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"content": "\u003cfigure id=\"attachment_19501\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Picture-iHealth-Align-Device-with-iPhone.jpg\">\u003cimg class=\"size-large wp-image-19501\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Picture-iHealth-Align-Device-with-iPhone-640x719.jpg\" alt=\"The iHealth mobile blood glucose monitor. (Courtesy: iHealth Lab)\" width=\"640\" height=\"719\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The iHealth mobile blood glucose monitor. (Courtesy: iHealth Lab)\u003c/figcaption>\u003c/figure>\n\u003cp>iHealth Labs, a Mountain View company focused on mobile, personal, health technology has received FDA approval for what the company says is the world's smallest mobile blood glucose monitor, called iHealth Align.\u003c/p>\n\u003cp>But for people with diabetes, the bigger news is likely to be the cost of the test strips that the device will use. People with diabetes often check their blood sugar one or more times a day. The test strips that users fit into a monitor list at a dollar each, for some of the larger brands. The strips for the new device will run 25 cents each. The device itself is $16.95.\u003c/p>\n\u003cp>\u003cspan style=\"color: #1a1a1a\">“It’s probably more of a known secret in the marketplace that the real margins is within the strips,” Adam Lin, president of iHealth Labs told \u003ca href=\"http://mobihealthnews.com/34056/ihealth-to-launch-smaller-glucometer-drop-test-strip-price/\" target=\"_blank\">MobiHealthNews\u003c/a>. “We (wanted) to pass on all that savings to the end users. It’s got to be simple to understand. You don’t have to go through all these issues for reimbursement. We brought it down to pretty much co-pay.”\u003c/span>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>The new glucose monitor is just bigger than a quarter, and it plugs into a phone's headphone jack. It can be used with either Apple or Android phones. It displays and stores readings using iHealth's app.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>More from \u003ca href=\"http://mobihealthnews.com/34056/ihealth-to-launch-smaller-glucometer-drop-test-strip-price/\" target=\"_blank\">mobihealthnews\u003c/a>:\u003c/p>\n\u003cblockquote>\n\u003cp style=\"color: #1a1a1a\">Lin thinks the lower cost will bring iHealth more market share, and it will be hard for the bigger players with larger overheads to follow suit. When users take their blood glucose with either of iHealth’s devices, they first scan the QR code on the box of test strips, which allows the app to track how many strips are left. iHealth is developing a feature by which users will be able to auto-reorder their strips based on that data, but right now the app simply reminds the user if strips are running low or about to expire.\u003c/p>\n\u003cp style=\"color: #1a1a1a\">iHealth’s Wireless Smart Gluco-Monitoring System was featured briefly at Apple’s WWDC event as an example of a smartphone-connected glucometer. Lin said that iHealth has plans to integrate all of its devices with HealthKit.\u003c/p>\n\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The product will be available next month, first from \u003ca href=\"http://www.ihealthlabs.com\" target=\"_blank\">iHealth's website \u003c/a>and later from Walgreens.\u003c/p>\n\n",
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"content": "\u003cfigure id=\"attachment_15440\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg\">\u003cimg class=\"size-full wp-image-15440\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg\" alt=\"While 90 percent of schools have made the transition to new school lunch standards, some schools insist that the standards are unworkable. (Photo: USDA)\" width=\"640\" height=\"424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122-400x265.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122-320x212.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While 90 percent of schools have made the transition to new school lunch standards, some schools insist that the standards are unworkable. (Photo: USDA)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Allison Aubrey and Jessica Pupovac\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/thesalt/2014/06/11/320882341/school-lunch-debate-whats-at-stake\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>School lunches have never been known for culinary excellence. But to be fair, the National School Lunch Program — which provides free or reduced lunches to about 31 million kids every day — has never aimed to dazzle as much as to fill little bellies.\u003c/p>\n\u003cp>In 2010, Congress gave the Federal School Lunch Program a nutrition make-over. New regulations called for:\u003c/p>\n\u003cul>\n\u003cli>Increasing the amount of whole grains served in school cafeterias\u003c/li>\n\u003cli>Shifting to fat free or low-fat milks\u003c/li>\n\u003cli>Limiting the amount of calories that can come from saturated fats to 10 percent\u003c/li>\n\u003cli>Offering fruits and vegetables on a daily basis\u003c/li>\n\u003cli>Implementing caloric minimums and maximums for each meal\u003c/li>\n\u003c/ul>\n\u003cp>Those were just the first steps. By the school year starting this fall, schools are also required to:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Reduce the amount of sodium school cafeterias can serve to a maximum of 1,230 to 1,420 milligrams a day for lunch (depending on age group) and 540 to 640 milligrams a day for breakfast.\u003c/li>\n\u003cli>Shift to 100 percent \"whole grain-rich\" products, which means that they are mostly whole grain.\u003c/li>\n\u003c/ul>\n\u003cp>In the agriculture appropriations bill, which may come to a vote on Thursday, schools would also receive additional support for making the transition to a healthier menu, including provisions to help them purchase new equipment to prepare fresher foods.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"gJWHEusGINj4Z7JafteoUw4hYBsSxLZ4\"]Sam Kass, senior advisor for nutrition policy at the White House, says 90 percent of schools have already — or are in the process of — implementing the new standards.\u003c/p>\n\u003cp>Currently, half of all products served in the school lunch program must be \"whole-grain rich,\" which USDA defines as products made of at least 50 percent whole grain. According to the new standards, by the start of the next school year, schools must use only products that are whole-grain rich.\u003c/p>\n\u003cp>But GOP leaders, as well as the School Nutrition Association, which represents school food service directors and several companies that supply school cafeterias, say the upcoming requirements are unworkable. They claim that kids don't want the healthy options and, as a result, too much food is being wasted. They also say that the cost of reducing sodium and other preservatives are placing an undue burden on schools.\u003c/p>\n\u003cp>Alabama Republican Congressman Robert Aderholt introduced a provision that would give school districts a year-long waiver from both old and new standards if they can show that they are losing money.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003ca href=\"http://blogs.kqed.org/bayareabites/2014/06/11/lobbyists-loom-behind-the-scenes-of-school-nutrition-fight/\" target=\"_blank\">Related: Lobbyists Loom Behind the Scenes of School Nutrition Fight\u003c/a>]\u003c/p>\n\u003cp>First Lady Michelle Obama, who helped spearhead the new regulations, is vehemently opposed to delaying or softening the new regulations.\u003c/p>\n\u003cp>So is Agriculture Secretary Tom Vilsack. He says that kids will eat healthier foods if they are provided with them and claims that, overall, school food revenues around the country are up by about $200 million dollars since the changes took effect.\u003c/p>\n\u003cp>\"The facts just don't basically support the notion that somehow school district are financially strapped to be able comply,\" he said.\u003c/p>\n\u003cp>His advice for schools that are struggling: instead of asking to opt-out, ask for help.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The hearings over the waivers started on the House floor Wednesday.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15440\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg\">\u003cimg class=\"size-full wp-image-15440\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg\" alt=\"While 90 percent of schools have made the transition to new school lunch standards, some schools insist that the standards are unworkable. (Photo: USDA)\" width=\"640\" height=\"424\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122-400x265.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7995796099_c60447daba_c-e1380770435122-320x212.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While 90 percent of schools have made the transition to new school lunch standards, some schools insist that the standards are unworkable. (Photo: USDA)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Allison Aubrey and Jessica Pupovac\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/thesalt/2014/06/11/320882341/school-lunch-debate-whats-at-stake\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>School lunches have never been known for culinary excellence. But to be fair, the National School Lunch Program — which provides free or reduced lunches to about 31 million kids every day — has never aimed to dazzle as much as to fill little bellies.\u003c/p>\n\u003cp>In 2010, Congress gave the Federal School Lunch Program a nutrition make-over. New regulations called for:\u003c/p>\n\u003cul>\n\u003cli>Increasing the amount of whole grains served in school cafeterias\u003c/li>\n\u003cli>Shifting to fat free or low-fat milks\u003c/li>\n\u003cli>Limiting the amount of calories that can come from saturated fats to 10 percent\u003c/li>\n\u003cli>Offering fruits and vegetables on a daily basis\u003c/li>\n\u003cli>Implementing caloric minimums and maximums for each meal\u003c/li>\n\u003c/ul>\n\u003cp>Those were just the first steps. By the school year starting this fall, schools are also required to:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Reduce the amount of sodium school cafeterias can serve to a maximum of 1,230 to 1,420 milligrams a day for lunch (depending on age group) and 540 to 640 milligrams a day for breakfast.\u003c/li>\n\u003cli>Shift to 100 percent \"whole grain-rich\" products, which means that they are mostly whole grain.\u003c/li>\n\u003c/ul>\n\u003cp>In the agriculture appropriations bill, which may come to a vote on Thursday, schools would also receive additional support for making the transition to a healthier menu, including provisions to help them purchase new equipment to prepare fresher foods.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"gJWHEusGINj4Z7JafteoUw4hYBsSxLZ4\"]Sam Kass, senior advisor for nutrition policy at the White House, says 90 percent of schools have already — or are in the process of — implementing the new standards.\u003c/p>\n\u003cp>Currently, half of all products served in the school lunch program must be \"whole-grain rich,\" which USDA defines as products made of at least 50 percent whole grain. According to the new standards, by the start of the next school year, schools must use only products that are whole-grain rich.\u003c/p>\n\u003cp>But GOP leaders, as well as the School Nutrition Association, which represents school food service directors and several companies that supply school cafeterias, say the upcoming requirements are unworkable. They claim that kids don't want the healthy options and, as a result, too much food is being wasted. They also say that the cost of reducing sodium and other preservatives are placing an undue burden on schools.\u003c/p>\n\u003cp>Alabama Republican Congressman Robert Aderholt introduced a provision that would give school districts a year-long waiver from both old and new standards if they can show that they are losing money.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003ca href=\"http://blogs.kqed.org/bayareabites/2014/06/11/lobbyists-loom-behind-the-scenes-of-school-nutrition-fight/\" target=\"_blank\">Related: Lobbyists Loom Behind the Scenes of School Nutrition Fight\u003c/a>]\u003c/p>\n\u003cp>First Lady Michelle Obama, who helped spearhead the new regulations, is vehemently opposed to delaying or softening the new regulations.\u003c/p>\n\u003cp>So is Agriculture Secretary Tom Vilsack. He says that kids will eat healthier foods if they are provided with them and claims that, overall, school food revenues around the country are up by about $200 million dollars since the changes took effect.\u003c/p>\n\u003cp>\"The facts just don't basically support the notion that somehow school district are financially strapped to be able comply,\" he said.\u003c/p>\n\u003cp>His advice for schools that are struggling: instead of asking to opt-out, ask for help.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The hearings over the waivers started on the House floor Wednesday.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Fruit Juice vs. Soda? Both Beverages Pack a Wallop of Sugar",
"title": "Fruit Juice vs. Soda? Both Beverages Pack a Wallop of Sugar",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19454\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/novembering/2681267111/in/photolist-7z8Yef-6nqoBm-4wgxYd-4qcHuZ-55WceT-63fWPV-55Wcii-5evmjg-bqmBok-bqmExM-bqmDcR-4Xdf6M-55Wbze-8PymWv\">\u003cimg class=\"size-large wp-image-19454\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/2681267111_74c66105ba_b-640x415.jpg\" alt=\"Minute Maid 100 percent apple juice has more fructose per liter than Coke and Pepsi. (Trisha Weir/Flickr)\" width=\"640\" height=\"415\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Minute Maid 100 percent apple juice has more fructose per liter than Coke and Pepsi. (Trisha Weir/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Eliza Barclay,\u003c/strong>\u003ca href=\"http://www.npr.org/blogs/thesalt/2014/06/09/319230765/fruit-juice-vs-soda-both-beverages-pack-in-sugar-and-health-risk\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cp>When it comes to choosing between sodas and juices in the beverage aisle, the juice industry has long benefited from a health halo.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'100 percent fruit juice is as bad as sugar-sweetened beverages for its effects on our health.' \u003c/aside>\n\u003cp>We know that juice comes from fruit, while soda is artificial. In particular, the sugars in juice seem more \"natural\" than high fructose corn syrup — the main sweetener in so many sodas. After all, we've gotten rid of most of the soda we used to offer kids at school, but schools can \u003ca href=\"http://www.fns.usda.gov/sites/default/files/allfoods_summarychart.pdf\" target=\"_blank\">still offer juice\u003c/a>.\u003c/p>\n\u003cp>But \u003ca href=\"http://www.nutritionjrnl.com/article/S0899-9007(14)00192-0/fulltext\" target=\"_blank\">a study\u003c/a> published online in the journal Nutrition, shows that on average fruit juice has a fructose concentration of about 45.5 grams per liter, only a bit less than the average of 50 grams per liter for sodas. The sneakiest — and sweetest — juice is Minute Maid 100 percent apple, with nearly 66 grams of fructose per liter. That's more than the 62.5 grams per liter in Coca-Cola and the 61 grams per liter in Dr. Pepper.\u003c!--more-->\u003c/p>\n\u003cfigure id=\"attachment_19450\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-09-at-11.28.59-AM.png\">\u003cimg class=\"size-large wp-image-19450\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-09-at-11.28.59-AM-640x664.png\" alt=\"Source: Nutrition journal (Graphic Credit: Alyson Hurt/NPR)\" width=\"640\" height=\"664\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: Nutrition journal\u003cbr>(Graphic Credit: Alyson Hurt/NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>Michael Goran, the director of the Childhood Obesity Research Center at the University of Southern California, led the study. He says he decided to measure the fructose, specifically, in juices and sodas because of a growing body of evidence suggesting fructose is a riskier substance than glucose.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The human body isn't designed to process this form of sugar at such high levels,\" Goran said in \u003ca href=\"http://news.usc.edu/63696/soda-consumers-may-be-drinking-more-harmful-sugar-than-labels-reveal/\" target=\"_blank\">a statement\u003c/a>. \"Unlike glucose, which serves as fuel for the body, fructose is processed almost entirely in the liver where it is converted to fat, which increases risk for diabetes, cardiovascular disease and liver disease.\"\u003c/p>\n\u003cp>Goran's assertion is not universally accepted. Other health researchers, like Fred Brouns at Maastricht University in the Netherlands, say sugar is basically sugar. He has argued that we should spend less time fixating on fructose and its role in the emerging chronic disease epidemics, and more time looking at sugar and energy over-consumption overall.\u003c/p>\n\u003cp>Goran says that while high fructose corn syrup in soda and food has become a focal point for researchers and public health advocates in recent years, there's been less attention on the link between fruit juice and obesity and diabetes.\u003c/p>\n\u003cp>\"But it's hard to imagine why any there's reason why juices wouldn't be as harmful as sodas if they're delivering the same amount of sugar,\" he tells us.\u003c/p>\n\u003cp>One of the biggest problems, Goran notes, is that nutrition labels only tells us the total grams of sugar — so it's hard to know how much fructose is in any product. (The term \"sugars\" on the label can include sucrose, which is a combination of glucose and fructose; lactose and other variations.)\u003c/p>\n\u003cp>But, Goran adds, if we're getting fructose from whole fruit, that's a different story. The fructose in whole fruit comes with fiber, which slows down and reduces the absorption of the sugar in the body, \"serving as a sort of antidote to the negative effects of fructose metabolism.\"\u003c/p>\n\u003cp>Barry Popkin, a leading obesity researcher and professor of nutrition at the University of North Carolina-Chapel Hill, agrees that fruit juice consumption is associated with health risks because of the high sugar content.\u003c/p>\n\u003cp>\"Yes, from our long-term, huge studies in Singapore, Australia, the U.S. and Europe, I think 100 percent fruit juice is as bad as sugar-sweetened beverages for its effects on our health,\" he tells us. And, Popkin adds, every long term study on the effects of 100 percent fruit juice intake on diabetes risk shows a very significant risk, too.\u003c/p>\n\u003cp>Popkin notes that only about nine countries have banned fruit juices from schools. \"However, all countries now say a maximum four ounces of fruit juice whereas 20 years ago we said unlimited,\" he adds.\u003c/p>\n\u003cp>So what's a juice lover to do with so many super-sweet products on the market? As \u003ca href=\"http://www.npr.org/blogs/health/2014/05/16/312823157/will-soda-lovers-drink-to-less-sugar-in-the-can\" target=\"_blank\">NPR has reported,\u003c/a> some beverage makers are now starting to cut the sugar. Goran recommends diluting juice you buy at the store with 50 percent water.\u003c/p>\n\u003cp>\"From a public health perspective, we're going to need to change the cultural norms about how sweet things like juice really need to be,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "USC researchers report that fruit juices have almost as much fructose as soda, making them just as unhealthful for you.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19454\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/novembering/2681267111/in/photolist-7z8Yef-6nqoBm-4wgxYd-4qcHuZ-55WceT-63fWPV-55Wcii-5evmjg-bqmBok-bqmExM-bqmDcR-4Xdf6M-55Wbze-8PymWv\">\u003cimg class=\"size-large wp-image-19454\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/2681267111_74c66105ba_b-640x415.jpg\" alt=\"Minute Maid 100 percent apple juice has more fructose per liter than Coke and Pepsi. (Trisha Weir/Flickr)\" width=\"640\" height=\"415\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Minute Maid 100 percent apple juice has more fructose per liter than Coke and Pepsi. (Trisha Weir/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Eliza Barclay,\u003c/strong>\u003ca href=\"http://www.npr.org/blogs/thesalt/2014/06/09/319230765/fruit-juice-vs-soda-both-beverages-pack-in-sugar-and-health-risk\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cp>When it comes to choosing between sodas and juices in the beverage aisle, the juice industry has long benefited from a health halo.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'100 percent fruit juice is as bad as sugar-sweetened beverages for its effects on our health.' \u003c/aside>\n\u003cp>We know that juice comes from fruit, while soda is artificial. In particular, the sugars in juice seem more \"natural\" than high fructose corn syrup — the main sweetener in so many sodas. After all, we've gotten rid of most of the soda we used to offer kids at school, but schools can \u003ca href=\"http://www.fns.usda.gov/sites/default/files/allfoods_summarychart.pdf\" target=\"_blank\">still offer juice\u003c/a>.\u003c/p>\n\u003cp>But \u003ca href=\"http://www.nutritionjrnl.com/article/S0899-9007(14)00192-0/fulltext\" target=\"_blank\">a study\u003c/a> published online in the journal Nutrition, shows that on average fruit juice has a fructose concentration of about 45.5 grams per liter, only a bit less than the average of 50 grams per liter for sodas. The sneakiest — and sweetest — juice is Minute Maid 100 percent apple, with nearly 66 grams of fructose per liter. That's more than the 62.5 grams per liter in Coca-Cola and the 61 grams per liter in Dr. Pepper.\u003c!--more-->\u003c/p>\n\u003cfigure id=\"attachment_19450\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-09-at-11.28.59-AM.png\">\u003cimg class=\"size-large wp-image-19450\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Screen-Shot-2014-06-09-at-11.28.59-AM-640x664.png\" alt=\"Source: Nutrition journal (Graphic Credit: Alyson Hurt/NPR)\" width=\"640\" height=\"664\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: Nutrition journal\u003cbr>(Graphic Credit: Alyson Hurt/NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>Michael Goran, the director of the Childhood Obesity Research Center at the University of Southern California, led the study. He says he decided to measure the fructose, specifically, in juices and sodas because of a growing body of evidence suggesting fructose is a riskier substance than glucose.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The human body isn't designed to process this form of sugar at such high levels,\" Goran said in \u003ca href=\"http://news.usc.edu/63696/soda-consumers-may-be-drinking-more-harmful-sugar-than-labels-reveal/\" target=\"_blank\">a statement\u003c/a>. \"Unlike glucose, which serves as fuel for the body, fructose is processed almost entirely in the liver where it is converted to fat, which increases risk for diabetes, cardiovascular disease and liver disease.\"\u003c/p>\n\u003cp>Goran's assertion is not universally accepted. Other health researchers, like Fred Brouns at Maastricht University in the Netherlands, say sugar is basically sugar. He has argued that we should spend less time fixating on fructose and its role in the emerging chronic disease epidemics, and more time looking at sugar and energy over-consumption overall.\u003c/p>\n\u003cp>Goran says that while high fructose corn syrup in soda and food has become a focal point for researchers and public health advocates in recent years, there's been less attention on the link between fruit juice and obesity and diabetes.\u003c/p>\n\u003cp>\"But it's hard to imagine why any there's reason why juices wouldn't be as harmful as sodas if they're delivering the same amount of sugar,\" he tells us.\u003c/p>\n\u003cp>One of the biggest problems, Goran notes, is that nutrition labels only tells us the total grams of sugar — so it's hard to know how much fructose is in any product. (The term \"sugars\" on the label can include sucrose, which is a combination of glucose and fructose; lactose and other variations.)\u003c/p>\n\u003cp>But, Goran adds, if we're getting fructose from whole fruit, that's a different story. The fructose in whole fruit comes with fiber, which slows down and reduces the absorption of the sugar in the body, \"serving as a sort of antidote to the negative effects of fructose metabolism.\"\u003c/p>\n\u003cp>Barry Popkin, a leading obesity researcher and professor of nutrition at the University of North Carolina-Chapel Hill, agrees that fruit juice consumption is associated with health risks because of the high sugar content.\u003c/p>\n\u003cp>\"Yes, from our long-term, huge studies in Singapore, Australia, the U.S. and Europe, I think 100 percent fruit juice is as bad as sugar-sweetened beverages for its effects on our health,\" he tells us. And, Popkin adds, every long term study on the effects of 100 percent fruit juice intake on diabetes risk shows a very significant risk, too.\u003c/p>\n\u003cp>Popkin notes that only about nine countries have banned fruit juices from schools. \"However, all countries now say a maximum four ounces of fruit juice whereas 20 years ago we said unlimited,\" he adds.\u003c/p>\n\u003cp>So what's a juice lover to do with so many super-sweet products on the market? As \u003ca href=\"http://www.npr.org/blogs/health/2014/05/16/312823157/will-soda-lovers-drink-to-less-sugar-in-the-can\" target=\"_blank\">NPR has reported,\u003c/a> some beverage makers are now starting to cut the sugar. Goran recommends diluting juice you buy at the store with 50 percent water.\u003c/p>\n\u003cp>\"From a public health perspective, we're going to need to change the cultural norms about how sweet things like juice really need to be,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_17715\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\">\u003cimg class=\"size-full wp-image-17715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-400x250.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-320x200.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Banning the use of food stamps to purchase sodas and other sugary drinks could reduce both obesity and Type 2 diabetes rates, according to new research from the Stanford University School of Medicine.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Shift in policy could prevent 400,000 cases of obesity.' \u003c/aside>\n\u003cp>About one in seven Americans — more than 46 million people — currently receive food stamps, now called the Supplemental Nutrition Assistance Program, or SNAP.\u003ca href=\"http://www.cdc.gov/nchs/nhanes/nhanes.htm\" target=\"_blank\"> Government surveys\u003c/a> show that the average SNAP recipient drinks the equivalent of a little more than a can of soda a day.\u003c/p>\n\u003cp>Stanford researchers used two data sets, one on diet and another on price data for food, and then used simulations to estimate the effect of a ban on using SNAP funds to buy sugary beverages, including sodas and sports drinks, but excluding 100 percent fruit juices.\u003c!--more-->\u003c/p>\n\u003cp>Over a 10-year period, the simulation indicated that such a ban would amount to a 2.4 percent drop in obesity prevalence and a 1.7 percent decline in Type 2 diabetes among SNAP recipients.\u003c/p>\n\u003cp>While those percentage changes sound small, lead author Dr. Sanjay Basu, a professor of medicine at Stanford, says the real impact across a population would be impressive.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This shift in policy would be preventing around 400,000 cases of obesity in the next decade and nearly 250,000 cases of Type 2 diabetes,\" Basu said.\u003c/p>\n\u003cp>The study was published in the journal \u003ca href=\"http://content.healthaffairs.org/content/33/6/1032.abstract\" target=\"_blank\">Health Affairs\u003c/a>.\u003c/p>\n\u003cp>[contextly_sidebar id=\"79b7f787c8ba45e85d9e5bfa25bc392d\"]\u003c/p>\n\u003cp>The American Beverage Association criticized the idea of a ban. In a statement, the group said a ban would be an \"expensive and unnecessary restriction that (has) negligible benefits.\" The association called instead for heath education and healthy incentives.\u003c/p>\n\u003cp>But Harold Goldstein, executive director of the California Center for Public Health Advocacy, was intrigued by the analysis. \"I look at these federal dollars as a subsidy to Coke and Pepsi,\" he said. \"Here's a strategy that could have a significant impact on low-income folks who have among the highest diabetes rates in the country.\" Goldstein was not involved in the research.\u003c/p>\n\u003cp>Another federal program, Women, Infants and Children, already does not allow the purchase of sugar-sweetened beverages.\u003c/p>\n\u003cp>The researchers also looked at the impact of giving 30 cents back to SNAP participants for each dollar they might spend on fruits and vegetables. While such a reward doubled the number of people eating the recommended requirements of fruits and vegetables, obesity and diabetes indicators \"did not improve considerably,\" Basu said.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/152651570&color=ff5500&auto_play=false&hide_related=false&show_artwork=true&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Last June, a bipartisan group of mayors \u003ca href=\"http://s3.documentcloud.org/documents/716748/mayors-request-house-limit-snap-access-to-soda.pdf\" target=\"_blank\">sent a letter\u003c/a> to House Speaker John Boehner and House Minority Leader Nancy Pelosi advocating improvements to the SNAP program, saying it was time to consider limiting subsidies for sugar-sweetened beverages.\u003c/p>\n\u003cp>Monday's study comes against a backdrop of renewed calls in California cities for a soda tax — and just days after the California Senate \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/5/senate-approves-soda-warning-bill\" target=\"_blank\">passed a bill \u003c/a>that would require a health warning label on sodas and other sugary beverages.\u003c/p>\n\u003cp>Doctors and other public health professionals are growing increasingly concerned about the health impact of sugary beverages, or what Goldstein referred to as \"liquid sugar.\"\u003c/p>\n\u003cp>\"We know that there is overwhelming science that the liquid sugar in these beverages is a unique driver in today's skyrocketing obesity epidemic,\" he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to clarify the American Beverage Association's opposition to a policy on banning food stamps for purchase of sugar-sweetened beverages.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17715\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\">\u003cimg class=\"size-full wp-image-17715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-400x250.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-320x200.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Banning the use of food stamps to purchase sodas and other sugary drinks could reduce both obesity and Type 2 diabetes rates, according to new research from the Stanford University School of Medicine.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Shift in policy could prevent 400,000 cases of obesity.' \u003c/aside>\n\u003cp>About one in seven Americans — more than 46 million people — currently receive food stamps, now called the Supplemental Nutrition Assistance Program, or SNAP.\u003ca href=\"http://www.cdc.gov/nchs/nhanes/nhanes.htm\" target=\"_blank\"> Government surveys\u003c/a> show that the average SNAP recipient drinks the equivalent of a little more than a can of soda a day.\u003c/p>\n\u003cp>Stanford researchers used two data sets, one on diet and another on price data for food, and then used simulations to estimate the effect of a ban on using SNAP funds to buy sugary beverages, including sodas and sports drinks, but excluding 100 percent fruit juices.\u003c!--more-->\u003c/p>\n\u003cp>Over a 10-year period, the simulation indicated that such a ban would amount to a 2.4 percent drop in obesity prevalence and a 1.7 percent decline in Type 2 diabetes among SNAP recipients.\u003c/p>\n\u003cp>While those percentage changes sound small, lead author Dr. Sanjay Basu, a professor of medicine at Stanford, says the real impact across a population would be impressive.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"This shift in policy would be preventing around 400,000 cases of obesity in the next decade and nearly 250,000 cases of Type 2 diabetes,\" Basu said.\u003c/p>\n\u003cp>The study was published in the journal \u003ca href=\"http://content.healthaffairs.org/content/33/6/1032.abstract\" target=\"_blank\">Health Affairs\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The American Beverage Association criticized the idea of a ban. In a statement, the group said a ban would be an \"expensive and unnecessary restriction that (has) negligible benefits.\" The association called instead for heath education and healthy incentives.\u003c/p>\n\u003cp>But Harold Goldstein, executive director of the California Center for Public Health Advocacy, was intrigued by the analysis. \"I look at these federal dollars as a subsidy to Coke and Pepsi,\" he said. \"Here's a strategy that could have a significant impact on low-income folks who have among the highest diabetes rates in the country.\" Goldstein was not involved in the research.\u003c/p>\n\u003cp>Another federal program, Women, Infants and Children, already does not allow the purchase of sugar-sweetened beverages.\u003c/p>\n\u003cp>The researchers also looked at the impact of giving 30 cents back to SNAP participants for each dollar they might spend on fruits and vegetables. While such a reward doubled the number of people eating the recommended requirements of fruits and vegetables, obesity and diabetes indicators \"did not improve considerably,\" Basu said.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/152651570&color=ff5500&auto_play=false&hide_related=false&show_artwork=true&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Last June, a bipartisan group of mayors \u003ca href=\"http://s3.documentcloud.org/documents/716748/mayors-request-house-limit-snap-access-to-soda.pdf\" target=\"_blank\">sent a letter\u003c/a> to House Speaker John Boehner and House Minority Leader Nancy Pelosi advocating improvements to the SNAP program, saying it was time to consider limiting subsidies for sugar-sweetened beverages.\u003c/p>\n\u003cp>Monday's study comes against a backdrop of renewed calls in California cities for a soda tax — and just days after the California Senate \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/5/senate-approves-soda-warning-bill\" target=\"_blank\">passed a bill \u003c/a>that would require a health warning label on sodas and other sugary beverages.\u003c/p>\n\u003cp>Doctors and other public health professionals are growing increasingly concerned about the health impact of sugary beverages, or what Goldstein referred to as \"liquid sugar.\"\u003c/p>\n\u003cp>\"We know that there is overwhelming science that the liquid sugar in these beverages is a unique driver in today's skyrocketing obesity epidemic,\" he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated to clarify the American Beverage Association's opposition to a policy on banning food stamps for purchase of sugar-sweetened beverages.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Doctors Say They Would Forego Aggressive Treatment When Near Death",
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"content": "\u003cfigure id=\"attachment_19303\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/468418291.jpg\">\u003cimg class=\"size-large wp-image-19303\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/468418291-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Katherine Hobson\u003c/strong>,\u003ca href=\"http://www.npr.org/blogs/health/2014/05/29/316701155/doctors-say-they-would-shun-aggressive-treatment-when-near-death\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cp>Everybody dies.\u003c/p>\n\u003cp>But when doctors' time is up, they are different from the rest of us. They \"go gently\" rather than opt for aggressive end-of-life treatments, \u003ca href=\"http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/\" target=\"_blank\">as one physician wrote\u003c/a> a few years ago. They have seen the suffering of their patients at the end of life and want no part of it.\u003c/p>\n\u003cp>In fact, nearly 9 in 10 young physicians just finishing up their residencies or fellowships wouldn't want to receive life-prolonging CPR or cardiac life support if they were terminally ill and their heart or breathing stopped, a Stanford University School of Medicine survey finds.\u003c/p>\n\u003cp>\u003ca href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0098246\" target=\"_blank\">The report\u003c/a>, published Wednesday in the journal PLOS ONE, notes the disconnect between the aggressive care the average person receives — an average of \u003ca href=\"http://www.medicarenewsgroup.com/context/understanding-medicare-blog/understanding-medicare-blog/2013/06/03/the-cost-and-quality-conundrum-of-american-end-of-life-care\" target=\"_blank\">about $7,000 worth\u003c/a> for Medicare beneficiaries in their last month of life — and what doctors would want for themselves.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>To be sure, nondoctors don't necessarily want that care. According to \u003ca href=\"http://www.chcf.org/publications/2012/02/final-chapter-death-dying\" target=\"_blank\">one survey, from the California HealthCare Foundation\u003c/a>, most people would prefer to die at home and want care to focus on comfort.\u003c/p>\n\u003cp>One of the big barriers that stands in the way is a health care system that defaults to aggressive care, says VJ Periyakoil, the Stanford geriatrician who led the survey of more than a thousand doctors. \"Our system is biased toward overtreatment, not undertreatment,\" both culturally and financially, she says.\u003c/p>\n\u003cp>Local health system culture and doctors' individual practice styles influence the kind of care patients get, she says. In addition, patients may not have given thought to the specifics of what they want, or told family members. So while family members resolve any conflicts between themselves, the patient continues to receive treatments. While everyone is well-intentioned, she says, the end result is care that often exceeds what patients would want.\u003c/p>\n\u003cp>So what's a person who wants a gentle death to do? First, really reflect on what matters to you the most, says Periyakoil. Is it most important that you die at home, with family? What forms of medical care do you really not want to endure?\u003c/p>\n\u003cp>Then you need to talk about your wishes with your family members or anyone else who might be making decisions when you no longer can. (The Conversation Project is an effort to promote these types of \u003ca href=\"http://www.npr.org/2013/12/28/257822206/helping-families-have-the-most-difficult-conversation\" target=\"_blank\">difficult but important discussions\u003c/a>.) Put your preferences in writing, using an \u003ca href=\"http://www.nlm.nih.gov/medlineplus/advancedirectives.html\" target=\"_blank\">advance directive\u003c/a> and, for people who are aware that they soon may die, a \u003ca href=\"http://www.polst.org\" target=\"_blank\">Physician Order for Life-Sustaining Treatment, or POLST\u003c/a>, form. Make your wishes known to your medical team, she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It's also important to revisit your advance directive periodically to make sure it's still in line with what you want, and be sure to keep your family members posted on any changes.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19303\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/468418291.jpg\">\u003cimg class=\"size-large wp-image-19303\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/468418291-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Katherine Hobson\u003c/strong>,\u003ca href=\"http://www.npr.org/blogs/health/2014/05/29/316701155/doctors-say-they-would-shun-aggressive-treatment-when-near-death\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cp>Everybody dies.\u003c/p>\n\u003cp>But when doctors' time is up, they are different from the rest of us. They \"go gently\" rather than opt for aggressive end-of-life treatments, \u003ca href=\"http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/\" target=\"_blank\">as one physician wrote\u003c/a> a few years ago. They have seen the suffering of their patients at the end of life and want no part of it.\u003c/p>\n\u003cp>In fact, nearly 9 in 10 young physicians just finishing up their residencies or fellowships wouldn't want to receive life-prolonging CPR or cardiac life support if they were terminally ill and their heart or breathing stopped, a Stanford University School of Medicine survey finds.\u003c/p>\n\u003cp>\u003ca href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0098246\" target=\"_blank\">The report\u003c/a>, published Wednesday in the journal PLOS ONE, notes the disconnect between the aggressive care the average person receives — an average of \u003ca href=\"http://www.medicarenewsgroup.com/context/understanding-medicare-blog/understanding-medicare-blog/2013/06/03/the-cost-and-quality-conundrum-of-american-end-of-life-care\" target=\"_blank\">about $7,000 worth\u003c/a> for Medicare beneficiaries in their last month of life — and what doctors would want for themselves.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To be sure, nondoctors don't necessarily want that care. According to \u003ca href=\"http://www.chcf.org/publications/2012/02/final-chapter-death-dying\" target=\"_blank\">one survey, from the California HealthCare Foundation\u003c/a>, most people would prefer to die at home and want care to focus on comfort.\u003c/p>\n\u003cp>One of the big barriers that stands in the way is a health care system that defaults to aggressive care, says VJ Periyakoil, the Stanford geriatrician who led the survey of more than a thousand doctors. \"Our system is biased toward overtreatment, not undertreatment,\" both culturally and financially, she says.\u003c/p>\n\u003cp>Local health system culture and doctors' individual practice styles influence the kind of care patients get, she says. In addition, patients may not have given thought to the specifics of what they want, or told family members. So while family members resolve any conflicts between themselves, the patient continues to receive treatments. While everyone is well-intentioned, she says, the end result is care that often exceeds what patients would want.\u003c/p>\n\u003cp>So what's a person who wants a gentle death to do? First, really reflect on what matters to you the most, says Periyakoil. Is it most important that you die at home, with family? What forms of medical care do you really not want to endure?\u003c/p>\n\u003cp>Then you need to talk about your wishes with your family members or anyone else who might be making decisions when you no longer can. (The Conversation Project is an effort to promote these types of \u003ca href=\"http://www.npr.org/2013/12/28/257822206/helping-families-have-the-most-difficult-conversation\" target=\"_blank\">difficult but important discussions\u003c/a>.) Put your preferences in writing, using an \u003ca href=\"http://www.nlm.nih.gov/medlineplus/advancedirectives.html\" target=\"_blank\">advance directive\u003c/a> and, for people who are aware that they soon may die, a \u003ca href=\"http://www.polst.org\" target=\"_blank\">Physician Order for Life-Sustaining Treatment, or POLST\u003c/a>, form. Make your wishes known to your medical team, she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It's also important to revisit your advance directive periodically to make sure it's still in line with what you want, and be sure to keep your family members posted on any changes.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19209\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005.jpg\">\u003cimg class=\"size-large wp-image-19209\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #111111\">\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/05/21/314586804/anxiety-and-mris-may-be-driving-the-rise-in-double-mastectomies\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp style=\"color: #111111\">The number of women getting double mastectomies after a breast cancer diagnosis has been rising in the past 10 years, even though most of them don't face a higher risk of getting cancer in the other breast.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003cspan style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy had no risk factors that would make it more likely that they would get breast cancer again.\u003c/span>\u003c/aside>\n\u003cp style=\"color: #111111\">That has cancer doctors troubled, because for those women having the other breast removed doesn't reduce their risk of getting breast cancer again or increase their odds of survival. And they don't know why women are making this choice.\u003c/p>\n\u003cp style=\"color: #111111\">Worry about the cancer coming back is one of the biggest reasons, according to a study of women in California and Michigan that tried to figure out which women decided on a double mastectomy, and why.\u003c/p>\n\u003cp style=\"color: #111111\">Women who had a breast MRI were more likely to decide on a double mastectomy, even if the scan didn't show more cancer.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp style=\"color: #111111\">\"Usually there's something on the image that can't be fully explained,\" says \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://www.med.umich.edu/cansort/bio_hawley.html\">Sarah Hawley\u003c/a>, an associate professor at the University of Michigan and lead author of the \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=1873911\">study\u003c/a>, which was published Wednesday in\u003cem> JAMA Surgery\u003c/em>. \"The thing that shows up on the MRI may well be nothing, but it's really difficult to know that you saw something unusual and then not worry about it.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley and her colleagues looked at 1,447 women who were diagnosed with breast cancer in one breast from 2005 to 2007 or from 2009 to 2010. In all, 19 percent of the women seriously considered having a double mastectomy, and almost 8 percent of them decided to have that surgery.\u003c/p>\n\u003cp style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy — 69 percent — had no genetic or family risk factors that would make it more likely that they would get breast cancer again.\u003c/p>\n\u003cp style=\"color: #111111\">Women with more education were more likely to choose double mastectomy, the study found, as were women who had had genetic testing, even if the results came back showing they had no increased risk.\u003c/p>\n\u003cp style=\"color: #111111\">That surprised Hawley; she thought women who got good news on a genetic test would be less likely to then have a prophylactic mastectomy. She doesn't know if simply having a genetic test is enough to get women thinking seriously about double mastectomy, or if they're making the decision before they get the results back.\u003c/p>\n\u003cp style=\"color: #111111\">Hawley studies how patients make decisions about cancer treatment and says this study raises a big question: Are women not understanding the risk information that doctors communicate, or do they understand and decide to go ahead with the surgery anyway?\u003c/p>\n\u003cp style=\"color: #111111\">\"I think the answer is both are going on,\" Hawley says. \"Women are hearing the message but not completely understanding. Risk information is difficult to convey and understand, especially when you're getting a cancer diagnosis. And even when women understand, they are choosing to go ahead.\"\u003c/p>\n\u003cp style=\"color: #111111\">Most women won't lower their risk of cancer by getting a double mastectomy because their risk of getting breast cancer again was already very low. And removing the noncancerous breast doesn't affect the survival rate from the existing cancer.\u003c/p>\n\u003cp style=\"color: #111111\">For women who don't have a family history of breast cancer or the BRCA genetic mutations, other cancer treatments, including lumpectomy and single mastectomy, can improve a woman's chances just as much as double mastectomy, Hawley says.\u003c/p>\n\u003cp style=\"color: #111111\">\"Not feeling like double mastectomy is the only thing you can do to 'do everything possible' would be a good thing to get out there,\" she adds. \"it seems like there's pressure to consider it now, and if you don't do it you're not doing everything possible.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley is testing a decision tool aimed to help women weigh their choices for breast cancer treatment and hopes that it will help reduce the anxiety that comes with a cancer diagnosis and the difficult decisions that follow.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"FnFrgdHm3CmxNVXNNmsSOH7vmlTadUe4\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp style=\"color: #111111\">\"Usually there's something on the image that can't be fully explained,\" says \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://www.med.umich.edu/cansort/bio_hawley.html\">Sarah Hawley\u003c/a>, an associate professor at the University of Michigan and lead author of the \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=1873911\">study\u003c/a>, which was published Wednesday in\u003cem> JAMA Surgery\u003c/em>. \"The thing that shows up on the MRI may well be nothing, but it's really difficult to know that you saw something unusual and then not worry about it.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley and her colleagues looked at 1,447 women who were diagnosed with breast cancer in one breast from 2005 to 2007 or from 2009 to 2010. In all, 19 percent of the women seriously considered having a double mastectomy, and almost 8 percent of them decided to have that surgery.\u003c/p>\n\u003cp style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy — 69 percent — had no genetic or family risk factors that would make it more likely that they would get breast cancer again.\u003c/p>\n\u003cp style=\"color: #111111\">Women with more education were more likely to choose double mastectomy, the study found, as were women who had had genetic testing, even if the results came back showing they had no increased risk.\u003c/p>\n\u003cp style=\"color: #111111\">That surprised Hawley; she thought women who got good news on a genetic test would be less likely to then have a prophylactic mastectomy. She doesn't know if simply having a genetic test is enough to get women thinking seriously about double mastectomy, or if they're making the decision before they get the results back.\u003c/p>\n\u003cp style=\"color: #111111\">Hawley studies how patients make decisions about cancer treatment and says this study raises a big question: Are women not understanding the risk information that doctors communicate, or do they understand and decide to go ahead with the surgery anyway?\u003c/p>\n\u003cp style=\"color: #111111\">\"I think the answer is both are going on,\" Hawley says. \"Women are hearing the message but not completely understanding. Risk information is difficult to convey and understand, especially when you're getting a cancer diagnosis. And even when women understand, they are choosing to go ahead.\"\u003c/p>\n\u003cp style=\"color: #111111\">Most women won't lower their risk of cancer by getting a double mastectomy because their risk of getting breast cancer again was already very low. And removing the noncancerous breast doesn't affect the survival rate from the existing cancer.\u003c/p>\n\u003cp style=\"color: #111111\">For women who don't have a family history of breast cancer or the BRCA genetic mutations, other cancer treatments, including lumpectomy and single mastectomy, can improve a woman's chances just as much as double mastectomy, Hawley says.\u003c/p>\n\u003cp style=\"color: #111111\">\"Not feeling like double mastectomy is the only thing you can do to 'do everything possible' would be a good thing to get out there,\" she adds. \"it seems like there's pressure to consider it now, and if you don't do it you're not doing everything possible.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley is testing a decision tool aimed to help women weigh their choices for breast cancer treatment and hopes that it will help reduce the anxiety that comes with a cancer diagnosis and the difficult decisions that follow.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"FnFrgdHm3CmxNVXNNmsSOH7vmlTadUe4\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19193\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682.jpg\">\u003cimg class=\"size-large wp-image-19193\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682-640x368.jpg\" alt=\"A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.\u003c/p>\n\u003cp>A new bird flu strain -- H7N9 -- emerged in March, 2013, World Health Organization \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china\" target=\"_blank\">report\u003c/a> 400 deaths since last April, most of them in Asia.\u003c/p>\n\u003cp>Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.\u003c/p>\n\u003cp>In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination -- 6 months instead of 9 -- would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleID=1872847\" target=\"_blank\">Annals of Internal Medicine\u003c/a> this week.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Influenza is a virus that changes its structure frequently. These subtle changes allow the virus to evade the human immune system and result in repetitive flu outbreaks. This is why each year we have to get a new flu shot.\u003c/p>\n\u003cp>Occasionally, the flu virus undergoes a major shift in its structure, allowing a strain that normally infects only animals to make the jump to humans. These major changes make the virus so unique that our immune systems cannot recognize and fight the virus -- meaning higher rates of infection and potentially causing a large regional or global pandemic.\u003c/p>\n\u003cp>The backbone of the U.S. Centers of Disease Control and Prevention’s response to an influenza pandemic is to develop and distribute an appropriate vaccine. Currently, flu vaccines are egg-based and require months for manufacturers to optimize growth conditions and produce vaccines.\u003c/p>\n\u003cp>\u003cspan>“Best-case scenario: egg-based vaccine delivery is completed in 5 months”, said Dr. Nayer Khazeni, lead author and assistant professor of medicine at the Stanford University School of Medicine. Moving toward new technologies \"can decrease this time by 2-3 months.\" \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Public Health Measures Can Save Lives in Pandemic\u003c/strong>\u003c/p>\n\u003cp>Still, regardless of the method of vaccine development, there will be a delay from the time a virus appears to delivery of a vaccine. During this time period, public health officials can limit the spread of the virus, the researchers said, possibly through school and childcare closures or even voluntary isolation. But, isolating the population until vaccines are delivered may not be practical or safe. The economic fallout alone could be detrimental.\u003c/p>\n\u003cp>The study found that a 33 percent decrease in contacts with infected individuals would save as many lives and reduce cost similar to vaccinating the population at 4 months into a pandemic. This could result in saving over 11,400 deaths and about $3.8 billion in health care costs compared to vaccinating at 9 months as in the 2009 flu pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"font-style: inherit;color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca style=\"font-weight: bold;color: #114999\" href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19193\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682.jpg\">\u003cimg class=\"size-large wp-image-19193\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682-640x368.jpg\" alt=\"A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.\u003c/p>\n\u003cp>A new bird flu strain -- H7N9 -- emerged in March, 2013, World Health Organization \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china\" target=\"_blank\">report\u003c/a> 400 deaths since last April, most of them in Asia.\u003c/p>\n\u003cp>Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.\u003c/p>\n\u003cp>In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination -- 6 months instead of 9 -- would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleID=1872847\" target=\"_blank\">Annals of Internal Medicine\u003c/a> this week.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Influenza is a virus that changes its structure frequently. These subtle changes allow the virus to evade the human immune system and result in repetitive flu outbreaks. This is why each year we have to get a new flu shot.\u003c/p>\n\u003cp>Occasionally, the flu virus undergoes a major shift in its structure, allowing a strain that normally infects only animals to make the jump to humans. These major changes make the virus so unique that our immune systems cannot recognize and fight the virus -- meaning higher rates of infection and potentially causing a large regional or global pandemic.\u003c/p>\n\u003cp>The backbone of the U.S. Centers of Disease Control and Prevention’s response to an influenza pandemic is to develop and distribute an appropriate vaccine. Currently, flu vaccines are egg-based and require months for manufacturers to optimize growth conditions and produce vaccines.\u003c/p>\n\u003cp>\u003cspan>“Best-case scenario: egg-based vaccine delivery is completed in 5 months”, said Dr. Nayer Khazeni, lead author and assistant professor of medicine at the Stanford University School of Medicine. Moving toward new technologies \"can decrease this time by 2-3 months.\" \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Public Health Measures Can Save Lives in Pandemic\u003c/strong>\u003c/p>\n\u003cp>Still, regardless of the method of vaccine development, there will be a delay from the time a virus appears to delivery of a vaccine. During this time period, public health officials can limit the spread of the virus, the researchers said, possibly through school and childcare closures or even voluntary isolation. But, isolating the population until vaccines are delivered may not be practical or safe. The economic fallout alone could be detrimental.\u003c/p>\n\u003cp>The study found that a 33 percent decrease in contacts with infected individuals would save as many lives and reduce cost similar to vaccinating the population at 4 months into a pandemic. This could result in saving over 11,400 deaths and about $3.8 billion in health care costs compared to vaccinating at 9 months as in the 2009 flu pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"font-style: inherit;color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca style=\"font-weight: bold;color: #114999\" href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong> \u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_19084\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/FatRats-e1400005363707.jpg\">\u003cimg class=\"size-large wp-image-19084\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/FatRats-640x428.jpg\" alt=\"UCLA psychology professor Aaron Blaisdell studied what happened to rats when they were fed a junk food diet. (Photo/Chris Richard)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCLA psychology professor Aaron Blaisdell studied what happened to rats when they were fed a junk food diet. (Photo/Chris Richard)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Chris Richard\u003c/strong>\u003c/p>\n\u003cp>A new UCLA psychology study has found evidence that being overweight may make people tired and then become more sedentary, not the other way around.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The rats on the junk food diet rested nearly twice as long as the lean rats. \u003c/aside>\n\u003cp> Researchers got the proof from testing rats, whose physiology is similar to that of human beings.\u003c/p>\n\u003cp>A team led by psychology professor Aaron Blaisdell of \u003ca href=\"http://www.bri.ucla.edu/\">UCLA's Brain Research Institute\u003c/a> put one group of 16 rats on the standard lab diet, largely ground corn, wheat, soybean and fish meal. A second group got a highly processed and refined diet, with casein as the main protein source, soybean oil, sugar and a little starch: a rat’s version of junk food.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It may be no surprise that after three months, the junk food eaters got fat.\u003c!--more-->\u003c/p>\n\u003cp>But what did strike the researchers is that as the rats gained weight, they lost energy. And they didn’t regain their verve when they started getting healthier food.\u003c/p>\n\u003cp>The study started with a long period of differentiating the animals’ diets and monitoring their weight. After six months, Blaisdell’s team started setting giving them tasks to perform.\u003c/p>\n\u003cp>Each rat was placed in a box with a lever that opened a little compartment. At first, the animals had to learn to press the lever to open the compartment and get a drink of sugar water, Blaisdell said. When all the rats had mastered that trick, the researchers made it harder, requiring three presses to open the compartment. Next, researchers demanded progressively more: three presses for the first treat, six for the second, nine for the third and so on.\u003c/p>\n\u003cp>“At a certain point, you’re going to say, ‘It isn’t worth it. I give up.’ And the question was, when would the rats give up?” Blaisdell said.\u003c/p>\n\u003cp>Even though all the rats had had their rations cut and were demonstrably hungry when the half-hour long testing sessions began, the fat animals showed little heart for getting the compartment open. The rats on the junk food diet rested nearly twice as long as the lean rats\u003cstrong> before r\u003c/strong>esuming their attempts to get at the sugar water, Blaisdell said.\u003c/p>\n\u003cp>An Australian study had noted that when rats lived on the kinds of foods typically served in cafeterias, the parts of their brains that control appetite degraded, but they started to recover when the animals got healthier food over a period of nine days.\u003c/p>\n\u003cp>Blaisdell thought the something similar would happen with his test subjects when he switched their diets around. But it didn’t.\u003c/p>\n\u003cp>Even on the healthier diets, the fat rats continued to have trouble sticking to their tasks, and they didn’t lose weight. Likewise, placing the lean rats on the junk food diet for nine days didn't increase their weight noticeably or impair their determination to get at the sugar treats.\u003c/p>\n\u003cp>This suggests that a long-running junk food diet causes the most physical and mental harm, not just the occasional binge, Blaisdell said. And the findings suggest that diet-induced obesity is a cause, not an effect, of lethargy.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"8DIq8xzgzJUQuXz3BqsiZOrMfoyqqqA3\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It may be no surprise that after three months, the junk food eaters got fat.\u003c!--more-->\u003c/p>\n\u003cp>But what did strike the researchers is that as the rats gained weight, they lost energy. And they didn’t regain their verve when they started getting healthier food.\u003c/p>\n\u003cp>The study started with a long period of differentiating the animals’ diets and monitoring their weight. After six months, Blaisdell’s team started setting giving them tasks to perform.\u003c/p>\n\u003cp>Each rat was placed in a box with a lever that opened a little compartment. At first, the animals had to learn to press the lever to open the compartment and get a drink of sugar water, Blaisdell said. When all the rats had mastered that trick, the researchers made it harder, requiring three presses to open the compartment. Next, researchers demanded progressively more: three presses for the first treat, six for the second, nine for the third and so on.\u003c/p>\n\u003cp>“At a certain point, you’re going to say, ‘It isn’t worth it. I give up.’ And the question was, when would the rats give up?” Blaisdell said.\u003c/p>\n\u003cp>Even though all the rats had had their rations cut and were demonstrably hungry when the half-hour long testing sessions began, the fat animals showed little heart for getting the compartment open. The rats on the junk food diet rested nearly twice as long as the lean rats\u003cstrong> before r\u003c/strong>esuming their attempts to get at the sugar water, Blaisdell said.\u003c/p>\n\u003cp>An Australian study had noted that when rats lived on the kinds of foods typically served in cafeterias, the parts of their brains that control appetite degraded, but they started to recover when the animals got healthier food over a period of nine days.\u003c/p>\n\u003cp>Blaisdell thought the something similar would happen with his test subjects when he switched their diets around. But it didn’t.\u003c/p>\n\u003cp>Even on the healthier diets, the fat rats continued to have trouble sticking to their tasks, and they didn’t lose weight. Likewise, placing the lean rats on the junk food diet for nine days didn't increase their weight noticeably or impair their determination to get at the sugar treats.\u003c/p>\n\u003cp>This suggests that a long-running junk food diet causes the most physical and mental harm, not just the occasional binge, Blaisdell said. And the findings suggest that diet-induced obesity is a cause, not an effect, of lethargy.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"8DIq8xzgzJUQuXz3BqsiZOrMfoyqqqA3\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19079\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/paul-w-locke/3849016443/in/photolist-6S8dut-9LRutM-8YmHem-aqg2sC-2ywFK8-dN2e9b-7GBePg-aDSwEo-csMBNC-9hE4j9-9wpRd5-c13yB3-deUPez-8nBLgJ-cfnnEJ-8kzYzM-7Mq3bq-dY7ZM-aowdxy-aaxMY2-au3E95-3dYZDg-aoxi41-7MoDtw-38GR1K-sGdyV-ayHQqr-NPBY2-co2oo5-4Q2oj6-cDEo3G-8GhAtS-3eic6B-bCdCg3-9uFCg3-6HStro-24erFm-atZDXa-7Uoh4A-egGgUo-9cqkMP-atZVS2-aE8cc9-2kFZqA-atZF1T-dd77vL-3GrytX-avLrhK-ftbWhj-9Latke\">\u003cimg class=\"size-large wp-image-19079\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/3849016443_b0c6b90277_b-640x426.jpg\" alt=\"Emotional symptoms such as frustration, and sleep difficulty can start more than a week after the initial injury and may be a sign of more serious concussion. (Paul-W/Flickr) \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While headaches and fatigue are the most common concussion symptoms, nearly one in five patients may also suffer emotional symptoms. (Paul-W/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>That big hit your child took on the football field was over a week ago. He says his headaches are gone -- but he’s just not himself. He can’t sleep and he just snapped back at you when you asked him how he was doing. You wonder if this is just normal teenager behavior or a sign of the concussion.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Frustration, irritability, and sleep difficulty a week or more after injury may signal a more serious concussion.\u003c/aside>\n\u003cp>Concussions are diagnosed by physical symptoms like headaches, dizziness, difficulty thinking clearly, or fatigue after a head injury. But those physical symptoms may evolve into emotional symptoms during the days and weeks after an injury according to \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/05/07/peds.2014-0158.abstract\" target=\"_blank\">a study \u003c/a>published Monday in the journal \u003cem>Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Yes, headaches and fatigue were the most common symptoms immediately following a concussion, according to researchers at Harvard Medical School. But emotional symptoms such as frustration, irritability, restlessness, and sleep difficulty were seen in up to 17 percent of patients a week or more after injury and may be a marker of a more serious concussion.\u003c!--more-->\u003c/p>\n\u003cp>The study followed 235 patients, ages 11-22 years old, at their initial visit to the emergency department for a concussion and then for 12 weeks following their concussion.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“For individuals who have a prolonged recovery [greater than 14 days], emotional or behavioral symptoms tend to occur later and may reflect different pathophysiology,” said Dr. Christopher Giza in an email. He's a pediatric neurologist at UCLA's David Geffen School of Medicine.\u003c/p>\n\u003cp>Dr. Michael Collins, a neuropsychologist and executive director of the University of Pittsburgh Sports Medicine Concussion Program, also believes that concussions with emotional symptoms may represent a unique subset of patients who have concussion. In particular, he believes that this kind of concussion is the result of injury to the nervous system that assists in balance and coordination. the vestibular system.\u003c/p>\n\u003cp>Dr. Collins says that some of the research suggests that there are unusual processes in the system the helps with balance and coordination -- what doctors call the vestibular system -- \"that may provoke emotional changes following concussions.\" He said that preliminary research suggests that rehabilitation for the vestibular system may help people recover from these unusual symptoms.\u003c/p>\n\u003cp>This \"vestibular rehabilitation\" involves graduated exercises focused on coordination and balance. Although vestibular rehabilitation is promising, more research must be done. Today, the mainstay treatment for concussions remains a short period -- days to weeks -- of \"cognitive rest,\" in effect resting the brain.\u003c/p>\n\u003cp>This kind of rest involves often involves time away from school or work, and other social activities. Although shown to be beneficial, kids must be closely monitored as the components of cognitive rest may also contribute to the development of emotional symptoms later on in recovery.\u003c/p>\n\u003cp>“Cognitive rest is an important component of recovery,\" said Dr. Matthew Eisenberg lead researcher in the study. He's an emergency medicine physician at Boston Children’s Hospital. \"Much like an athlete would avoid jumping on a sprained ankle, there does seem to be a period after which the cost-benefit ratio changes. It is difficult to say when this switch occurs.”\u003c/p>\n\u003cp>The difficulty that many patients with concussions suffer is that unlike ankle injuries there is no cast or crutches to remind others of the injury, which can provoke pressure to return to “normal” in the classroom and athletic field. This social pressure may also contribute to emotional symptoms that develop during recovery.\u003c/p>\n\u003cp>Parents, coaches, and others taking care of patients should have patience during their child’s recovery and keep in mind that all concussions are different and requires close monitoring immediately after the injury, as well as later during recovery.\u003c/p>\n\u003cp>“The biggest takeaway is that while your child may be showing some signs of improvement from the physical symptoms of concussion, it is important to watch out for the late-arriving emotional symptoms,” said Dr. Eisenberg, “The child who is isolating him/herself, exhibiting personality changes, altered sleep behavior, or depressed mood may be experiencing very severe post-concussive symptoms even as his or her headache have resolved.”\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"98QLXKoIsFuO0vSQit7GAMy5ZUuvSEsM\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19079\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/paul-w-locke/3849016443/in/photolist-6S8dut-9LRutM-8YmHem-aqg2sC-2ywFK8-dN2e9b-7GBePg-aDSwEo-csMBNC-9hE4j9-9wpRd5-c13yB3-deUPez-8nBLgJ-cfnnEJ-8kzYzM-7Mq3bq-dY7ZM-aowdxy-aaxMY2-au3E95-3dYZDg-aoxi41-7MoDtw-38GR1K-sGdyV-ayHQqr-NPBY2-co2oo5-4Q2oj6-cDEo3G-8GhAtS-3eic6B-bCdCg3-9uFCg3-6HStro-24erFm-atZDXa-7Uoh4A-egGgUo-9cqkMP-atZVS2-aE8cc9-2kFZqA-atZF1T-dd77vL-3GrytX-avLrhK-ftbWhj-9Latke\">\u003cimg class=\"size-large wp-image-19079\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/3849016443_b0c6b90277_b-640x426.jpg\" alt=\"Emotional symptoms such as frustration, and sleep difficulty can start more than a week after the initial injury and may be a sign of more serious concussion. (Paul-W/Flickr) \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While headaches and fatigue are the most common concussion symptoms, nearly one in five patients may also suffer emotional symptoms. (Paul-W/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>That big hit your child took on the football field was over a week ago. He says his headaches are gone -- but he’s just not himself. He can’t sleep and he just snapped back at you when you asked him how he was doing. You wonder if this is just normal teenager behavior or a sign of the concussion.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Frustration, irritability, and sleep difficulty a week or more after injury may signal a more serious concussion.\u003c/aside>\n\u003cp>Concussions are diagnosed by physical symptoms like headaches, dizziness, difficulty thinking clearly, or fatigue after a head injury. But those physical symptoms may evolve into emotional symptoms during the days and weeks after an injury according to \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/05/07/peds.2014-0158.abstract\" target=\"_blank\">a study \u003c/a>published Monday in the journal \u003cem>Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Yes, headaches and fatigue were the most common symptoms immediately following a concussion, according to researchers at Harvard Medical School. But emotional symptoms such as frustration, irritability, restlessness, and sleep difficulty were seen in up to 17 percent of patients a week or more after injury and may be a marker of a more serious concussion.\u003c!--more-->\u003c/p>\n\u003cp>The study followed 235 patients, ages 11-22 years old, at their initial visit to the emergency department for a concussion and then for 12 weeks following their concussion.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“For individuals who have a prolonged recovery [greater than 14 days], emotional or behavioral symptoms tend to occur later and may reflect different pathophysiology,” said Dr. Christopher Giza in an email. He's a pediatric neurologist at UCLA's David Geffen School of Medicine.\u003c/p>\n\u003cp>Dr. Michael Collins, a neuropsychologist and executive director of the University of Pittsburgh Sports Medicine Concussion Program, also believes that concussions with emotional symptoms may represent a unique subset of patients who have concussion. In particular, he believes that this kind of concussion is the result of injury to the nervous system that assists in balance and coordination. the vestibular system.\u003c/p>\n\u003cp>Dr. Collins says that some of the research suggests that there are unusual processes in the system the helps with balance and coordination -- what doctors call the vestibular system -- \"that may provoke emotional changes following concussions.\" He said that preliminary research suggests that rehabilitation for the vestibular system may help people recover from these unusual symptoms.\u003c/p>\n\u003cp>This \"vestibular rehabilitation\" involves graduated exercises focused on coordination and balance. Although vestibular rehabilitation is promising, more research must be done. Today, the mainstay treatment for concussions remains a short period -- days to weeks -- of \"cognitive rest,\" in effect resting the brain.\u003c/p>\n\u003cp>This kind of rest involves often involves time away from school or work, and other social activities. Although shown to be beneficial, kids must be closely monitored as the components of cognitive rest may also contribute to the development of emotional symptoms later on in recovery.\u003c/p>\n\u003cp>“Cognitive rest is an important component of recovery,\" said Dr. Matthew Eisenberg lead researcher in the study. He's an emergency medicine physician at Boston Children’s Hospital. \"Much like an athlete would avoid jumping on a sprained ankle, there does seem to be a period after which the cost-benefit ratio changes. It is difficult to say when this switch occurs.”\u003c/p>\n\u003cp>The difficulty that many patients with concussions suffer is that unlike ankle injuries there is no cast or crutches to remind others of the injury, which can provoke pressure to return to “normal” in the classroom and athletic field. This social pressure may also contribute to emotional symptoms that develop during recovery.\u003c/p>\n\u003cp>Parents, coaches, and others taking care of patients should have patience during their child’s recovery and keep in mind that all concussions are different and requires close monitoring immediately after the injury, as well as later during recovery.\u003c/p>\n\u003cp>“The biggest takeaway is that while your child may be showing some signs of improvement from the physical symptoms of concussion, it is important to watch out for the late-arriving emotional symptoms,” said Dr. Eisenberg, “The child who is isolating him/herself, exhibiting personality changes, altered sleep behavior, or depressed mood may be experiencing very severe post-concussive symptoms even as his or her headache have resolved.”\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"98QLXKoIsFuO0vSQit7GAMy5ZUuvSEsM\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19022\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818.jpg\">\u003cimg class=\"size-large wp-image-19022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818-640x433.jpg\" alt=\"So common that it will help doctors determine when bleeding is normal, when interveetinon is necessary. (Getty Images)\" width=\"640\" height=\"433\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The researchers hope their findings will help doctors and patients understand what \"normal\" bleeding is during perimenopause. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong> By Jennifer Huber\u003c/strong>\u003c/p>\n\u003cp>I could hear the fear and panic in my friend’s voice over the phone. She was having her period, but bleeding so heavily that she was debating whether to go to the emergency room. Yet she wasn't sure. She wondered if she might be over-reacting, if her experience was simply what happened as a woman approached menopause.\u003c/p>\n\u003caside class=\"pullquote alignleft\">More than three-fourths of women in the study reported periods lasting at least 10 days.\u003c/aside>\n\u003cp>As women get older, their periods can begin to change. This perimenopausal time typically starts when a woman is in her 40s and lasts about four years. (The average age of menopause, when periods stop, is 51.) For some women, the transition means unpredictable, prolonged or heavy bleeding, and that can be frightening. Now new research shows that these changes may be quite normal.\u003c/p>\n\u003cp>In \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12768/abstract%20\" target=\"_blank\">the study\u003c/a>, researchers from across the country, including UC Davis and UCLA, reviewed data from 1,320 women ages 42-52 who kept detailed records of their menstrual cycles over time. The researchers found that instances of heavy or prolonged bleeding were very common.\u003c!--more-->\u003c/p>\n\u003cp>Researchers found the following rates reported at least three times during the 10-year study period:\u003c/p>\n\u003cul>\n\u003cli>78 percent of women: periods lasted at least 10 days\u003c/li>\n\u003cli>67 percent: spotting lasted six or more days\u003c/li>\n\u003cli>35 percent: heavy bleeding lasted three or more days\u003c/li>\n\u003c/ul>\n\u003cp>The report was recently published in \u003cem>BJOG: An International Journal of Obstetrics and Gynaeocology.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"These data confirm that two types of bleeding, longer menses with more days of spotting and heavier menses, occur in most women during the (transition to menopause),\" the authors noted.\u003c/p>\n\u003cp>The researchers used data from the \u003ca href=\"http://www.swanstudy.org/about.asp\" target=\"_blank\">Study of Women’s Health Across the Nation\u003c/a> (SWAN), a study of middle-aged women living in the U.S.\u003c/p>\n\u003cp>The participating women completed daily menstrual calendars and provided information monthly on hormone therapy, gynecological procedures, smoking and physical activity.\u003c/p>\n\u003cp>\u003cstrong>First Major Multi-Racial Study of Its Kind\u003c/strong>\u003c/p>\n\u003cp>This was the first long-term study to include a large population of women of multiple races: African-American, Japanese, Chinese and white. More than half the women in the study were not white. Previous studies were short and mostly limited to white women.\u003c/p>\n\u003cp>Very few differences were seen between races. African-American women were less likely to bleed for 10 or more days or to spot for six or more days compared to white women. And Japanese women were less likely to have three or more days of heavy bleeding compared to white women.\u003c/p>\n\u003cp>The researchers hope that their study will help guide both clinicians and patients, by defining “normal” bleeding patterns for women during midlife.\u003c/p>\n\u003cp>“Women need more descriptive information about the bleeding changes they can expect,” said author and University of Michigan professor Sioban Harlow in \u003ca href=\"http://ns.umich.edu/new/releases/22121-prolonged-and-heavy-bleeding-during-menopause-is-common%20\" target=\"_blank\">a statement\u003c/a>. “We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.”\u003c/p>\n\u003cp>The study was funded by the National Institutes of Health and other federal government health agencies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"HvsaE1friuAlqV5hibJLYCWI5Kne58E1\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19022\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818.jpg\">\u003cimg class=\"size-large wp-image-19022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818-640x433.jpg\" alt=\"So common that it will help doctors determine when bleeding is normal, when interveetinon is necessary. (Getty Images)\" width=\"640\" height=\"433\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The researchers hope their findings will help doctors and patients understand what \"normal\" bleeding is during perimenopause. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong> By Jennifer Huber\u003c/strong>\u003c/p>\n\u003cp>I could hear the fear and panic in my friend’s voice over the phone. She was having her period, but bleeding so heavily that she was debating whether to go to the emergency room. Yet she wasn't sure. She wondered if she might be over-reacting, if her experience was simply what happened as a woman approached menopause.\u003c/p>\n\u003caside class=\"pullquote alignleft\">More than three-fourths of women in the study reported periods lasting at least 10 days.\u003c/aside>\n\u003cp>As women get older, their periods can begin to change. This perimenopausal time typically starts when a woman is in her 40s and lasts about four years. (The average age of menopause, when periods stop, is 51.) For some women, the transition means unpredictable, prolonged or heavy bleeding, and that can be frightening. Now new research shows that these changes may be quite normal.\u003c/p>\n\u003cp>In \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12768/abstract%20\" target=\"_blank\">the study\u003c/a>, researchers from across the country, including UC Davis and UCLA, reviewed data from 1,320 women ages 42-52 who kept detailed records of their menstrual cycles over time. The researchers found that instances of heavy or prolonged bleeding were very common.\u003c!--more-->\u003c/p>\n\u003cp>Researchers found the following rates reported at least three times during the 10-year study period:\u003c/p>\n\u003cul>\n\u003cli>78 percent of women: periods lasted at least 10 days\u003c/li>\n\u003cli>67 percent: spotting lasted six or more days\u003c/li>\n\u003cli>35 percent: heavy bleeding lasted three or more days\u003c/li>\n\u003c/ul>\n\u003cp>The report was recently published in \u003cem>BJOG: An International Journal of Obstetrics and Gynaeocology.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"These data confirm that two types of bleeding, longer menses with more days of spotting and heavier menses, occur in most women during the (transition to menopause),\" the authors noted.\u003c/p>\n\u003cp>The researchers used data from the \u003ca href=\"http://www.swanstudy.org/about.asp\" target=\"_blank\">Study of Women’s Health Across the Nation\u003c/a> (SWAN), a study of middle-aged women living in the U.S.\u003c/p>\n\u003cp>The participating women completed daily menstrual calendars and provided information monthly on hormone therapy, gynecological procedures, smoking and physical activity.\u003c/p>\n\u003cp>\u003cstrong>First Major Multi-Racial Study of Its Kind\u003c/strong>\u003c/p>\n\u003cp>This was the first long-term study to include a large population of women of multiple races: African-American, Japanese, Chinese and white. More than half the women in the study were not white. Previous studies were short and mostly limited to white women.\u003c/p>\n\u003cp>Very few differences were seen between races. African-American women were less likely to bleed for 10 or more days or to spot for six or more days compared to white women. And Japanese women were less likely to have three or more days of heavy bleeding compared to white women.\u003c/p>\n\u003cp>The researchers hope that their study will help guide both clinicians and patients, by defining “normal” bleeding patterns for women during midlife.\u003c/p>\n\u003cp>“Women need more descriptive information about the bleeding changes they can expect,” said author and University of Michigan professor Sioban Harlow in \u003ca href=\"http://ns.umich.edu/new/releases/22121-prolonged-and-heavy-bleeding-during-menopause-is-common%20\" target=\"_blank\">a statement\u003c/a>. “We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.”\u003c/p>\n\u003cp>The study was funded by the National Institutes of Health and other federal government health agencies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"HvsaE1friuAlqV5hibJLYCWI5Kne58E1\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Silicon Valley Health-Tech Wrestles with the FDA",
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"content": "\u003cfigure id=\"attachment_18948\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hongiiv/3129766406/in/photolist-5LySvL-5weVaD-4tHu8p-5LyQXU-5LyQDm-5LuCbn-5LuAcv-5LuC58-5wjffw-5LyPSC-hKsNWb-6Fg42Y-4bG9Qy-9tLWy1-5wjfcw-5LyQds-5LuBmK-5LuBDr-5weV7r-5LuB7Z-5LuBPc-5PbrNx-5LyR5A-4tHu98-5LyQQw-4tHu7T-5PfFv7-5weV8g-5LuAi6-5wjfdy-5LuBui-4fYr81-5HDkKA-8mM5aA-5nLnEy-9yFvui-4nQTup-2wGsW7-4nVtjy-4T1jMh-iEassb-4pdB6y-4oDoyx-CS7Rc-4m61oD-4Yqs7k-czsfKw-d6MJns-5kDcJH-4mzerB\">\u003cimg class=\"size-large wp-image-18948\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3129766406_3f62c12d6a_o-640x426.jpg\" alt=\"The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cp>Health care entrepreneurs are a different breed than most entrepreneurs. Rather than hunkering down to build a cool product, they need to think about regulation and red tape -- right from the start.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Ignoring the FDA and pushing ahead with a product is not a viable option. \u003c/aside>\n\u003cp>As boring as it may sound, health-tech founders need to develop a relationship with the U.S. Food and Drug Administration (FDA). This process might drag on for some time, as this authority has the unenviable job of overseeing an explosion of \u003ca href=\"http://mobihealthnews.com/28361/rock-health-1-97b-invested-in-digital-health-startups-in-2013/\" target=\"_blank\">new medical technology\u003c/a>, whether it’s a new electronic health record or a device that turns your smartphone into an ear scope.\u003c/p>\n\u003cp>As the recent \u003ca href=\"http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/ucm376296.htm\" target=\"_blank\">enforcement action\u003c/a> against genetic testing firm 23andMe demonstrated, ignoring the FDA and pushing ahead with a product is \u003ca href=\"http://venturebeat.com/2014/03/12/23andme-ceo-we-need-to-return-to-delivering-health-information/\" target=\"_blank\">not a viable option\u003c/a>.\u003c/p>\n\u003cp>In recent years, Silicon Valley's entrepreneurs have become increasingly critical, attacking the agency's antiquated processes in a string of interviews and \u003ca href=\"http://www.usatoday.com/story/opinion/2014/02/15/fischer-king-health-information-technology/5464693/\" target=\"_blank\">op-eds\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There is this perceived myth that the FDA will change its mind on a dime,” said Ellie Cachette, an entrepreneur and health advocate who has served on a number of committee boards for the National Institutes of Health.\u003c/p>\n\u003cp>The crux of the problem is a mismatch of priorities.\u003c/p>\n\u003cp>The FDA's chief mandate is to \u003ca href=\"http://www.fda.gov/aboutfda/transparency/basics/ucm194877.htm\" target=\"_blank\">protect public health\u003c/a>, but some (perhaps many) entrepreneurs fear that it’s under-resourced, overwhelmed, and a roadblock to life-saving innovation. Life sciences-focused venture capitalists say the FDA is prone to delays and abrupt policy changes, making health care a precarious bet.\u003c/p>\n\u003cp>“The first cause of death for our startups is a lack of capital, and if investors aren’t confident that they can scale the FDA hurdles, they simply won’t invest,” said Kyra Davis, a program manager at the Entrepreneurship Center at UCSF, who works closely with budding health-tech entrepreneurs.\u003c/p>\n\u003cp>Life sciences startups are in a particularly tough spot, with investment in a downward spiral. (Note: The picture looked a bit rosier in the first quarter of 2014, in part due to a few successful \u003ca href=\"http://medcitynews.com/2014/04/biotech-attracts-1b-in-venture-capital-funding-medical-device-deal-size-trends-higher/\" target=\"_blank\">recent biotech IPOs\u003c/a>.)\u003c/p>\n\u003cp>Whether it’s justified or not, the FDA is often cited by health investors as the reason for this decline.\u003c/p>\n\u003cp>“We have been pushing the FDA on how difficult it is to get products approved,” said Michael Carusi, a general partner at \u003ca href=\"http://www.atvcapital.com/\">ATV Capital\u003c/a>, in an interview for a series I wrote in April, 2013 for \u003cem>VentureBeat\u003c/em> on Silicon Valley’s perceptions of the FDA.\u003c/p>\n\u003cp>\u003ca href=\"http://venturebeat.com/2013/04/30/stifled-by-regulation-entrepreneurs-take-life-saving-devices-overseas/\">For that article,\u003c/a> the FDA responded that it is doing its best with entrepreneurs and VCs to “develop smart regulation that balance patient safety and innovation.”\u003c/p>\n\u003cp>\u003cstrong>Tension Between Protecting Public Health and Regulating Innovation\u003c/strong>\u003c/p>\n\u003cp>The FDA’s crack down on 23andMe last November prompted health entrepreneurs to quake in their boots and angry Internet commentators to rail against \"Big Government.\" In February, Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska) \u003ca href=\"http://venturebeat.com/2014/02/26/new-digital-health-bill-proposes-to-undermine-the-fda-draws-mixed-reactions/\" target=\"_blank\">proposed a bill \u003c/a>in Congress to prevent the agency from regulating “low risk” health IT altogether.\u003c/p>\n\u003cp>But the FDA has stepped up in one important regard. After demurring for several months, it released its \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm\" target=\"_blank\">final guidance\u003c/a> on how it plans to regulate the explosion in mobile medical technology, a particularly trendy space. Most mobile medical apps do not require federal regulation, the FDA found, so developers and investors could breathe a bit easier.\u003c/p>\n\u003cp>According to John Wilson, a health policy expert and advisor to the \u003ca href=\"http://www.newmeaccelerator.com/\" target=\"_blank\">NewMe startup accelerator\u003c/a>, the FDA is doing its job and doesn’t deserve the bad rep.\u003c/p>\n\u003cp>“Entrepreneurs have a tendency to over-promise and under-deliver. But in health care, people’s lives are at stake,” he explained.\u003c/p>\n\u003cp>“When the company doesn’t work out, the FDA is often blamed. Startups are looking for a fall guy.\"\u003c/p>\n\u003cp>While Wilson believes in a “checks and balancing” body like the FDA, he does admit that the agency has plenty of work to do.\u003c/p>\n\u003cp>It’s a boom time for technology, and some of it is genuinely breaking new ground. It will take some time to determine whether this new tech is potentially harmful, and how it should be classified. For instance, it’s a matter of ongoing debate among geneticists and lawyers whether 23andMe should have been treated as a medical device. This field of consumer genetic reporting is nascent, making it a particularly problematic area for the FDA.\u003c/p>\n\u003cp>Meanwhile, Silicon Valley expects to move quickly -- and doesn’t respond well to hesitation and delays.\u003c/p>\n\u003cp>“The pendulum swings with the FDA -- or at least it has in my 25 years,” added Joe Kiani, chief executive of California-based Masimo Corp., a medical technology company that was founded in 1989 and went public in 2007.\u003c/p>\n\u003cp>“Sometimes, the agency can be very difficult, and other times it’s easy and formulaic. Right now, it’s one of those difficult periods.”\u003c/p>\n\u003cp>\u003cstrong>\"Don't View the FDA As This Scary Thing\"\u003c/strong>\u003c/p>\n\u003cp>Even those who are sympathetic to the FDA would admit that the regulatory processes are no small matter.\u003c/p>\n\u003cp>Amy Sheng, founder of a company that develops a low-risk medical device, estimates that it required \"hundreds of thousands of dollars\" and a “truck-load” of paperwork to implement a full quality system.\u003c/p>\n\u003cp>Sheng hired several consultants to navigate legislation, as well as a few key employees. She advises health-tech entrepreneurs to raise significant funding at the outset -- and bring the right set of legal and quality assurance experts on board.\u003c/p>\n\u003cp>\"I've been speaking the medical device language my whole career, so I don't view the FDA as this scary thing,\" said Sheng. \"Just keep in mind that the agency's mission is to protect patients and make sure your product is safe and accurate.\"\u003c/p>\n\u003cp>Meanwhile, Malay Gandhi, chief strategy officer at digital health accelerator \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>, would advise entrepreneurs to take a deep breath and relax. He has a far more optimistic view about regulatory processes, and doesn’t believe that the FDA is \"out to get” health entrepreneurs.\u003c/p>\n\u003cp>“There is some level of fear but the process is well defined and you can get through it,” he said. “There are countless numbers of people who have done it already.”\u003c/p>\n\u003cp>According to Gandhi, the entrepreneurs in Rock Health will often approach the FDA for clarification and typically receive a response within a few weeks. In the past few years, none of the founders were publicly admonished in a similar manner to 23andMe.\u003c/p>\n\u003cp>“At the end of the day, there aren’t that many health companies that are anything like 23andMe,” he added.\u003c/p>\n\u003cp>For those who don’t have the requisite funding, another good option is to take the business overseas.\u003c/p>\n\u003cp>Kiani often advises newcomers to launch their products in Europe first, where regulation is far more predictable. It can take years (and those hundreds of thousands of dollars) for U.S.-based entrepreneurs to gain approval from the FDA -- and in that time, many founders will find success in international markets.\u003c/p>\n\u003cp>“China and Japan and Brazil have their own regulatory difficulties, Japan is a predictable process, but Europe is probably best,” said Kiani. “It’s the fastest way to market.”\u003c/p>\n\u003cp>Ultimately, the experts stress that the FDA is unlikely to pay attention unless something is seriously wrong. Pass the regulatory checks, file the paperwork, do the research, and avoid making overblown statements in marketing to patients.\u003c/p>\n\u003cp>For health entrepreneurs, getting in the FDA’s good graces is money and time well-spent, Walter de Brouwer, founder of Scanadu, a hand-held medical device, told \u003cem>Fast Company.\u003c/em> Despite the efforts of politicians like Senators King and Fisher, the agency is not going anywhere anytime soon, so de Brouwer advises getting in its good graces.\u003c/p>\n\u003cp>“Trying to do something medical and avoiding the FDA, that is a lost battle. It’s like asking the Vatican to become atheist.”\u003c/p>\n\u003cp>\u003cem style=\"color: #1f1f1f\">Christina Farr is a San Francisco-based journalist covering health technology. She previously wrote for Venture Beat, The Bay Citizen and SFGate.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"CNmeBBlBPPwQslZMYMxjOTuOuvmvqRlu\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18948\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hongiiv/3129766406/in/photolist-5LySvL-5weVaD-4tHu8p-5LyQXU-5LyQDm-5LuCbn-5LuAcv-5LuC58-5wjffw-5LyPSC-hKsNWb-6Fg42Y-4bG9Qy-9tLWy1-5wjfcw-5LyQds-5LuBmK-5LuBDr-5weV7r-5LuB7Z-5LuBPc-5PbrNx-5LyR5A-4tHu98-5LyQQw-4tHu7T-5PfFv7-5weV8g-5LuAi6-5wjfdy-5LuBui-4fYr81-5HDkKA-8mM5aA-5nLnEy-9yFvui-4nQTup-2wGsW7-4nVtjy-4T1jMh-iEassb-4pdB6y-4oDoyx-CS7Rc-4m61oD-4Yqs7k-czsfKw-d6MJns-5kDcJH-4mzerB\">\u003cimg class=\"size-large wp-image-18948\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3129766406_3f62c12d6a_o-640x426.jpg\" alt=\"The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cp>Health care entrepreneurs are a different breed than most entrepreneurs. Rather than hunkering down to build a cool product, they need to think about regulation and red tape -- right from the start.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Ignoring the FDA and pushing ahead with a product is not a viable option. \u003c/aside>\n\u003cp>As boring as it may sound, health-tech founders need to develop a relationship with the U.S. Food and Drug Administration (FDA). This process might drag on for some time, as this authority has the unenviable job of overseeing an explosion of \u003ca href=\"http://mobihealthnews.com/28361/rock-health-1-97b-invested-in-digital-health-startups-in-2013/\" target=\"_blank\">new medical technology\u003c/a>, whether it’s a new electronic health record or a device that turns your smartphone into an ear scope.\u003c/p>\n\u003cp>As the recent \u003ca href=\"http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/ucm376296.htm\" target=\"_blank\">enforcement action\u003c/a> against genetic testing firm 23andMe demonstrated, ignoring the FDA and pushing ahead with a product is \u003ca href=\"http://venturebeat.com/2014/03/12/23andme-ceo-we-need-to-return-to-delivering-health-information/\" target=\"_blank\">not a viable option\u003c/a>.\u003c/p>\n\u003cp>In recent years, Silicon Valley's entrepreneurs have become increasingly critical, attacking the agency's antiquated processes in a string of interviews and \u003ca href=\"http://www.usatoday.com/story/opinion/2014/02/15/fischer-king-health-information-technology/5464693/\" target=\"_blank\">op-eds\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There is this perceived myth that the FDA will change its mind on a dime,” said Ellie Cachette, an entrepreneur and health advocate who has served on a number of committee boards for the National Institutes of Health.\u003c/p>\n\u003cp>The crux of the problem is a mismatch of priorities.\u003c/p>\n\u003cp>The FDA's chief mandate is to \u003ca href=\"http://www.fda.gov/aboutfda/transparency/basics/ucm194877.htm\" target=\"_blank\">protect public health\u003c/a>, but some (perhaps many) entrepreneurs fear that it’s under-resourced, overwhelmed, and a roadblock to life-saving innovation. Life sciences-focused venture capitalists say the FDA is prone to delays and abrupt policy changes, making health care a precarious bet.\u003c/p>\n\u003cp>“The first cause of death for our startups is a lack of capital, and if investors aren’t confident that they can scale the FDA hurdles, they simply won’t invest,” said Kyra Davis, a program manager at the Entrepreneurship Center at UCSF, who works closely with budding health-tech entrepreneurs.\u003c/p>\n\u003cp>Life sciences startups are in a particularly tough spot, with investment in a downward spiral. (Note: The picture looked a bit rosier in the first quarter of 2014, in part due to a few successful \u003ca href=\"http://medcitynews.com/2014/04/biotech-attracts-1b-in-venture-capital-funding-medical-device-deal-size-trends-higher/\" target=\"_blank\">recent biotech IPOs\u003c/a>.)\u003c/p>\n\u003cp>Whether it’s justified or not, the FDA is often cited by health investors as the reason for this decline.\u003c/p>\n\u003cp>“We have been pushing the FDA on how difficult it is to get products approved,” said Michael Carusi, a general partner at \u003ca href=\"http://www.atvcapital.com/\">ATV Capital\u003c/a>, in an interview for a series I wrote in April, 2013 for \u003cem>VentureBeat\u003c/em> on Silicon Valley’s perceptions of the FDA.\u003c/p>\n\u003cp>\u003ca href=\"http://venturebeat.com/2013/04/30/stifled-by-regulation-entrepreneurs-take-life-saving-devices-overseas/\">For that article,\u003c/a> the FDA responded that it is doing its best with entrepreneurs and VCs to “develop smart regulation that balance patient safety and innovation.”\u003c/p>\n\u003cp>\u003cstrong>Tension Between Protecting Public Health and Regulating Innovation\u003c/strong>\u003c/p>\n\u003cp>The FDA’s crack down on 23andMe last November prompted health entrepreneurs to quake in their boots and angry Internet commentators to rail against \"Big Government.\" In February, Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska) \u003ca href=\"http://venturebeat.com/2014/02/26/new-digital-health-bill-proposes-to-undermine-the-fda-draws-mixed-reactions/\" target=\"_blank\">proposed a bill \u003c/a>in Congress to prevent the agency from regulating “low risk” health IT altogether.\u003c/p>\n\u003cp>But the FDA has stepped up in one important regard. After demurring for several months, it released its \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm\" target=\"_blank\">final guidance\u003c/a> on how it plans to regulate the explosion in mobile medical technology, a particularly trendy space. Most mobile medical apps do not require federal regulation, the FDA found, so developers and investors could breathe a bit easier.\u003c/p>\n\u003cp>According to John Wilson, a health policy expert and advisor to the \u003ca href=\"http://www.newmeaccelerator.com/\" target=\"_blank\">NewMe startup accelerator\u003c/a>, the FDA is doing its job and doesn’t deserve the bad rep.\u003c/p>\n\u003cp>“Entrepreneurs have a tendency to over-promise and under-deliver. But in health care, people’s lives are at stake,” he explained.\u003c/p>\n\u003cp>“When the company doesn’t work out, the FDA is often blamed. Startups are looking for a fall guy.\"\u003c/p>\n\u003cp>While Wilson believes in a “checks and balancing” body like the FDA, he does admit that the agency has plenty of work to do.\u003c/p>\n\u003cp>It’s a boom time for technology, and some of it is genuinely breaking new ground. It will take some time to determine whether this new tech is potentially harmful, and how it should be classified. For instance, it’s a matter of ongoing debate among geneticists and lawyers whether 23andMe should have been treated as a medical device. This field of consumer genetic reporting is nascent, making it a particularly problematic area for the FDA.\u003c/p>\n\u003cp>Meanwhile, Silicon Valley expects to move quickly -- and doesn’t respond well to hesitation and delays.\u003c/p>\n\u003cp>“The pendulum swings with the FDA -- or at least it has in my 25 years,” added Joe Kiani, chief executive of California-based Masimo Corp., a medical technology company that was founded in 1989 and went public in 2007.\u003c/p>\n\u003cp>“Sometimes, the agency can be very difficult, and other times it’s easy and formulaic. Right now, it’s one of those difficult periods.”\u003c/p>\n\u003cp>\u003cstrong>\"Don't View the FDA As This Scary Thing\"\u003c/strong>\u003c/p>\n\u003cp>Even those who are sympathetic to the FDA would admit that the regulatory processes are no small matter.\u003c/p>\n\u003cp>Amy Sheng, founder of a company that develops a low-risk medical device, estimates that it required \"hundreds of thousands of dollars\" and a “truck-load” of paperwork to implement a full quality system.\u003c/p>\n\u003cp>Sheng hired several consultants to navigate legislation, as well as a few key employees. She advises health-tech entrepreneurs to raise significant funding at the outset -- and bring the right set of legal and quality assurance experts on board.\u003c/p>\n\u003cp>\"I've been speaking the medical device language my whole career, so I don't view the FDA as this scary thing,\" said Sheng. \"Just keep in mind that the agency's mission is to protect patients and make sure your product is safe and accurate.\"\u003c/p>\n\u003cp>Meanwhile, Malay Gandhi, chief strategy officer at digital health accelerator \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>, would advise entrepreneurs to take a deep breath and relax. He has a far more optimistic view about regulatory processes, and doesn’t believe that the FDA is \"out to get” health entrepreneurs.\u003c/p>\n\u003cp>“There is some level of fear but the process is well defined and you can get through it,” he said. “There are countless numbers of people who have done it already.”\u003c/p>\n\u003cp>According to Gandhi, the entrepreneurs in Rock Health will often approach the FDA for clarification and typically receive a response within a few weeks. In the past few years, none of the founders were publicly admonished in a similar manner to 23andMe.\u003c/p>\n\u003cp>“At the end of the day, there aren’t that many health companies that are anything like 23andMe,” he added.\u003c/p>\n\u003cp>For those who don’t have the requisite funding, another good option is to take the business overseas.\u003c/p>\n\u003cp>Kiani often advises newcomers to launch their products in Europe first, where regulation is far more predictable. It can take years (and those hundreds of thousands of dollars) for U.S.-based entrepreneurs to gain approval from the FDA -- and in that time, many founders will find success in international markets.\u003c/p>\n\u003cp>“China and Japan and Brazil have their own regulatory difficulties, Japan is a predictable process, but Europe is probably best,” said Kiani. “It’s the fastest way to market.”\u003c/p>\n\u003cp>Ultimately, the experts stress that the FDA is unlikely to pay attention unless something is seriously wrong. Pass the regulatory checks, file the paperwork, do the research, and avoid making overblown statements in marketing to patients.\u003c/p>\n\u003cp>For health entrepreneurs, getting in the FDA’s good graces is money and time well-spent, Walter de Brouwer, founder of Scanadu, a hand-held medical device, told \u003cem>Fast Company.\u003c/em> Despite the efforts of politicians like Senators King and Fisher, the agency is not going anywhere anytime soon, so de Brouwer advises getting in its good graces.\u003c/p>\n\u003cp>“Trying to do something medical and avoiding the FDA, that is a lost battle. It’s like asking the Vatican to become atheist.”\u003c/p>\n\u003cp>\u003cem style=\"color: #1f1f1f\">Christina Farr is a San Francisco-based journalist covering health technology. She previously wrote for Venture Beat, The Bay Citizen and SFGate.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "California Legislature To Consider Antibiotic Ban in Animals",
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"content": "\u003cfigure id=\"attachment_18838\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit.jpg\">\u003cimg class=\"size-large wp-image-18838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit-640x557.jpg\" alt=\"Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\" width=\"640\" height=\"557\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>A new bill in the California Legislature could give California the distinction of going where the federal government hasn’t — more strictly regulating the way that livestock are given antibiotics.\u003c/p>\n\u003cp>But freshman state Assemblyman Kevin Mullin (D-South San Francisco), who is introducing state Assembly Bill 1437, says getting it through the agricultural committee is a bit of long shot.\u003c/p>\n\u003cp>More than 70 percent of all antibiotics in the U.S. are given to animals, often to healthy livestock. Until very recently drug companies marketed the growth-promoting benefits of antibiotics. And many meat producers, keen for additional profits and assured by pharmaceutical companies that the practice was safe for people and animals, would routinely add antibiotics to feed.\u003c/p>\n\u003cp>In December, the Food and Drug Administration, after years of debate on the issue, asked drug companies to voluntarily stop marketing the growth-promoting benefits of antibiotics out of concerns for public health. The companies are largely complying. But critics like the Natural Resources Defense Council and New York Times food writer \u003ca href=\"http://www.nytimes.com/2013/12/18/opinion/bittman-the-fdas-not-really-such-good-news.html?pagewanted=all&_r=0\" target=\"_blank\">Mark Bittman\u003c/a> have criticized the FDA’s approach as lax and unlikely to lead to any real change.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->There is reason critics are skeptical about how much change is actually happening. The European Union took a similar step banning the use of antibiotics for animal growth promotion back in 2006. A \u003ca href=\"http://www.wageningenur.nl/en/Research-Results/Projects-and-programmes/MARAN-Antibiotic-usage/Trends-in-use-per-species/Antibiotic-usage-in-broilers.htm\" target=\"_blank\">study\u003c/a> of antibiotic use in the Netherlands found that usage actually went up in chickens in the ensuing years. It seems as if chicken ranches and feed lots continued to use antimicrobials at the same rate, but for disease prevention instead of overtly for growth promotion. It wasn’t until 2009 that rates began to tumble when bans on most of those prophylactic uses of antibiotics started to take effect.\u003c/p>\n\u003cp>Like a similar bill that U.S. Sen. Dianne Feinstein (D-Calif.) has been floating for several years, Mullin’s bill seeks to mirror those tougher European standards.\u003c/p>\n\u003cp>On Tuesday, Dr. David Relman, an infectious disease specialist from Stanford University, spoke at a Sacramento press conference in favor of AB 1437. He said he is treating more and more patients who have contracted so-called superbugs. He recalled one case last year that haunts him, a woman with an infection in her bloodstream that was resistant to every known antibiotic. He couldn’t save her.\u003c/p>\n\u003cp>When asked if the prolific use of antibiotics in livestock were really partly to blame for her death, Relman said, “To that particular woman, we can't say. But to many, many woman and men like her, we would have to say the burden of evidence says yes.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146153547&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>That burden of evidence includes some studies that are showing more conclusive evidence of resistant pathogens in animals jumping to people. A recent Johns Hopkins School of Medicine \u003ca href=\"http://www.nature.com/news/pig-manure-fertilizer-linked-to-human-mrsa-infections-1.13752\" target=\"_blank\">examination\u003c/a> found that residents living near a pig farm in Pennsylvania were more likely to become infected with methicillin-resistant Staphylococcus aureus (MRSA) bacteria.\u003c/p>\n\u003cp>The real worry is the unknown. As Relman described it, antimicrobial resistance is a bit like climate change. Every bit of antibiotic overuse can add up to a bigger problem.\u003c/p>\n\u003cp>But Bill Mattos, president of the California Poultry Association, says the health concerns over the use of antibiotics in livestock are being overblown.\u003c/p>\n\u003cp>“Most of the problem comes from doctors overmedicating their patients,\" Mattos said. \"That’s where the problem is because everybody wants antibiotics when they get sick.\"\u003c/p>\n\u003cp>Mattos said he is confident that AB 1437 won’t survive its committee hearing next week because the bill doesn’t have enough supporters. The Poultry Association is backing a competing and more modest bill in the State Senate authored by Jerry Hill (D-San Mateo). Hill’s bill essentially makes the recent FDA’s recommendations mandatory, rather than voluntary in California.\u003c/p>\n\u003cp>Mattos said every year California produces 300 million chickens. Those chickens employ and feed a lot of people.\u003c/p>\n\u003cp>“If you want an antibiotic free product, you can buy it. It says it on the label. Ten to 15 percent of people are looking for antibiotic free, 80 percent don’t care,” Mattos said.\u003c/p>\n\u003cp>On Tuesday, in his assembly office, Mullin — who represents cities in San Mateo County just south of San Francisco — was sounding like a man about to possibly lose a battle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There is no question that in this building, we are in an uphill fight to get this public health issue heard and to have action taken on the bill,\" Mullin said. \"But we remain optimistic and hopeful that as the general public becomes more aware of these concerns, that that will change the political calculus at the state capital.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18838\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit.jpg\">\u003cimg class=\"size-large wp-image-18838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit-640x557.jpg\" alt=\"Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\" width=\"640\" height=\"557\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>A new bill in the California Legislature could give California the distinction of going where the federal government hasn’t — more strictly regulating the way that livestock are given antibiotics.\u003c/p>\n\u003cp>But freshman state Assemblyman Kevin Mullin (D-South San Francisco), who is introducing state Assembly Bill 1437, says getting it through the agricultural committee is a bit of long shot.\u003c/p>\n\u003cp>More than 70 percent of all antibiotics in the U.S. are given to animals, often to healthy livestock. Until very recently drug companies marketed the growth-promoting benefits of antibiotics. And many meat producers, keen for additional profits and assured by pharmaceutical companies that the practice was safe for people and animals, would routinely add antibiotics to feed.\u003c/p>\n\u003cp>In December, the Food and Drug Administration, after years of debate on the issue, asked drug companies to voluntarily stop marketing the growth-promoting benefits of antibiotics out of concerns for public health. The companies are largely complying. But critics like the Natural Resources Defense Council and New York Times food writer \u003ca href=\"http://www.nytimes.com/2013/12/18/opinion/bittman-the-fdas-not-really-such-good-news.html?pagewanted=all&_r=0\" target=\"_blank\">Mark Bittman\u003c/a> have criticized the FDA’s approach as lax and unlikely to lead to any real change.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->There is reason critics are skeptical about how much change is actually happening. The European Union took a similar step banning the use of antibiotics for animal growth promotion back in 2006. A \u003ca href=\"http://www.wageningenur.nl/en/Research-Results/Projects-and-programmes/MARAN-Antibiotic-usage/Trends-in-use-per-species/Antibiotic-usage-in-broilers.htm\" target=\"_blank\">study\u003c/a> of antibiotic use in the Netherlands found that usage actually went up in chickens in the ensuing years. It seems as if chicken ranches and feed lots continued to use antimicrobials at the same rate, but for disease prevention instead of overtly for growth promotion. It wasn’t until 2009 that rates began to tumble when bans on most of those prophylactic uses of antibiotics started to take effect.\u003c/p>\n\u003cp>Like a similar bill that U.S. Sen. Dianne Feinstein (D-Calif.) has been floating for several years, Mullin’s bill seeks to mirror those tougher European standards.\u003c/p>\n\u003cp>On Tuesday, Dr. David Relman, an infectious disease specialist from Stanford University, spoke at a Sacramento press conference in favor of AB 1437. He said he is treating more and more patients who have contracted so-called superbugs. He recalled one case last year that haunts him, a woman with an infection in her bloodstream that was resistant to every known antibiotic. He couldn’t save her.\u003c/p>\n\u003cp>When asked if the prolific use of antibiotics in livestock were really partly to blame for her death, Relman said, “To that particular woman, we can't say. But to many, many woman and men like her, we would have to say the burden of evidence says yes.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146153547&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>That burden of evidence includes some studies that are showing more conclusive evidence of resistant pathogens in animals jumping to people. A recent Johns Hopkins School of Medicine \u003ca href=\"http://www.nature.com/news/pig-manure-fertilizer-linked-to-human-mrsa-infections-1.13752\" target=\"_blank\">examination\u003c/a> found that residents living near a pig farm in Pennsylvania were more likely to become infected with methicillin-resistant Staphylococcus aureus (MRSA) bacteria.\u003c/p>\n\u003cp>The real worry is the unknown. As Relman described it, antimicrobial resistance is a bit like climate change. Every bit of antibiotic overuse can add up to a bigger problem.\u003c/p>\n\u003cp>But Bill Mattos, president of the California Poultry Association, says the health concerns over the use of antibiotics in livestock are being overblown.\u003c/p>\n\u003cp>“Most of the problem comes from doctors overmedicating their patients,\" Mattos said. \"That’s where the problem is because everybody wants antibiotics when they get sick.\"\u003c/p>\n\u003cp>Mattos said he is confident that AB 1437 won’t survive its committee hearing next week because the bill doesn’t have enough supporters. The Poultry Association is backing a competing and more modest bill in the State Senate authored by Jerry Hill (D-San Mateo). Hill’s bill essentially makes the recent FDA’s recommendations mandatory, rather than voluntary in California.\u003c/p>\n\u003cp>Mattos said every year California produces 300 million chickens. Those chickens employ and feed a lot of people.\u003c/p>\n\u003cp>“If you want an antibiotic free product, you can buy it. It says it on the label. Ten to 15 percent of people are looking for antibiotic free, 80 percent don’t care,” Mattos said.\u003c/p>\n\u003cp>On Tuesday, in his assembly office, Mullin — who represents cities in San Mateo County just south of San Francisco — was sounding like a man about to possibly lose a battle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There is no question that in this building, we are in an uphill fight to get this public health issue heard and to have action taken on the bill,\" Mullin said. \"But we remain optimistic and hopeful that as the general public becomes more aware of these concerns, that that will change the political calculus at the state capital.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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"tagline": "True-life supernatural stories",
"info": "",
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