Information for your Consideration…

The Sweet Solution – There are many things we learn when we travel. In addition to learning about the people, the environment, the ambiance of places around the world, I also listen for interesting “healthcare tidbits.” Such was the case during my trip to New Zealand. I learned something that dermatologists already knew (as I found out from my dermatology wife) – Manuka honey in addition to being a fabulous sweetener is also an antibacterial, antioxidant, and anti-inflammatory accelerator with strong wound healing properties. It’s also used for treatment of coughs, ulcers, and oral health problems. The claim is based on the presence of Methylglyoxal (MGO), a major antibacterial agent contained in the honey. The level of MGO in the honey is used to create the Unique Manuka Factor (UMF) – and, the higher the UMF number, the better the health-supporting capabilities AND, the price goes up considerably as that number increases. So, how does this work? Evidently Manuka honey stimulates the inflammatory cells to release which assist in the early stages of healing. So, the next time your kids skin their knees playing on the driveway or you cut or cut your skin while working on the yard, consider a dab of Manuka honey. It’s the sweet solution. Now, as for the COVID challenge, I’m working on it but it never hurts to consider a home remedy like Manuka-infused cocktail if you start to get symptoms of upper respiratory problems.

Furthermore, I was informed that an infectious disease specialist from Australia did research on 20-some materials for the treatment of COVID at the start of the pandemic and Manuka honey came out as the #1 material for diminishing and preventing COVID infections. The initial COVID research study commissioned by the National Institute for Health and Care Excellence (NICE) and Public Health England (PHE) summarized their findings by stating:

“It is already proved that honey plays a potential role against several enveloped viruses. Honey may be beneficial for patients with COVID-19 which is caused by an enveloped virus SARS-CoV-2 by boosting the host immune system, improving comorbid conditions, and antiviral activities. Therefore, we can say that honey may have a protective/beneficial effect on COVID-19.” “…as a first-line treatment for cough due to upper respiratory tract infection, which is the main well-identified COVID-19 symptom. Honey might safely disinfect the throat and trap virus particles, beside a major advantage that it has no side effects and [is] of great nutritional value.”

So, it seems that there is support for the claim for moderating the course of COVID illness although it does not seem to be a “cure”. More likely, it serves as an adjunctive treatment modality. Long story short: A little honey in the morning will likely sweeten up the day as well as offer a bit of anti-viral protection ta boot!!

Medical Debt Removed From Credit Reports – To the relief of increasing numbers of Americans, medical debt will no longer be included in the evaluation of an individual’s credit score under new regulations adopted by the Consumer Financial Protection Bureau (CFPB). The bureau issued the new rules that will essentially remove about $49 billion in medical bills from consumer credit reports. It is estimated that around 15 million Americans will benefit from the change in policy. It represents a significant change in the credit ratings for individuals – especially with the increase in the amount of medical debts citizens are taking on due to lack of insurance coverage, reallocation of medical costs to consumers by insurance companies and other similar actions. Through the policy change, debt collectors will not even be aware of medical debt by consumers. The ruling will have an impact on the credit evaluations done related to long-term purchases such as home lending and other major purchases by consumers.

The Evolving GLP-1 Revolution – If GLP-1’s had been available 35 years ago, I would have been a prime candidate for taking this new, revolutionary drug. I weighed in at the time at a mere 395# - more of a linebacker than a leader at the time. I ended up with a Duodenal Switch procedure to promote sustained weight loss. And, it worked BUT there have been unexpected long-term implications which would cause the length of this blog to become too long. So, I will forego the assessment. But, the procedure worked!! I have weighed about 170# now for near 25 years. But, there’s a new wonder drug option that is taking over as the prime treatment for obesity – a major problem throughout the world!! It’s kind of amazing but 1 in 8 people worldwide live with the curse (= my opinion) of obesity, costs the global economy $2 trillion in productivity reductions and premature mortality. And, over the next decade those costs will nearly double for $4 trillion!

The new GLP-1s could be one of the major factors in creating economic development for many countries throughout the world – but, especially in the USA where obesity has become a major problem. Drugs like Lilly’s Tirsepatide (= Zepbound) can precipitate weight loss of up to 22% of body weight which is sustained following the weight loss without rebound. That’s impressive. In addition, the drug reduces the risk of diabetes by over 90%. Furthermore, the research is showing that people on the GLP-1’s experience sustained weight loss. In other words, there is no bounce back to the formerly obese state. I must admit that when the drugs first came out I was a bit skeptical but, the ongoing research is clearly showing a very positive course of treatment for those who choose to take action on losing excessive weight.

The final positive note to be highlighted are the findings of the initial pre-clinical trials that show a potential impact on neurodegenerative diseases. Specifically, in Parkinson’s disease patients, the medications have results in restoration of acceptable dopamine levels. And, for Alzheimer’s disease patients, there was less shrinkage in the brain. While the outcome of GLP-1 medications is yet to be firmly entrenched into the armamentarium, it seems that the medication is moving down the track of “antibiotics” whereby we are at the formative stages of development in the GLP-1 field. Stay tuned…

A Tidbit On Trivia Memory – I recently learned about Deepu V. who recently accomplished a Guinness Book of World Records feat by recalling and repeating aloud 14,000 digits in Euler’s number. It’s a “constant” number (= 2.71828…) that is found in many contexts and used as a base for natural logarithms including exponential growth, radioactive decay, and the growth of wealth calculations through compound interest calculations. It’s similar to “pi” which is a never-ending number as well. So, what is so special about Mr. Deepu V’s accomplishment? What’s remarkable is that he recited from memory the first 14,000 digits in Euler’s number. He accomplished the feat by organizing the number into detailed organizing of digits into rows and columns for precise recall. The prior record was 10,122 digits. Now…what is the phone number of my brother? And, where did I lay my pen last night so I would not forget it this morning?

Inauguration Trivia – For those watching the Presidential Inauguration, you may have noticed the number of CEOs sitting in the dais behind President Trump (e.g. Elon Musk – of course, Jeff Bezos, Tim Cook, among a couple of others). They got the good seats for support of him during the campaign but, also paid a slight fee of $1 million for the special privilege. Following the inauguration they all jetted off in their personal jets to the annual World Economic Forum confab in Davos, Switzerland. The cost for that event was a mere $300,000…

 

Information for your Consideration…

The Slippery Slope – A recent 2024 Gallup poll offered a somber outline on the perspective of Americans towards the medical and health system. Specifically, only 34% of Americans still trust the medical system! If only 34% TRUST the MEDICAL SYSTEM, the collective WE have our work cut out for us!!

Aging And Friendly Care Delivery – A new report released by the John A Hartford Foundation and completed in collaboration with Age Wave revealed a striking misstep in the USA health care system - widespread dissatisfaction among older adults with care delivery. The researchers combined information from a Harris Poll, focus group analysis, and recent research reports. The report deserves your attention and I would recommend downloading a copy of the report entitled Meeting the Growing Demand for Age-Friendly Care: Health Care at the Crossroads. For all of us who are leaders in health care and/or deliverers of care…an important read.

Oh No – Don’t Tell Me It’s True! – Sorry, but it does seem to be true. According to a recent article in the journal Nature, the Large Language Models (LLMs) used in AI products are beginning to get the drift of how to lie. Yes, lie!! There is logic to everything from structured information that gives answers to complete questions to how best to lie about some issue or topic. As a result – according to the article – the LLMs are becoming less reliable because they are increasingly recognizing that it is more important to “make things up” rather than to not provide an answer. “Millions of people are using general-purpose artificial intelligence (AI) systems based on large language models (LLMs), which have become commonplace in areas such as education⁶, medicine⁷, science^8,9 and administration^10,11” [NOTE: citations copied directly from the article]. Although the LLMs are increasing their reliability, they are also getting better at lying!

At the same time – as a proponent of learning how to effectively integrate AI/ML learning derived from LLMs into medical and healthcare delivery – there is reason to be positive. In a recent post, Azeem Azhar argued that humanity needs to embrace AI as a source for accelerating our knowledge development capabilities. I agree! Rather than rejecting AI/ML or putting it in a box, we need to determine how best to use it, what policies are required to assure its value to society, how to prevent misuse of the technology, and a host of other thoughts. It’s very clear that the path of Generative AI/ML development is on a much more accelerated pathway of development than either the use of personal computers or the Internet. I remember introducing the use of computers to office work in the early 1980s. Then, I was on the horn in the early 1990s learning about this new resource called “the web”. And, where we’ve come from those early days is incredible! And, the acceleration is even accelerating with the advent of OpenAI – the beginning tool of down-the-road tools that we will need to integrate into the medical and health system. AND, we are not educating or training our young health and medical graduates across the board in the effective use of AI/ML – let alone those who are in practice today.

Alzheimer’s Disease, Dementia, And Falls – In a new report from JAMA Network Open researchers found that when controlled study parameters were put in place death and falling were associated with a 21% increased risk of a subsequent dementia diagnosis. The metanalysis examined almost 2.5 million Medicare claims to derive the assessment. The claims were for older adults who had a traumatic injury leading to an emergency room visit as a result of a fall. The researchers found that within one year of the incident “new dementia diagnoses were more common in people with falls than other injuries.” They didn’t say anything about falling out of your office chair when you swivel around quickly – like I did yesterday. However, I was able to jump up right away and luckily no one was around to see the incident. Now about those stairs, I walk up and down from the kitchen at least 10x per day…hmmm…

Step It Up A Notch – Of late, I’ve become a lot more interested in the use of physical exercise as a mode for sustaining health. I guess that getting older has something to do with my enhanced interest. Nonetheless, the data shows very clearly that physical exercise is a proven modality of not only managing but also preventing chronic disease. This is especially apropos for any adults 65 and older such as an increased number of independent living years, reduced risk of falling – one of the major contributors to decline among the elderly – and improved brain health in the form of reduced dementia, including Alzheimer’s disease. If you’re looking for more immediate results consider the value of sleep quality, reduction in blood pressure, weight loss (a good thing unless you’re ill), bone health derived from exercise, and less anxiety. You should start early and go often. It makes a difference. I’m finding that it’s made life a lot better for me and increased my sense of well-being. So, step it up a notch to better in the end… 

Ubiquitous Microplastics Found In Brain Tissue – In another study from JAMA Network Open by Brazilian researchers, they found that microplastics were prevalent in brain tissue derived from human cadavers. The sampling was small where the olfactory bulb was sampled in 15 patients between the ages of 15 and 100. Samples from eight of the cadavers contained microplastics — tiny bits of plastic that ranged from 5.5 micrometers to 26.4 micrometers in size consisting of plastic fibers and particles. The composition of the plastics were polyethylene vinyl acetate, polypropylene, and polyamide – all common materials used in coverings for commercial products. Yikes!! It’s unclear what the presence of plastics means but foreign bodies inside the body for any reason are cause for concern. And, it’s clear that microplastics are a ubiquitous problem for the world. It’s another “world health” problem we need to be thinking about – and, more importantly – doing something about…

The Vaccination Dilemma – It was very disturbing to read an Associated Press release noting that: “…U.S. kindergarten vaccination rates dipped last year and the proportion of children with exemptions rose to an all-time high, according to federal data...where the percent “of kids exempted from vaccine requirements rose to 3.3%, up from 3% the year before.” Although a large percentage of kindergartners got their shots (=92.7%), the fact that we’re seeing a gradual increase in non-vaccinated kids over the last several years is a disturbing trend. In fact, vaccine exemptions increased in 40 of the states according to CDC data. And, it’s occurring across the board for measles, mumps, rubella, diphtheria, tetanus, and pertussis – diseases that we’ve been working to wipe out BUT that will no doubt recur without attention to effective vaccination programs. As a result of the vaccination decline, there were 13 measles outbreaks this past year compared to four in 2023. And, more generally the states with the greatest number of outbreaks have been in California, Florida, Illinois, Minnesota, New York, and Oregon. I’m of the age where I remember having playmates with sequelae from a number of these diseases. Let’s not let them come back. Once again, it seems that we need to counter the misinformation.

Information for your Consideration… 

Ficky Errors – I got a message that some of my hyperlinks did not work in the last edition of The Fickenscher Files. I apologize for the inconvenience and hope it did not present a problem with the readers. BTW – feedback is always appreciated… BTW, The Fickenscher Files are prepared by me not ChatGPT although I do use Grammarly for checking the grammar in my blog. However, the content is determined by me – so you can hold me accountable there…

On The Medicare Roller Coaster – The Medicare program has become over the years an “essential” asset for those who are Medicare eligible and those with disabilities. As a consumer of the program, I take note of any changes. Most people may not be aware but President Biden recently signed bipartisan legislation that passed both the Senate and House for implementing the Inflation Reduction Act. The new legislation will affect access and make financial relief available for the 49 million older adults and those with disabilities who rely upon Medicare for drug services. For the very first time, there will be an annual limit on what Medicare beneficiaries pay out-of-pocket for their prescription medications!! That’s big news. There are six elements to the Act which affect Medicare:

• Starting in 2023: 1) Vaccines can be obtained without copays; and, 2) Insulin co-pays are limited to a max of $35/month;
• Starting in 2024: 1) More people will become eligible for the “Extra Help” program which offsets out-to-pocket costs for those who fall under certain income limits; and, 2) the 5% co-insurance requirement for catastrophic coverage is eliminated; and,
• Starting in 2025: 1) the annual cap on prescription medications costs will be $2000; and, 2) recipients can opt for monthly payments to “smooth” out the yearly out-of-pocket costs for their prescription medications, if desired.

The only problem with the new system is that the payments for advisors who went through all of the options to provide recommendations for Medicare recipients are going away! So, it will be more difficult to obtain unbiased advice on which of the Medicare Advantage or regular Medicare programs to select. Those of us who are Medicare-eligible will have to do a lot more homework to prepare for the October 15 – 30 sign-up period. The problem I foresee is for those individuals who have disabilities and/or medical problems (e.g. Alzheimer’s) that prevent them from making good decisions on the fly. Whoever created the rules on this front seemed to miss the mark in my estimation. While I can make good decisions on which direction to take I have some colleagues and friends that will be baffled if they have to figure out the options on their own. If anyone thinks I’m overstating it – let me know. So, it is a bit of a roller coaster… 

Paul Keckley’s Thoughts And Considerations – If you don’t get the “Keckley Report”, it is definitely one to read regularly. Paul (a good friend) regularly offers up his thoughts on all things health care. I was struck by his recent post on: “ Are Employers Ready to Move from the Back Bench in U.S. Healthcare?” from August 26, 2024. Here are a few highlights that he noted that are important for all of us in the healthcare industry to consider as we look to the future:

• For 2024, the USA population was 342 million citizens. Of that population, 92.3% (= 316M) have health insurance of which just over half of this group (51.9%) are through employment-based coverage, 17.8% (61M) hold Medicare coverage; and, 23.1% (79M) have Medicaid/CHIP coverage and 164 million through employment-based coverage.
• The Congressional Budget Office (CBO) is predicting that Medicare coverage will increase by an estimated 18% through 2032 with Medicaid/CHIP remaining about the same and employer-based coverage increasing by about 3.0% Needless to say, this puts the focus on the federal level on the state of Medicare – something America’s seniors care a lot about!! It’s an area that is ripe for further evolution and change.
• The cost of health care has risen more than 50% since 2017. Such unmitigated cost increases are clearly a front-burner issue for government, employers, self-pay individuals, or anyone taking a hard look at the healthcare world over the next several years.

Staying abreast of all these changes within the industry as well as policy analysis is a part of The Keckley Report, a period analysis on all things healthcare. If you don’t already subscribe, I highly, HIGHLY recommend it as a resource for staying abreast of policy and developments within the healthcare arena. Paul is methodical in his assessments and a trusted advisor. You will not go wrong in signing up for his regular reports. The level of increases across the board is the biggest reason that I believe we are headed toward a “value-based” financing approach to healthcare in the not-too-distant future. Too many people are affected for change not to occur!!

Private Equity Takes a Hit – The California legislature recently passed Assembly Bill (AB) 3129 on August 31, 2024. Governor Newsom (D-CA) has until September 30^th to decide on whether or not to sign it into law or to veto the legislation. In essence, effective January 1, 2024, the new law will require healthcare investors – of any type – to notify and obtain written consent from the California Attorney General before finalizing the investment in certain healthcare facilities or with healthcare providers. The bill essentially raises the bar on the corporate practice of medicine by creating a protective oversight responsibility in the AG’s office to guard against commercial exploitation of the industry by private equity groups or hedge funds. While a majority of states ban corporations from practicing medicine, there are loopholes in many of those state bans. The private equity groups have become quite good at taking advantage of those loopholes by manipulating the financial levers to create mechanisms for controlling physician behavior and services.

So, why is there an evolving outrage in the healthcare community toward private equity? It’s because the only focus of these investments is on profitability – not outcomes. Most analysts within the industry – including me – have concluded that an outright ban on private equity ownership of doctors’ practices is the only way to mitigate the risks of a focus on profitability over outcomes and value. This, in essence, is the reason the California bill received such strong support in the legislature. But, the California bill goes one step further. It also includes hospitals and nursing homes in the mix. Why? Because – if you follow the money – the American taxpayer ends up with the brunt of the cost shift as these equity expenditures are folded into pricing increases by private insurance, Medicare, and Medicaid reimbursement. We – the taxpayers – end up paying the piper!!

And, to add fuel to the fire, a new report was recently released by the industry watchdog group Private Equity Stakeholder Project (PESP) on the continuing trend of bankruptcies among private equity-owned healthcare companies. In fact, private equity bankruptcies represent nearly a fourth of all bankruptcies in the healthcare space for 2024. In some respects, such levels are not surprising since many of these investments are made in high-risk ventures at the start. Eileen O’Grady, the Director of Programs at PESP observed in a statement of Health Exec on the topics: “Private equity’s aggressive financial strategies increase the risk of bankruptcy and threaten the delivery of critical healthcare services. The use of excessive debt by these firms can have significant ripple effects on the broader healthcare industry. This year might see a grim scenario of more healthcare bankruptcies if current trends persist.” In further analysis by PESP, the increase in private equity bankruptcies over the last five years has escalated by 112% with these firms holding responsibility for 1/5 of all healthcare bankruptcies. 

CDC Recommends Watercress – A recent announcement by the Centers for Disease Control and Prevention (CDC) caught my attention. It was an analysis of the “nutrient density” of various foods or, in lay terms – the “healthiest” foods which were all vegetables in the top tier. And, the winner? Watercress which came in with a density score of 100 out of 100!! The runners-up included: Chinese cabbage (91.99 points), Swiss chard (89.27 points), Beetroot (87.08 points); and, Spinach (86.43 points). I thanked my lucky stars that Spinach was on the list. It’s become one of my favs among the vegetables – more so than Watercress. Which is a cruciferous vegetable that is part of the same family as kale, broccoli, Chinese cabbage, arugula, and Brussels sprouts (the underlined veggies are my other go-to's). So, the CDC findings were in line with my wife’s (almost) daily admonition that I need to eat “6 cups of fruits or vegetables” per day; and, she also reminds me that “Burger King does not serve them!” Take note and enjoy the Watercress or, Spinach – if you’re like me…but, Broccoli and Brussels Sprouts are also scrumdiliumptious! 

Incidence Of Male Cancer Expected To Increase By 2050 – In a new report coming out of Australia in the journal, Cancer. the incident of “…cancer cases and deaths among men are expected to surge by 2050.” The investigators analyzed cancer cases and deaths for 30 different types of cancer across 185 territories and countries in 2022. The increase in cancer cases goes from 10.3M to 19M over the 28 years or, an 84% increase! And, more importantly, the death rate also increases from 5.4M to 10.5M or, a 117% increase. Now, this applies to men over the age of 65 years. The question is “Why?” Most likely, it’s because the number of men moving into the age cohort will also be increasing AND, globally, cancer care/treatment on an international level is not equivalent to US standards. The result is a global increase in male cancer incidence and death rates.

Information for your Consideration…

Concerns Of “We The People” – The Kaiser Family Foundation completed a health tracking poll last February 2024 to ascertain the public’s perspective on the state of the Accountable Care Act (ACA) and health care costs. To put it mildly – health care is a BIG CONCERN! The surveyed about 1,300 adult voters across the political spectrum. And, across that spectrum, several key points of pain were identified:

• 74% were “somewhat” or “very” worried about their ability to afford unplanned medical bills (NOTE: Count me in as well!!)
• 73% were “somewhat” or “very” concerned about the overall cost of healthcare services.
• Of those with health insurance, 48% were concerned about the cost of their monthly premiums.
• And, of those who are lacking insurance – 25% have delayed or postponed accessing healthcare services but 61% of the uninsured simply skip needed medical care.
• Where the two sides differed was on the issues related to the ACA with 59% of Democrats noting a favorable view of the plan; and, 23% of Republicans wanting to limit the plan and 39% being favorable toward outright repeal.
• And, not to be forgotten, 36% of Republicans versus 71% of Democrats viewed the future of ACA as “very important”

Shuffling The Chairs At DHHS  - There seems to be a fair amount of movement in the US Department of Health and Human Services (DHHS) of late with the recent announcement on the creation of an Assistant Secretary for Technology Policy – which in reality represents an expansion of the Office of the National Coordinator. But, it’s a noteworthy advancement because it not only includes an upper level oversight appointment but also the creation of a Chief Technology Officer, Chief Data Officer and a Chief AI Officer. Yowser!! Or, perhaps I should say – Finally!! In making the announcement, Andrea Palm, DHHS Deputy Secretary said: “These organizational changes will ensure that HHS is best suited to serve the American people during this incredibly dynamic time in the technology space.” All of this recent activity and response stems from the 2023 Biden Executive Order on AI that charged DHHS with responsibility for implementing a plan to deal with the evolving avalanche of all things AI/ML affecting health care. So, we are likely to see even more down the road…for example, like the following…

But, There’s More: Kudos To ONC – For those of us who follow the information technology space, the Office of the National Coordinator (ONC) recently issued a new proposed rule for all healthcare providers and health plans receiving Health and Human Service funding of any type. It would require use of “certified” health information tech tools and adherence to ONC standards by all health care providers and plans. The implications are significant. Why? Because the new requirements related to the acquisition, implementation, and upgrading of all health information and the systems used for sharing the information. In essence, it moves the idea of “interoperability” objectives previously described in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) into reality.

In essence, the new rule is designed to ensure that all health IT systems procured by HHS or that connect to the agency in any form such as healthcare providers, health plans, or insurance issuers who contract for payments be fully compliant with the standards and implementation specifications set by regulation. The penalties are not inconsequential. For example, there are penalties for those vendors that prevent the “unreasonable” access, exchange or sharing of electronic health information (EHI) of up to $1 million. And, furthermore, “unreasonableness” is not just a technical connectivity issue. It also applies to the fees charged by IT vendors for providing the connectivity. It’s a good measure. The feds through Medicare, Medicaid, FQHCs, the VA and other funding operations are the biggest game in town when it comes to health care finance. It creates quite a strong incentive by the vendors and payors to move forward on something that should have been accomplished (my perspective) several decades ago!! In sum, the good news is that all of the major Health Info Tech (HIT) organizations have been working on the interoperability issues and while there will no doubt be some hiccups, the industry is finally moving forward in this most important area for enhancing care delivery across the board. If you have any comments on the proposed rule, they must be submitted by October 8, 2024. Shortly after that point, the rule will be finalized.’’

The Summer COVID-19 Surge Is Upon Us – Throughout early August and as we move into the Fall, the US Centers for Disease Control and Prevention is issuing warnings that COVID-19 is once again running rampant. The coastal areas of the USA seem to be the hardest hit. Furthermore, through my information “friends survey,” it seems that travelers coming from Europe and the Far East are bringing the virus home 😊. So, taking some precautions by those travelers coming home after wonderful trips abroad should definitely be considered. The Family Physician Newsletter does a good job of tracking the pandemic and includes information on “long COVID”, treatment options, testing and testing options. Check it out for good, reliable, and readable information.

And, Don’t Forget The Other Virus – In addition to the covert COVID-19 virus that passes human-to-human, it’s now summertime. The West Nile Virus is still out there and increasingly being identified by health departments across the USA. The rate of infections is far, far less than but can be just as problematic. And, like COVID-19, the spread is a function of community. So, lather up with mosquito repellent and keep those mosquito growth areas (e.g. stagnant water pools) cleaned up.

More Dementia News – Some might wonder why I’m reporting more information on dementia these days. It’s for two reasons. First, I’ve reached an inflection point where I’m now beyond the 70 year mark when dementia seems to reach an accelerating velocity among friends and neighbors. And, second, the research on preventive and treatment options for managing the problem area is also accelerating. For example, there’s a new study recently published in JAMA Network Open on the dietary patterns of dementia patients. The report noted that eating an anti-inflammatory diet of whole grains, fruits and vegetables instead of an inflammatory diet consisting primarily of red or processed meats and ultra-processed foods (e.g. sodas, sugar-coated cereals, fries and ice cream) resulted in lowering of the risk of dementia risk by 31%! Furthermore, the researchers noted that the benefits were also present for those patients with a history of stroke, heart disease and type-2 diabetes. This speaks to my wife’s daily mantra of: “Six cups of fruits and vegetables per day”. BTW, I do miss the mark but not as frequently as I once did AND, I do like ice cream 😊.

Now – About The Caffeine – As my long-time readers will know, I’m obsessed with ongoing studies, trials and reports on caffeine consumption. Why? Because for many years now, I’m one of the top consumers (my suggestion) of caffeine – in the form of strong coffee. I love it. I rarely get the signs and symptoms of too much consumption (e.g. headaches, jitteriness, etc.) and find the flavors of the various grinds to be wonderful. But, yet another report has come out reporting that individuals who drink more than 400 milligrams of caffeine a day appear more likely to develop heart disease. In fact, the investigators discovered that individuals consuming the highest amounts of caffeine (e.g. 600 milligrams/day or more) had significantly elevated heart rate and blood pressure even after five minutes of rest following a three-minute step test. Whew!! I’ll just be safe 😊. My BP runs in the “just over the 100s over 60s” and my pulse is a solid 82 (there’s nothing like reliable pacemakers). So, perhaps I’m an outlier. Actually, several people have mentioned that but I don’t think it related to caffeine…