Greg Nicholaides

Nearly 60% of respondents to one medical school survey said they received no nutritional education at all.

By Nathaniel Johnson & Madeline Comeau

Sept. 25, 2024

On television shows like “Grey’s Anatomy,” “The Resident” and “Chicago Med,” physicians seem to always have the right answer.  But when it comes to nutrition and dietary advice, that may not be the case.  One of us is an assistant professor of nutrition and dietetics; the other is a medical student with a master’s degree in nutrition.

Both of us understand the powerful effects that food has on your health and longevity. A poor diet may lead to cardiovascular disease, diabetes, obesity and even psychological conditions like depression and anxiety. Diet-related diseases are the leading causes of death in the U.S., and a poor diet is responsible for more deaths than smoking.

These health problems are not only common and debilitating, but expensive. Treating high blood pressure, diabetes and high cholesterol costs about US$400 billion per year. Within 25 years, those costs are expected to triple, to $1.3 trillion.

These facts support the need for physicians to give accurate advice about diet to help prevent these diseases. But how much does a typical physician know about nutrition? The deficiencies in nutrition education happen at all levels of medical training.

What doctors don’t know

In a 2023 survey of more than 1,000 U.S. medical students, about 58% of respondents said they received no formal nutrition education while in medical school for four years. Those who did averaged about three hours of nutrition education per year.

That is woefully short of the goals set by the U.S. Committee on Nutrition in Medical Education back in 1985: that med students should receive a total of 25 hours of nutrition education while in school – a little more than six hours per year.

But a 2015 study showed only 29% of medical schools met this goal, and a 2023 study suggests the problem has become even worse – only 7.8% of med students reported 20 or more hours of nutrition education across all four years of med school. If this is representative of medical schools throughout the country, it has happened despite efforts to bolster nutrition education through numerous government initiatives.

Not surprisingly, the lack of education has had a direct impact on physicians’ nutrition knowledge. In a study of 257 first- and second-year osteopathic medical students taking a nutrition knowledge quiz, more than half flunked the test. Prior to the test, more than half the students – 55% – felt comfortable counseling patients on nutrition.

Unfortunately, this problem is not limited to U.S. medical schools. A 2018 global study concluded that no matter the country, nutrition education of med students is insufficient throughout the world.

Bringing nutrition education back

Even though evidence suggests that nutrition education can be effective, there are many reasons why it’s lacking. Medical students and physicians are some of the busiest people in society. The amount of information taught in medical curricula is often described as overwhelming – like drinking out of a fire hose.

First- and second-year medical students focus on dense topics, including biochemistry, molecular biology and genetics, while they learn clinical skills such as interviewing patients and understanding heart and lung sounds. Third- and fourth-year students are practicing in clinics and hospitals as they learn from physicians and patients.

As a result, their schedules are already jammed. There is no room for nutrition. And once they are physicians, it gets no better. Providing preventive care including nutrition counseling to patients would take them more than seven hours per week – and that’s not counting the time they would have to spend on continuing education to keep up with new findings in nutrition science.

On top of that, the lack of nutrition education in medical schools has been attributed to a dearth of qualified instructors for nutrition courses, as most physicians do not understand nutrition well enough to teach it.

Ironically, many medical schools are part of universities that have nutrition departments with Ph.D.-trained professors; those academicians could fill this gap by teaching nutrition to medical students. But those classes are often taught by physicians who may not have adequate nutrition training – which means truly qualified instructors, within reach of most medical schools, are left out of the process.

This doctor said he learned virtually nothing about nutrition in medical school.

Finding the right advice

The best source of nutrition information, whether for medical students or the general public, is a registered dietitian, certified nutrition specialist or some other type of nutrition professional with multiple degrees and certification. They study for years and record many practice hours in order to give dietary advice.

Although anyone can make an appointment with a nutrition professional for dietary counseling, typically a referral from a health care provider like a physician is needed for the appointment to be covered by insurance. So, seeing a physician or other primary care provider is often a step before meeting with a nutrition professional.

This extra step might be one reason why many people look elsewhere, such as on their phones, for nutrition advice. However, the worst place to look for accurate nutrition information is social media. There, about 94% of posts about nutrition and diet are of low value – either inaccurate or lacking adequate data to back up the claim.

Keep in mind that anyone can post nutrition advice on social media, regardless of their qualifications. Good dietary advice is individualized and takes into account one’s age, sex, body weight, goals and personal preferences. This complexity is tough to capture in a brief social media post.

The good news is that nutrition education, when it occurs, is effective, and most medical students and physicians acknowledge the critical role nutrition plays in health. In fact, close to 90% of med students say nutrition education should be a mandatory part of medical school.

We hope that nutrition education, after being devalued or ignored for decades, will soon be an integral part of every medical school’s curriculum. But given its history and current status, this seems unlikely to happen anytime soon.

In the meantime, those who want to learn more about a healthy diet should meet with a nutrition professional, or at the very least read the 2020-2025 Dietary Guidelines for Americans or the World Health Organization’s healthy diet recommendations.

By Becky Upham

Healthy AgingNews

June 21, 2024

Key Takeaways

• A new study looked at different lifestyle factors that help people live to 100.
• The researchers found that exercise was associated with a 31 percent higher likelihood that a person would become a centenarian, followed by never smoking (25 percent higher chance) and a healthy diet (23 percent more likely).
• Even for people who are already 80 or older, good lifestyle choices increase the odds of reaching 100.

What does it take to live to be 100 years old? If you answered good genes mixed with a little luck, you may be in for a surprise: There are actually a few habits that increase your chances of joining the “centenarian club,” according to a new study.

When it comes to lifestyle choices, physical activity appears to be the most important to extend life into the 100s, followed by never smoking and having a healthy diet, says a coauthor of the study, Xiang Gao, MD, PhD, a professor and researcher at the Institute of Nutrition at Fudan University in Shanghai.

These findings highlight the importance of a healthy lifestyle in maximizing lifespan, both in younger people and those who are 80 or older, the authors wrote. “Our findings suggest that adhering to a healthy lifestyle is important, even later in life,” says Dr. Gao.

The Big 3 Factors in Living to 100

Although there’s plenty of evidence that people following a healthy lifestyle generally have a lower risk of many chronic diseases, the researchers wanted to find out if practicing certain habits after the age of 80 would continue to have life-extending benefits.

People aged 80 or older who could potentially live to 100 by 2018 were randomly selected from a nationwide survey. Researchers matched centenarians with four “controls” who were the same age and sex but who died before reaching 100, for a total of 5,222 participants in all. 

The investigators then collected data through face-to-face interviews, and included age, sex, place of residence, years of education, marital status, and if they had any chronic conditions such as diabetes, heart disease, hypertension, or cancer.  Lifestyle factors, including smoking, alcohol use, exercise, dietary diversity, and body mass index (BMI), were combined to create a healthy lifestyle score. 

Never or not smoking, not drinking or moderate drinking, regular exercise, dietary diversity, and a BMI within the normal range were all considered favorable. For each category, participants were assessed on both their current and former status.  Scientists evaluated participants’ diets based on how often they ate fruit, vegetables, fish, beans, and tea. The more often they ate foods from that group, the higher their diet diversity score. Overall, a higher healthy-lifestyle score was associated with greater odds of reaching 100 years. 

When viewing each element individually, researchers found that exercise was the most important factor in longevity and was associated with a 31 percent higher likelihood a person would become a centenarian, followed by never smoking (25 percent higher chance) and a healthy diet (23 percent more likely). 

Alcohol Use and BMI Weren’t Linked to Living to 100

Researchers didn’t find a significant link between alcohol use or BMI and the likelihood of living to be 100 years old. Although the study wasn’t designed to discover why that might be the case, investigators suggested that moderate alcohol use wasn’t necessarily related to adverse health outcomes, and that a higher BMI may have a protective effect against frailty in older people. 

When scientists calculated the healthy-lifestyle score using only exercise, diet, and smoking status, they found that a higher score was even more strongly linked to centenarians. Compared with people with the lowest score, people with the highest healthy-lifestyle score were 60 percent more likely to be a centenarian. 

This type of study can be valuable but represents only one pillar in our understanding of how people can live longer, says Valter Longo, MD, a professor of gerontology and biological sciences and the director of the Longevity Institute at the University of Southern California in Los Angeles, who was not involved in the study.

One issue is that the method of data collection can sometimes oversimplify or hide important nuances. “For example, someone reporting low protein intake could be very healthy, but in some cases could also be someone who is malnourished. In that group of ‘low protein intake’ you would then be combining the very healthy and the malnourished, which would hide the health effects of the diet,” he says.

It’s Never Too Late to Start Making Healthy Changes

Dr. Longo agrees a healthy lifestyle can help improve the chances of seeing your 100th birthday and says that it’s never too late to make positive changes, especially when it comes to a healthy diet.  People who get regular exercise, see good healthcare providers, and have a biological age lower than their chronological age all have improved chances of hitting the century mark as well. Biological age is based on an analysis of chemical modifications in your DNA that can estimate how quickly or slowly you’re aging compared with your peers. 

Expert Advice for Getting Into the ‘100 Club’

Longo has written books on longevity and developed a fasting mimicking diet (FMD) that lowered participants’ biological age by about 2.6 years. Here are his tips for eating to live longer.

Eat mostly vegan. Longo suggests a primarily plant-based diet that limits meals with fish to a maximum of two or three per week. Choose seafood with a high omega-3, omega-6, and vitamin B12 content (salmon, anchovies, sardines, cod, sea bream, trout, clams, shrimp) and try to choose ones with low levels of mercury.

Keep protein intake low. If you are younger than 65, keep protein intake low – between 0.31 to 0.36 grams (g) per pound of body weight. That comes to 40 to 47 g of protein per day for a person weighing 130 pounds (lb), and 60 to 70 g of protein per day for someone weighing 200 to 220 lb.  After age 65, you should slightly increase protein intake by way of fish, other lean proteins, eggs, dairy (he suggests goat and sheep products), beans, nuts, and legumes.

Minimize saturated fats from animal and vegetable sources. Limit meat, cheese, and sugar, and maximize good fats and complex carbs. 

Focus on whole grains and veggies. That includes tomatoes, broccoli, carrots, legumes and generous amounts of olive oil (3 tablespoons per day).

By Dennis Thompson – HealthDay News – May 6, 2024

Key Takeaways

• Seniors in the U.S. are worried about health care costs, a new poll says
• Five of the six top health-related issues had to do with cost
• Cost worries run across all different groups

Worries over health-related costs are plaguing the minds of older Americans of all backgrounds, a new poll suggests. Five of the six health-related issues that most people found very concerning had to do with health care costs, according to results from the University of Michigan National Poll on Healthy Aging.  And the sixth issue – financial scams and fraud – also had to do with money, results show.

“In this election year, these findings offer a striking reminder of how much health care costs matter to older adults,” Dr. John Ayanian, director of the University of Michigan Institute for Healthcare Policy and Innovation, where the poll is based, said in a news release. The poll is supported by AARP and Michigan Medicine, U-M’s academic medical center.

Overall, 56% of people over 50 said they’re concerned about the cost of medical care for older adults, poll results show. Other top concerns included assisted living costs (56%), prescription medicine costs (54%), scams and fraud (53%), cost of health insurance or Medicare (52%), and the cost of dental care (45%), the poll found.

The same six topics rose to the top regardless of age, gender, race, ethnic group, region of the country, political ideology or income level, researchers said.

Other topics rounding out the top 10 health issues included access to quality assisted living (38%), overall quality of health care (35%), inaccurate or misleading health information (34%) and access to affordable healthy food (33%).

“This survey validates AARP research that shows affording health care is a kitchen table issue among older adults, their families, and their caregivers,” AARP Senior Vice President of Research Indira Venkat said in a news release. “It is critical that we continue improving health care access and affordability for the millions of Americans struggling to pay for insurance premiums and copays, prescription drugs, and long-term care while putting food on the table and paying bills.”

However, differences emerged between groups beyond issues related to health care costs, the poll found. For example, women were more likely than men to say they’re very concerned about access to quality home care, assisted living or nursing home care (44% versus 32%). Women were also more likely to say they’re concerned about social isolation and loneliness (34% versus 22%) and aging in place (33% versus 22%).

Half of Black older adults (50%) said they were concerned about racial or ethnic discrimination, compared with 26% of Hispanic older adults and 15% of whites. Black seniors also were more likely to say they were more concerned about age-based discrimination, unequal access to health care and unequal access to mental health care.

“As our society strives to improve the health and well-being of people as they age, it’s important to understand to what extent different health-related topics are of concern for older adults and how perspectives vary,” poll director Dr. Jeffrey Kullgren said in a news release. “The high level of concern about cost-related issues across demographic groups points to a particularly important opportunity for action.”

The poll was conducted online and via phone in February and March 2024 among 3,379 adults 50 and older.

Greg Says can attest to the results of the Univ. of Michigan survey based on conversations with our clients. We like to remind our clients that “health insurance” does not ensure good health, a healthy lifestyle does that.  Even so, things can happen that will impact our quality-of-life ie; accidents, pandemics, and heredity for example.  We’re here to help our clients remain protected from the high cost of healthcare which continues to escalate.  Call us if you have concerns about your coverage – 404-210-7970.

By Dan Smith

In the tapestry of family, the relationship between grandparents and grandchildren weaves a narrative of love, wisdom, and cherished moments. As seniors reflect on the timeless connection they share with the younger generation, a mosaic of heartwarming stories emerges, illustrating the profound impact that spans generations.

A Symphony of Laughter and Lessons:

For many seniors, the relationship with their grandchildren is a symphony of laughter and lessons. Whether it’s recounting tales from their own youth or imparting timeless wisdom, grandparents become storytellers, weaving a rich tapestry of shared experiences.

Passing Down Traditions:

Grandparents often serve as the torchbearers of family traditions. From holiday rituals to culinary secrets, the passing down of traditions fosters a sense of continuity and connection, creating lasting memories that grandchildren carry into their own lives.

Unconditional Love and Acceptance:

The bond between grandparents and grandchildren is a sanctuary of unconditional love and acceptance. Seniors often express the joy of watching their grandchildren grow, embracing their unique personalities, and providing a safe haven where love knows no bounds.

Wisdom Across the Generations:

Grandparents, with the wisdom garnered through a lifetime of experiences, offer invaluable insights to guide their grandchildren. Whether it’s navigating challenges, making life choices, or simply sharing pearls of wisdom, the intergenerational exchange is a source of profound learning.

Quality Time and Shared Adventures:

The moments spent together, whether in quiet conversations or shared adventures, become the building blocks of a strong bond. Grandparents relish the opportunity to impart life lessons while creating treasured memories that transcend time.

Grandparents as Pillars of Support:

In the journey of life, grandparents often stand as pillars of support for their grandchildren. Their unwavering encouragement, comforting presence, and belief in the potential of the younger generation become guiding lights that shape the paths of those they love.

Cultural Roots and Identity:

Grandparents play a pivotal role in nurturing a sense of cultural identity. Through stories of heritage, family origins, and ancestral roots, they instill a pride in cultural heritage that becomes a cornerstone for grandchildren to build upon.

Technology Bridging the Gap:

In the digital age, technology serves as a bridge that spans generational gaps. Grandparents and grandchildren connect across distances through video calls, sharing snippets of their lives and maintaining a closeness that defies physical boundaries.

Legacy of Love:

As seniors reflect on their connection with grandchildren, they acknowledge the legacy of love they are creating. The love, values, and traditions passed down through generations become a testament to the enduring impact of familial bonds.

Conclusion:

“Grand Stories” is a celebration of the timeless connection between seniors and their grandchildren. It encapsulates the essence of shared laughter, the wisdom exchanged, and the enduring love that forms the foundation of familial ties. As seniors reflect on the chapters they’ve written together with their grandchildren, it becomes evident that the grandparent-grandchild relationship is not just a connection across generations; it is a legacy of love that continues to unfold with each passing day.

August 28, 2024

By Ahmed Aboulenein and Amina Niasse

More than 1 million people in the U.S. will save over $1,000 a year beginning in 2025, when an annual $2,000 cap on prescription drug out-of-pocket costs kicks in, the leading lobbying group for older Americans said on Wednesday.

The cap, introduced as part of President Joe Biden’s Inflation Reduction Act, applies to the Medicare program for people age 65 and over and those with disabilities. Its prescription drug component, known as Part D, provides coverage for around 56 million people.

AARP, which lobbied in favor of the law, commissioned health consultancy Avalere to conduct a study on the new benefit and published a report on the findings on Wednesday. The $2,000 cap will lower prices in 2025 for more than 3.2 million people, or around 8.4% of Part D beneficiaries who do not receive other subsidies, AARP said in its report.

That represents a stark change from how Medicare Part D previously worked. Before the Inflation Reduction Act, beneficiaries who did not qualify for low-income subsidies were required to pay 5% of drug costs regardless of how much they had already paid.

The cap is expected to provide long-term savings, particularly for those most in need, even if Part D premiums rise next year as expected, Leigh Purvis, an AARP prescription drug pricing expert, said during a press briefing. By 2029, the lowered cap will help 4.1 million people, or around 9.6% of beneficiaries, AARP said.

The biggest impact will be felt by those who use high-priced, branded drugs the most. Diana DiVito, 82, said the cost of the treatment she takes for chronic leukemia has averaged $858 per month over more than five years.

Her co-insurance was 33% of the drug’s cost until she reached the Part D cap of several thousand dollars. After that, she still had to pay 5% of the drug’s cost, DiVito said. In 2024, the law eliminated that additional payment. “When I saw the first copay, I almost had a heart attack,” DiVito, an AARP member, said during the briefing. “It’s a tremendous weight off my shoulders and I’m incredibly grateful.”

Almost 40% of people who reach the cap between 2025 and 2029, some 1.4 million, will save more than $1,000 a year, including 420,000 people, or around 12%, who will save more than $3,000 annually. Currently, some patients pay over $10,000 a year, AARP said in its report.

The study excluded Part D beneficiaries who receive low-income subsidies and pay nominal amounts for drugs from its analysis.

“The money seniors will no longer have to spend out-of-pocket is money they can invest in their families, broader health needs or simply save to achieve greater financial stability,” AARP CEO Jo Ann Jenkins said.