As researchers debate protein intake, some argue that the recommended daily allowance (RDA) of 0.8 grams per kilogram of body weight is insufficient. Jose Antonio, a health researcher, suggests sedentary adults aim for double, while active individuals need more than 2.2 grams per kilogram. However, other experts counter that too much protein might have diminishing returns, causing bodily discomfort and potential nutrient imbalances. The dilemma lies between protein's undeniable importance and avoiding excess. Amidst the protein frenzy, moderation appears vital to maintain personal well-being and environmental sustainability. You'll Probably Never Know How Much Protein You Actually Need - The Atlantic.

Mini-Siestas

Napping isn't just for lazy days – it's scientifically shown to enhance memory, productivity, and overall well-being. Short daytime naps of around 20 to 30 minutes offer many perks, from improved mental functioning and creativity to better problem-solving abilities and reduced stress. However, excessive napping, significantly beyond 30 minutes, can lead to sleep inertia – grogginess upon waking. Striking a balance and adopting good practices, like timing naps right and avoiding caffeine dependency, can make napping a refreshing addition to a healthy lifestyle. Remember, naps should complement, not replace, regular nighttime sleep.Short naps can improve memory, increase productivity, reduce stress, and promote a healthier heart.

On Procrastination

"A more realistic definition of procrastination is that it's not a blockage of inherent reason but a simple absence of desire." Slate had an interesting article on why we put things off: Why do I procrastinate, and how do I stop procrastinating? Procrastination advice fails to account for one key thing.

+I could not mention procrastination without mentioning Wait But Why. Why Procrastinators Procrastinate — Wait But Why

Blue Zones on Netflix

Netflix has a new documentary series on Blue Zones, regions where people are claimed to live or have recently lived longer than average. Secrets of the Blue Zones.

Medicare's Drug Cost Cutting

The healthcare giant Medicare is starting its journey towards slashing drug prices with a ten-drug hit list. These ten medications, known to cost $50.5 billion annually, are in the hot seat for negotiations that could offer relief for seniors and save the US government almost $100 billion by 2031 as part of President Biden's Inflation Reduction Act. Though Democrats are celebrating, skeptics, like the health policy analyst behind this explanation, foresee hurdles, legal battles, and potential industry resistance slowing down the process. The prescription price saga, starring high stakes and complex dynamics, has just begun. Medicare starts a long road to cutting prices for drugs, starting with ten costing it $50.5 billion annually – a health policy analyst explains why negotiations are promising but will take years.

How to Become a Morning Person

I am most decidedly a night owl. If I had an intention of change, I'd pay attention to the advice in this article: How to Wake Up Earlier: 4 Ways to Become a Morning Person - The New York Times. (gift article)

Nociplastic Pain

Chronic pain affects nearly a third of the world's population. This mysterious, lingering affliction is more than physical; it carries psychological burdens like depression. Traditional painkillers often fall short of bringing relief. A new category, nociplastic pain, baffles researchers as it seems to have no anatomical cause. Emerging theories point to glitches in the brain's altered pain-processing network or immune system. New creative solutions for relief include harnessing neuroplasticity with psychedelics and personalized treatments using quantitative sensory testing. While relief remains elusive, understanding the enigma of chronic pain offers hope for future therapies. Some forms of chronic pain are particularly mysterious-The Economist.

Talking to Strangers

Embracing diversity isn't just about virtue signaling; it's a happiness hack. Research suggests that engaging with people from different walks of life enhances society and enriches individual well-being. Our natural tendency to flock to those who mirror us might feel cozy, but stepping out of this comfort zone fosters personal growth and contentment. Shaking hands with strangers, seeking out divergent viewpoints, and promoting a friend circle that celebrates heresy can bring zest to life. Happiness thrives where minds mingle. Talk to a Stranger and Be Happier - The Atlantic.