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By Dennis Thompson
HealthDay News

June 24, 2019

Green tea is a popular health trend, with many people sipping it in hopes of deriving benefits from the brew. There’s nothing wrong with that, dietitians say — green tea is a healthy drink loaded with antioxidants. But the jury’s still out on many of its purported health benefits.

“Clinical trials related to green tea are still in their early stages,” said Nancy Farrell Allen, a registered dietitian nutritionist in Fredericksburg, Va. “I say drink it, enjoy it. It’s not going to hurt, and it might have worthy benefits to it. But nutrition is a science, and it takes time for our understanding to evolve.”

Green tea’s potential health benefits derive from catechins, which are powerful antioxidant compounds known as flavonoids, said Chelsey Schneider, clinical nutrition supervisor at Mount Sinai Beth Israel Cancer Center in New York City. One catechin in particular, known as EGCG, is found at higher levels in green tea than in either white or black tea, she said. “This compound can be even stronger than vitamin C and E, which are very, very strong antioxidants,” Schneider said. Antioxidants help prevent damage to cells.

Green, black and white tea all come from the same plant, said Allen, who is a spokeswoman for the Academy of Dietetics and Nutrition. Green tea is made from the leaves of the mature plant, while white tea is made of leaves plucked early in development. Black tea is made from green tea leaves that are laid out and covered with a damp cloth, she said. “They dry and blacken and ferment a little, giving black tea that darker, richer flavor,” Allen said. But this process also reduces levels of catechins in black tea.

Weight loss has been associated with green tea, with experts suggesting that its mixture of caffeine and catechins can enhance a person’s metabolism and processing of fat, according to the University of California-Davis Department of Nutrition. But it appears that folks have to drink a lot of green tea to get substantial weight loss benefits and carefully watch the rest of their diet, UC-Davis says.

Green tea also has been tied to heart health. For example, green tea was shown to reduce “bad” LDL cholesterol in a 2018 study of more than 80,000 Chinese published in the Journal of the American Heart Association. Evidence suggests catechins in green tea also could lower risk of heart attacks, help blood vessels relax and reduce inflammation, UC-Davis says.

Green tea even has been associated with a lower risk of some cancers. The American Cancer Society says studies have linked green tea to a reduction in ovarian cancer risk. And UC-Davis said experimental models have shown that green tea might reduce risk of a variety of other cancers. But a 2016 evidence review by the Cochrane Library concluded that there is “insufficient and conflicting evidence to give any firm recommendations regarding green tea consumption for cancer prevention.”

Schneider said the research is limited. “Some small studies say green tea can maybe be preventative for certain cancers, like breast, ovarian, endometrial, pancreatic and oral cancers, but there aren’t so many conclusive human trials that support that,” she said.

Green tea also might help keep your brain younger. A 2014 study in the journal PLOS One found that Japanese who drank more green tea had significantly less decline in brain function, although researchers couldn’t rule out the possibility that these folks might have other healthy habits that helped keep them mentally sharp. One caveat with all of this research is that it tends to take place in Asian countries, where people drink much more green tea. There might be significant differences for Americans.

And the way you take your green tea could diminish any potential positive effects, Schneider added. “A lot of people are adding processed white sugar to their green tea, which really makes something beautiful and healthy into something unhealthy,” she said. Adding milk or cream to your tea also might not be a good idea. “There are some studies that say having milk in green tea can actually block the effects of you absorbing the antioxidant,” Schneider said. “If it was me, I’d drink it straight up.”

Before we answer this question, let’s first ask another, more basic question: What exactly is a “vegetarian”? You might think the answer to this question is obvious, but not all vegetarians are created equal. Most people would agree that there are seven types of vegetarians, and they all differ from each other in some respects.

What are the Different Types of Vegetarians?

Vegans

Vegans consume no animal products or by-products. This means they consume no fish, fowl, or any type of meat. They also don’t consume any eggs or dairy. And when we say no animal products or by-products, that’s exactly what we mean. They typically don’t use honey, gelatin, beeswax, silk, wool, or leather either.

Lacto-Vegetarians

These vegetarians don’t eat any meat, fish, eggs, or fowl. However, they do consume dairy products such as cheese and milk, which is where they get the name “lacto-vegetarian.”

Ovo-Vegetarians

Just like lacto-vegetarians, these vegetarians don’t eat any meat, fish, or fowl. They are also the exact opposite as lacto-vegetarians because they eat eggs and no dairy products.

Lacto-Ovo Vegetarians

Lacto-ovo vegetarians are the most common form of vegetarians because they do not consume any meat, fish, eggs, or fowl, but they do eat both eggs and dairy products.

Pescatarians

Members of this group only eat fish and other seafood; they do not eat any land-based animals, meaning no red or white meat. These people are considered “semi-vegetarians.”

Pollotarians

Pollotarians only eat poultry or fowl, so they, like pescetarians, are considered to be more semi-vegetarians. These people do not eat red meat, fish, or seafood.

Flexetarians

These folks follow a mostly plant-based diet with an occasional meat item. They try to limit their meat consumption as much as possible, but needless to say, this is not considered a “true” vegetarian diet.

Are Vegetarians Less Likely to Develop Heart Disease?

There have been conflicting reports about the health benefits of vegetarian diets. Some studies claim meat and dairy are health hazards, while others attest that plant-based diets can do more harm than good. One study published in the American Journal of Clinical Nutrition, attempted to examine some of these contradicting claims. By analyzing data from different groups of vegetarians in California and Britain, researchers concluded that vegetarians seem to experience lower rates of coronary heart disease (CHD), hypertension, and diabetes, and also higher life expectancy rates.

Due to the lack of red meat in their diet, vegetarians have lower LDL cholesterol levels, which greatly influences CHD. Even though vegetarian diets are healthy and can decrease the risk for developing heart disease, the study also concluded that “different types of vegetarians may not experience the same effects on health.”

Some Plant-Based Diets are Healthier than Others

Although many studies have supported the efficacies of vegetarian diets against heart disease, some diets are healthier than others. In fact, some plant-based diets are associated with a higher CHD risk. A study in the Journal of the American College of Cardiology analyzed three different groups of people over a 20-year period to determine the correlation between diet and CHD. The groups were based on the type of plant-based diet:

1. Diets that maximized plant-based nutrients, but did not exclude animal-based nutrients
2. Plant-based diets that maximized intake of healthy plant foods (fruits, veggies, whole-grains)
3. Plant-based diets consisting mostly of unhealthy plant-derived foods (sweetened beverages, potatoes, sweets, and refined grains)

“When we examined the associations of the three food categories with heart disease risk, we found that healthy plant foods were associated with lower risk, whereas less healthy plant foods and animal foods were associated with higher risk [of heart disease],” says Dr. Ambika Satija.

Choose the Right Diet for Your Lifestyle

Just because you’ve cut red meat and sugar out of your diet doesn’t mean it’s a healthy diet. Simultaneously, only following a plant-based diet doesn’t guarantee a disease-free life. The best thing you can do is develop a diet and exercise routine that works for you.

However, try to stay away from processed foods that contain added sugar and sodium even if they are derived from plants, fruits, or nuts. The most heart-healthy diet is a diet that maximizes your intake of healthy fruits, veggies, and whole-grains.

A stroke is the number five cause of death and disability in the U.S. A stroke can happen to anyone at any time, which means knowing how to spot a stroke early can prevent long term disability or even save a life. 

In honor of the fact that it was National Stroke Awareness Month in May, people are gathering together to discuss the latest advancements in brain health and to raise awareness for stroke warning signs and prevention tips. Here is what you need to know about strokes and how to spot them in time. 

What is a Stroke? 

A stroke occurs when the arteries in and around the brain either become blocked or rupture due to a clot. This blockage can prevent the brain from getting the blood and oxygen it needs, which causes brain cells to start to die. If treated quickly, doctors can help minimize the long-term effects created by the blockage. This means that stroke symptoms must be treated with a sense of urgency. 

Different Types of Stroke 

There are two types of strokes: Ischemic stroke and hemorrhagic stroke. While both forms of stroke are cause for medical attention, they require different types of treatment. 

Ischemic Stroke

An ischemic stroke is the most common form of stroke, accounting for 87 percent of all strokes. This type occurs when a clot causes a blockage in a brain vessel. Treatment for an ischemic stroke focuses on removing or breaking up the clot. 

Hemorrhagic Stroke

When a stroke is caused by a ruptured blood vessel in the brain, it is classified as a hemorrhagic stroke. This form of stroke is less common and is treated by stopping the bleeding.  

5 Signs of a Stroke 

It’s important to know the warning signs involved with a stroke, so you can seek medical attention for yourself or a loved one. Symptoms associated with a stroke are often times simply the side effect of a less serious issue, such as dehydration or a medication. However, if you experience the following signs altogether, it may in fact be a stroke.

1. Numbness: Sudden numbness, weakness or paralysis in the face, leg, or arm can occur. Typically, it will only be on one side of the body, and it can happen on the left or right. 
2. Vision Problems: If the stroke occurs on the right side of the brain, it may suddenly become difficult to see out of one or both eyes.
3. Language Confusion: If the stroke occurs on the left side of the brain, it can make it difficult to speak or understand others.
4. Severe Headache: Headaches can happen for many reasons, but if you experience a severe headache with no explainable cause, it could be a stroke.
5. Dizziness: Dizzy spells, a loss of balance, and trouble walking can all be signs of a stroke.

Are there Treatment Options for a Stroke? 

The long-term effects of a stroke can vary depending on where the clot is located in the brain along with the severity if the blockage. The treatment options vary depending on whether the stroke was ischemic or hemorrhagic. Unfortunately, after a person suffers a stroke, the risk of suffering a second one goes up dramatically. 

Greg Says agrees that strokes may be scary, but the good news is that 80 percent are preventable with the right treatment.

By Michelle Andrews

Kaiser Health News – March 20, 2019

When Beverly Dunn called her new primary care doctor’s office last November to schedule an annual checkup, she assumed her Medicare coverage would pick up most of the tab.

The appointment seemed like a routine physical, and she was pleased that the doctor spent a lot of time with her.

Until she got the bill: $400.

Dunn, 69, called the doctor’s office assuming there was a billing error. But it was no mistake, she was told. Medicare does not cover an annual physical exam.

Dunn, of Austin, Texas, was tripped up by Medicare’s confusing coverage rules. Federal law prohibits the health care program from paying for annual physicals, and patients who get them may be on the hook for the entire amount. But beneficiaries pay nothing for an “annual wellness visit,” which the program covers in full as a preventive service.

“It’s very important that someone, when they call to make an appointment, uses those magic words, ‘annual wellness visit,’” said Leslie Fried, senior director of the Center for Benefits Access at the National Council on Aging. Otherwise, “people think they are making an appointment for an annual wellness visit and it ends up they are having a complete physical.”

An annual physical typically involves an exam by a doctor along with bloodwork or other tests. The annual wellness visit generally doesn’t include a physical exam, except to check routine measurements such as height, weight and blood pressure.

The focus of the Medicare wellness visitis on preventing disease and disability by coming up with a “personalized prevention plan” for future medical issues based on the beneficiary’s health and risk factors.

At their first wellness visit, patients will often fill out a risk-assessment questionnaire and review their family and personal medical history with their doctor, a nurse practitioner or physician assistant. The clinician will typically create a schedule for the next decade of mammograms, colonoscopies and other screenings and evaluate people for cognitive problems and depression as well as their risk of falls and other safety issues.

They may also talk about advance care planning with beneficiaries to make decisions about what type of medical treatment they want in the future if they can’t make decisions for themselves.

At subsequent annual wellness visits, the doctor and patient will review these issues and check basic measurements. Beneficiaries can also receive other covered preventive services such as flu shots at those visits without charge.

When the Medicare program was established more than 50 years ago, its purpose was to cover the diagnosis and treatment of illness and injury in older people. Preventive services were generally not covered, and routine physical checkups were explicitly excluded, along with routine foot and dental care, eyeglasses and hearing aids.

Over the years, preventive services have gradually been added to the program, and the Affordable Care Act establishedcoverage of the annual wellness visit. Medicare beneficiaries pay nothing as long as their doctor accepts Medicare.

However, if a wellness visit veers beyond the bounds of the specific covered preventive services into diagnosis or treatment — whether at the urging of the doctor or the patient — Medicare beneficiaries will typically owe a copay or other charges. (This can be an issue when people in private plans get preventive care, too. And it can affect patients of all ages. The ACA requires insurers to provide coverage, without a copay, for a range of preventive services, including immunizations. But if a visit goes beyond prevention, the patient may encounter charges.)

And to add more confusion, Medicare beneficiaries can opt for a “Welcome to Medicare” preventive visit within the first year of joining Medicare Part B, which covers physician services.  Meanwhile, some Medicare Advantage plans cover annual physicals for their members free of charge.

Many patients want their doctor to evaluate or treat chronic conditions like diabetes or arthritis at the wellness visit, said Dr. Michael Munger, who chairs the board of the American Academy of Family Physicians. But Medicare generally won’t cover lab work, such as cholesterol screening, unless it’s tied to a specific medical condition.

At Munger’s practice in Overland Park, Kan., staffers routinely ask patients who come in for a wellness visit to sign an “advance beneficiary notice of non-coverage” acknowledging that they understand Medicare may not pay for some of the services they receive.

As long as beneficiaries understand the coverage rules, it’s not generally a problem, Munger said.  “They don’t want to come back for a separate visit, so they just understand that there may be extra charges,” he said.

Beneficiaries may not be the only ones who are unclear about what an annual wellness visit involves, said Munger. Providers may be put off if they think that it’s just another task that adds to their paperwork.

A recent study published in the journal Health Affairs found that in 2015 just over half of practices with eligible Medicare patients didn’t offer the annual wellness visit. That year, only 18.8 percent of eligible beneficiaries received an annual wellness visit, the analysis found.

Primary care physicians generally want to see their patients at least once a year, Munger said, but it needn’t be for a complete physical exam.  A wellness visit or even a visit for a sprained ankle could give doctors an opportunity to check in with patients and make sure they’re on track with preventive and other care, Munger said.

When Dunn called the doctor’s office about the $400 bill, she said, the staff told her she had signed papers agreeing to pay whatever Medicare didn’t cover.  Dunn doesn’t dispute that.  “There were lots of papers that I signed,” she said. “But nobody told me I would get a bill for $400. I would remember that.”

In the end, the clinic waived all but $100 of the charge, but warned her that next year she’ll have to pay $300 if she wants an annual physical with that doctor. If she comes in just for an annual wellness visit, she’ll be seen by a physician assistant.

Dunn is considering her options. She would like to stay with her new doctor, who came highly recommended, and she’s worried she might have trouble finding another one just as good who accepts Medicare. But $300 seems steep to her for a checkup.

Greg Says is trying to help the Medicare beneficiaries on its mailing list to be better informed about how to take full advantage of Medicare’s benefits and avoid unexpected costs.

And how we can (hopefully) prevent that from happening.

Written by: Michael Douglass at TMF Enterprise

Americans are worried about Social Security.

Whether it’s Transamerica’s annual retirement survey (44% of workers fear a reduction in or elimination of Social Security benefits), Gallup (67% of workers worry a “great deal” or “fair amount” about the Social Security system as of March 2019), or any of a variety of other surveys, the trend is clear. Americans fear that Social Security won’t be around (or at least won’t be as generous) in the future.

As the ratio of workers to retirees narrows — from between 3.2 and 3.4 between 1974 and 2008 down to a projected 2.2 in 2035 — the program will certainly be put under additional strain, and it is currently slated to run out of reserves in about 16 years.

Social Security’s Board of Trustees issues an annual report which reveals its exact prediction as to when Social Security will run out of money — and what happens next.

The deficits start shortly

According to the trustees’ report, the Old Age, Survivors and Disability Insurance (or OASDI) funds will start paying out more than they’re taking in next year. And by 2035, the combined funds of OASDI will be depleted.

(Technically speaking, OASI and DI are two separate programs — OASI is slated to deplete its reserves in 2034, with DI hanging on until 2052. But I digress.)

So, in short, Congress has about 16 years left to fix Social Security before it goes broke.

Here’s what happens if those efforts fail

If Social Security continues in its current arc and the trustees’ predictions are accurate, when the combined OASDI funds run out of money in 2035, Social Security will have to immediately reduce the benefits it pays out. OASDI will still be receiving money from payroll taxes, so the Social Security Administration will be able to pay out 80% of previously promised benefits.

Again, that differs between OASI and DI — OASI would be able to pay 77% of promised benefits when funds are depleted in 2034, and DI could pay 91% of benefits when its reserves empty in 2052. 

That’s certainly quite a bit better than “Social Security folds up shop and stops all benefits” (which was never a serious risk — though a persistent myth), but it’s still not great. Consider that Social Security represents at least half of income for 48% of married retirees and 69% of unmarried retirees. That’s a hefty cut to their retirement livelihood — at a time when it can be difficult to make up the deficit. (And given how expensive healthcare is in retirement, it’s not as if they necessarily have a lot of wiggle room.)

So what can be done?

To ensure 75 years of solvency going forward, the trustees recommend either immediately increasing taxes or reducing benefits (or both). To solve the issue using only additional tax revenue, they recommend increasing the payroll tax to 15.1% (from today’s 12.4%). Their benefit cut solution is to either reduce Social Security payouts by 17% for everyone (including current retirees), or by 20% to all new beneficiaries starting in 2019. Or, again, some combination of the above.

As you can imagine, neither of these solutions is terribly politically palatable. Nonetheless, there are plenty of historical precedents — the 1983 bill that stabilized Social Security increased both funding and the retirement age. (Increasing the retirement age functions as a benefit cut for future retirees, even if it isn’t explained that way.)

Of course, waiting longer makes it worse. The trustees predict that waiting until 2035 — when the combined funds net run dry — would necessitate a 3.65 percentage point increase in the payroll tax (to 16.05%) or a permanent 23% benefit reduction.

One way to ease the pain

An intriguing third option — albeit with some risk attached — involves investing a portion of Social Security funds in the stock market. Currently, Social Security’s roughly $2.9 trillion fund surplus is invested in U.S. Treasuries. While those are certainly safe securities, they don’t offer a lot of opportunity for growth.

Boston College’s Center for Retirement Research released a report back in 2017 that makes a compelling case for the Social Security funds taking on some investing risk in exchange for significantly better potential returns. The authors analyzed stock market returns and concluded that the Social Security funds would be in better shape today had they been invested in stocks starting in either 1997 or 1984 — despite the 2001 and 2008 stock market slumps. Their simulations also predict that “investing a portion (a maximum of 40%) of Social Security trust fund assets in equities would reduce the need for greater payroll tax contributions or benefit reductions.” (To be precise, 97% of their simulations found the trust fund strengthened, assuming stock investment began as of the study’s publication in 2017.)

What does this mean for you?

If you’re retired, I sincerely doubt you’ll face a benefit cut. It’s far more likely that the pain will fall on non-retired generations because most people understand how terrible it would be to force a massive benefit cut on current retirees.

If you’re still working, know that Social Security isn’t going to go belly-up and suddenly stop paying out benefits — even in the worst-case scenario. But you can’t necessarily depend on it as much as your parents’ generation did — so now’s the time to turbocharge your savings and build up your retirement income base. (And consider calling your Congressperson, if you have a strong opinion as to how the government should fix Social Security.)