Month: May 2020

‘How Could the CDC Make That Mistake?’ The Atlantic

Two swabs forming an ex

The government’s disease-fighting agency is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies. Pennsylvania, Georgia, Texas, and other states are doing the same.

Editor’s Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here.

The Centers for Disease Control and Prevention is conflating the results of two different types of coronavirus tests, distorting several important metrics and providing the country with an inaccurate picture of the state of the pandemic. We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus. The upshot is that the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19. The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons.

This is not merely a technical error. States have set quantitative guidelines for reopening their economies based on these flawed data points.Several states—including Pennsylvania, the site of one of the country’s largest outbreaks, as well as Texas, Georgia, and Vermont—are blending the data in the same way. Virginia likewise mixed viral and antibody test results until last week, but it reversed course and the governor apologized for the practice after it was covered by the Richmond Times-Dispatch and The Atlantic. Maine similarly separated its data on Wednesday; Vermont authorities claimed they didn’t even know they were doing this.

The widespread use of the practice means that it remains difficult to know exactly how much the country’s ability to test people who are actively sick with COVID-19 has improved.

“You’ve got to be kidding me,” Ashish Jha, the K. T. Li Professor of Global Health at Harvard and the director of the Harvard Global Health Institute, told us when we described what the CDC was doing. “How could the CDC make that mistake? This is a mess.”

Viral tests, taken by nose swab or saliva sample, look for direct evidence of a coronavirus infection. They are considered the gold standard for diagnosing someone with COVID-19, the disease caused by the virus: State governments consider a positive viral test to be the only way to confirm a case of COVID-19. Antibody tests, by contrast, use blood samples to look for biological signals that a person has been exposed to the virus in the past.

A negative test result means something different for each test. If somebody tests negative on a viral test, a doctor can be relatively confident that they are not sick right now; if somebody tests negative on an antibody test, they have probably never been infected with or exposed to the coronavirus. (Or they may have been given a false result—antibody tests are notoriously less accurate on an individual level than viral tests.) The problem is that the CDC is clumping negative results from both tests together in its public reporting.

Mixing the two tests makes it much harder to understand the meaning of positive tests, and it clouds important information about the U.S. response to the pandemic, Jha said. “The viral testing is to understand how many people are getting infected, while antibody testing is like looking in the rearview mirror. The two tests are totally different signals,” he told us. By combining the two types of results, the CDC has made them both “uninterpretable,” he said.

The public-radio station WLRN, in Miami, first reported that the CDC was mixing viral and antibody test results. Pennsylvania’s and Maine’s decisions to mix the two tests have not been previously reported.

Kristen Nordlund, a spokesperson for the CDC, told us that the inclusion of antibody data in Florida is one reason the CDC has reported hundreds of thousands more tests in Florida than the state government has. The agency hopes to separate the viral and antibody test results in the next few weeks, she said in an email.

But until the agency does so, its results will be suspect and difficult to interpret, says William Hanage, an epidemiology professor at Harvard. In addition to misleading the public about the state of affairs, the intermingling “makes the lives of actual epidemiologists tremendously more difficult.”

The CDC stopped publishing anything resembling a complete database of daily test results on February 29. When it resumed publishing test data last week, a page of its website explaining its new COVID Data Tracker said that only viral tests were included in its figures. “These data represent only viral tests. Antibody tests are not currently captured in these data,” the page said as recently as May 18.

Yesterday, that language was changed. All reference to disaggregating the two different types of tests disappeared. “These data are compiled from a number of sources,” the new version read. The text strongly implied that both types of tests were included in the count, but did not explicitly say so.

The CDC’s data have also become more favorable over the past several days. On Monday, a page on the agency’s website reported that 10.2 million viral tests had been conducted nationwide since the pandemic began, with 15 percent of them—or about 1.5 million—coming back positive. But yesterday, after the CDC changed its terms, it said on the same page that 10.8 million tests of any type had been conducted nationwide. Yet its positive rate had dropped by a percent. On the same day it expanded its terms, the CDC added 630,205 new tests, but it added only 52,429 positive results.

This is what concerns Jha. Because antibody tests are meant to be used on the general population, not just symptomatic people, they will, in most cases, have a lower percent-positive rate than viral tests. So blending viral and antibody tests “will drive down your positive rate in a very dramatic way,” he said.

The absence of clear national guidelines has led to widespread confusion about how testing data should be reported. Pennsylvania reports negative viral and antibody tests in the same metric, a state spokesperson confirmed to us on Wednesday. The state has one of the country’s worst outbreaks, with more than 67,000 positive cases. But it has also slowly improved its testing performance, testing about 8,000 people in a day. Yet right now it is impossible to know how to interpret any of its accumulated results.

Texas, where the rate of new COVID-19 infections has stubbornly refused to fall, is one of the most worrying states (along with Georgia). The Texas Observer first reported last week that the state was lumping its viral and antibody results together. On Tuesday, Governor Greg Abbott denied that the state was blending the results, but the Dallas Observer reports that it is still doing so.

Continue reading here: ‘How Could the CDC Make That Mistake?’

COVID and Releasing Obsessive Fear – Being Well with Dr. Rick Hanson

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Occasional anxiety and worry are a part of life. But when they disrupt the normal flow of life, work and school are harder, family and social relationships suffer, and life is not as enjoyable. Preoccupied by painful emotions and thoughts, we can begin to feel fatigued and hopeless, believing there is nothing we can do to change things.

Dr. Dan Kalb, an expert on anxiety disorders and OCD, explores how we can release obsessive fear during this particularly anxiety-provoking time.

ON THIS EPISODE WE EXPLORE:

·        What is an anxiety disorder?

·        Mindfulness and being in the present moment.

·        Releasing obsessions, and not becoming ensnared by negative thoughts.

·        Acceptance, and useful vs. harmful self-reassurance.

·        Fears of death, and how to manage them.

·         Key techniques for releasing fear.

CHECK OUT THE FULL EPISODE

ASK RICK:

How can you find courage when everything around you is falling apart, even globally?

Hanson2

It’s natural to feel stressed and overwhelmed by it all. My suggestion at times like this is to make a clear list of what you can actually do each day, and focus on that.

Take the steps you can. It’s classic advice for a reason: it’s profoundly true.

Time is like money: spend it where it will help you most.

For example, if you want to make a painting, set aside the time to do that and protect that time. Disengage from what you can’t change and focus on what you can. And then find confidence and refuge and self-respect in knowing that you are making honorable efforts and also making progress where you can.

Action and clarity can really help when we feel stuck in a fog; they are not the only things – self-compassion, perspective, and calming help, too! – but they are important pieces, and under our control.

READ MORE “ASK RICK” ANSWERS

 

Biomarker Analysis Supports Heart Benefit of Plant-Based Diets – Physician’s Weekly

DASH diet or high fruit and vegetable diet equally beneficial

Regardless of health status, eating more fruits and vegetables — meaning 10 or more servings daily — can reduce subclinical damage to the heart, according to findings published in Annals of Internal Medicine.

Stephen P. Juraschek, MD, PhD of Beth Israel Deaconess Medical Center in Boston, and colleagues looked back at serology samples from the DASH study that sought to determine the effect of diet on blood pressure and cholesterol. The 8-week long DASH study compared three diets — a traditional American diet, a diet rich in fruits and vegetables, and the so-called DASH diet, which was heavy on fruits and vegetables but also low in fats — to determine the dietary impact on biomarkers of subclinical damage to the heart.

In this new analysis, they compared levels of highly sensitivity cardiac troponin I, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity c-reactive protein in blood samples collected at baseline in the DASH study and after the 8-week-long intervention. They analyzed specimens from 326 of the original 459 DASH trial participants.

The original DASH trial was conducted in the mid-1990s and, at that time, the mean age of the participants was “was 45.2 years, 48% were women, 49% were black, and mean baseline BP was 131/85 mmHg.”

In this analysis, both the fruit and vegetable diet and the DASH diet reduced troponin I concentrations and NT-proBNP levels, compared to the control diet. “But levels of hs-CRP did not differ among diets,” they wrote. “We believe these findings strengthen recommendations for the DASH diet and, more generally, for increased consumption of fruits and vegetables as a means of optimizing cardiovascular health.

“Compared with the control diet, the fruit-and-vegetable diet reduced hs-cTnI levels by 0.5 ng/L (95% CI, 0.9-0.2 ng/L) and NT-proBNP levels by 0.3 pg/mL (CI, 0.5-0.1 pg/mL). Compared with the control diet, the DASH diet reduced hs-cTnI levels by 0.5 ng/L (CI, 0.9-0.1 ng/L) and NT-proBNP levels by 0.3 pg/mL (CI, 0.5-0.04 pg/mL),” they found.

Juraschek and colleagues noted that the original study found the DASH diet lowered both systolic and diastolic blood pressure and reduced LDL-C more than the fruit and vegetable diet.

However, that benefit “did not translate into significant differences in hs-cTnI and NT-proBNP levels between the fruit-and-vegetable and DASH diets at 8 weeks,” they explained. “Although reductions in these markers reflect short-term improvements in subclinical CVD injury, their relationships with CVD events have been observed independent of pathways predicted by traditional risk factors. Thus, they do not necessarily capture, for example, long-term ischemic risk from atherosclerotic plaque burden and potential rupture. This distinction is important, because the BP- and cholesterol-reducing features of the DASH diet probably still play an important role in long-term CVD risk prevention. Further research is needed to study the longitudinal effects of the DASH diet on CVD events.”

In an editorial that accompanied the report by Juraschek et al, Ramon Estruch, MD, PhD, and Rosa Casas, MD, PhD, from the University of Barcelona, along with Emilio Ros, MD, PhD, Instituto de Salud Carlos III, Madrid, Spain, were enthusiastic in their praise of the findings, noting that the researchers took advantage of the original data set and stored serum specimens of the DASH clinical trial (4) and compared the effects of the 3 feeding interventions…”

Estuch, Casas, and Ros pointed out that highly sensitive troponin I “is useful for diagnosing minor myocardial injury in patients with clinical manifestations of atherosclerotic CVD and is an excellent predictor of heart failure hospitalization and cardiac death (5); NT-proBNP has emerged as a hallmark biomarker for the diagnosis and prognosis of heart failure… ” but hs-CRP—the inflammatory marker that was not affected by diet — “is a much debated nonspecific marker of systemic inflammation, for which inconsistent results have been found concerning its incremental value in CVD risk prediction.”

The researchers and the editorialists noted that the benefits of a diet rich in fruits and vegetables include “higher amounts of potassium, magnesium, and fiber,” benefits that may explain the observed effects.

“High intake of fruits and vegetables is the basis of a healthy diet, and almost all medical and nutrition societies, as well as governments, recommend eating these foods daily to reduce the risk for CVD and improve overall health. However, the recommendations vary, from up to 400 g/d (5 servings per day) in England to 640 to 800 g/d (around 8 to 10 servings per day) in the United States,” wrote Ramon Estruch, Casas, and Ros. “Likewise, a recent meta-analysis of 95 prospective studies concluded that for each 200-g/d (2.5 servings per day) increase in the intake of fruits, vegetables, or fruits and vegetables combined, coronary heart disease risk decreased 8% to 16%, stroke risk decreased 13% to 18%, CVD risk decreased 8% to 13%, and all-cause mortality risk decreased 10% to 15%. When consumption of fruits and vegetables was 800 g/d or greater (>10 servings per day), these risks were reduced by 24%, 33%, 38%, and 31%, respectively. The same meta-analysis found that the foods with the strongest beneficial associations with CVD and mortality were apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, tomatoes, and fresh salads. In contrast, intake of canned fruits was associated with an increased risk for CVD and all-cause mortality.”

Among the study limitations listed by Juraschek and colleagues was the fact that they were not able to analyze samples from all DASH trial participants, thus the findings “are observational and susceptible to confounding.”

Also, they suggested that the freezing-thawing process used for the serum specimens may have degraded the utility of hs-CRP.

Finally, they noted that 8-weeks is a short study duration — to0 short to assess clinical events.

That said, the editorial writers offered a broad interpretation of the significance of the findings, suggesting that recommendations “to increase the intake of fruits and vegetables to at least 10 servings per day should be generalized to the overall population, regardless of health status.”

Continue reading: https://www.physiciansweekly.com/biomarker-analysis-supports-heart-benefit-for-of-plant-based-diets/

Vegans Must Get DHA To Prevent Depression Or Dementia – Dr. Joel Fuhrman

Joel Fuhrman M.D., a board-certified family physician who specializes in preventing and reversing disease through nutritional and natural methods, and #1 New York Times bestselling author of Eat to Live, Super Immunity and The End of Diabetes, delivers a powerful paradigm-shifting lecture showing us how and why we never need to diet again.

You will understand the key principles of the science of health, nutrition and weight loss. It will give you a simple and effective strategy to achieve—and maintain—an optimal weight without dieting for the rest of your life. This new approach will free you forever from a merry-go-round of diets and endless, tedious discussions about dieting strategies. This is the end of dieting.”

Dr. Fuhrman’s website

 

Vitamin B12: All Your Questions Answered | Forks Over Knives

Vegans are regularly advised to mind their levels of vitamin B12, but vegetarians and even meat eaters often come up short on this important nutrient, which helps keep nerves and blood cells healthy. In this informative Q&A—and in the video below—Dr. Sofia Pineda Ochoa goes deep on where vitamin B12 comes from, why we need it, and how to ensure we’re getting enough.

What is vitamin B12, and why do we need it?

Vitamin B12 is a water-soluble vitamin that is important for the maintenance of the nervous system and in the formation of red blood cells.

Continued here: Vitamin B12: All Your Questions Answered | Forks Over Knives

How to Make Veggie Sushi from Forks Over Knives

Sushi is easy to make at home, and it’s a super-healthy option for snacks and meals. Plus, you can get creative and max out on your favorite plant-based fillings. Here’s how to make and roll your own vegan sushi.

Select and Season the Grains 

No, you don’t need specialty rice to make sushi. Any short-grain rice type will work, as will other small whole grains such as quinoa, millet, barley, and bulgur.

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MASTER PLANT-BASED COOKING WITH FORKSChoose one of our two fun, flexible at-home cooking courses. Courses begin June 16.

The real secret to tasty sushi rice and grains is the seasoning. This master recipe provides that perfect balance of sour and sweetness with a touch of salt—the flavor profile that gives the grains their “sushiness.” Be sure to use the optional arrowroot powder or cornstarch with non-rice grains, as it will help them stick together.

Master Recipe: Sushi Rice (or Other Grains)

  • 2 tablespoons brown rice vinegar or distilled white vinegar
  • 1 tablespoon maple syrup
  • 1½ teaspoons arrowroot powder or cornstarch, optional
  • ¼ teaspoon salt, optional
  • 2 cups hot cooked brown rice or other whole grains

Stir the vinegar, maple syrup, arrowroot (if using), and salt into 2 cups of hot (just-cooked) grains. Cover, and let stand 15 minutes so the grains absorb the flavors. Cool until easy to handle, then use to make sushi.

Continued here: How to Make Veggie Sushi

9 Things You Need to Know About Diet and Depression from Forks Over Knives

Your gut and your brain are closely connected. Here are key ways in which diet can impact depression and overall mental health.

More than 8 percent of American adults age 20 and older have experienced depression in a given two-week period, according to Centers for Disease Control data. Here are key ways in which diet can impact depression and overall mental health.

The Gut Is Connected to the Brain

Mounting research suggests that clinical depression may be affected by the bacteria in the gut. In a 2019 study published in Nature Microbiology, researchers observed that gut bacteria produce neurotransmitters, such as dopamine and serotonin, that are connected to the brain via the vagus nerve, immune system, and other pathways, potentially influencing mood and behavior. They also noticed that depressed subjects tend to be lacking in two specific species of gut bacteria.

Continued here: 9 Things You Need to Know About Diet and Depression

Medical Meat Bias | NutritionFacts.org, Dr. Michael Greger

When famed surgeon Michael DeBakey was asked why his studies published back in the 1930s linking smoking and lung cancer were ignored, he had to remind people about what it was like back then. We were a smoking society. Smoking was in the movies, on airplanes. Medical meetings were held in “a heavy haze of smoke.”

Continue reading here: Medical Meat Bias | NutritionFacts.org

Warm Miso Spinach Salad (Raw Vegan) – Hippocrates Institute

Warm Miso Spinach Salad (Raw Vegan)

Ingredients

  • 2 ounces of lemon juice
  • 2 cups sliced parsnip
  • Inch and a half of ginger sliced
  • 6 oz. of water (add more to achieve desired consistency)
  • 1.5 tbsp tahini
  • 1 tbsp miso

Method

  1. For the dressing: 2 ounces of lemon juice, 2 cups sliced parsnip, Inch and a half of ginger sliced, 6 oz. of water (add more to achieve desired consistency). Blend till creamy.
  2. Then add in… 1.5 tbsp tahini, 1 tbsp miso.
  3. For the salad: Place your spinach in the dehydrator for one hour. The process of dehydrating helps to enhance and intensify the flavor of the spinach.
  4. Shape the wilted spinach into rounds and plate. (Optional:add brags liquid aminos).
  5. Add the dressing, garnish with black sesame seeds and serve.
A beautiful warm summer appetizer that is full of flavor, nutrients, and exceptionally healthy ingredients.

Meal Plans & Recipes

Fancy a new recipe to try? Discover a variety of delicious vegan recipes including our “world famous” Hippocrates Green Juice recipe!

View all recipes

Flashback Friday: Effect of Sucralose (Splenda) on the Microbiome Michael Greger M.D. FACLM

What effect do artificial sweeteners such as sucralose (Splenda), saccharin (Sweet & Low), aspartame (Nutrasweet), and acesulfame K (Sweet One) have on our gut bacteria?

DOCTOR’S NOTE

Can’t get enough of artificial sweeteners? Check out:

Erythritol May Be a Sweet Antioxidant, but there are some caveats for it and other nontoxic, low-calorie sweeteners. See:

Does it really matter if our gut flora get disrupted? You’re in for a surprise. See:

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