Dr. Bob's Mouthly Report

With sugary sodas and other sweetened drinks considered a key driver of the obesity epidemic worldwide, a new research review evaluates how well various measures work to reduce consumption of these calorie laden drinks.

Strategies including limited availability of sodas in schools, removal from children’s menus at restaurants and better labeling could help reduce consumption, according to the analysis published in The Cochrane Database of Systematic Reviews.

“Governments and industry in particular must do their part to make the healthy choice the easy choice for consumers. This review highlights key measures that can help accomplish this.”

Read more at Reuters

After years of sharp increases in fatal drug overdoses in the U.S., provisional federal data provide reason for cautious optimism. The drug overdose death rate dropped slightly between 2017 and 2018, according to the new estimates, after two decades of near-constant upticks.

Between 1999 and 2017 the age-adjusted overdose mortality rate increased from 6.1 to 21.7 deaths per 100,000 people, according to federal data. According to data released June 11 by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS), that number dropped to an estimated 20.8 deaths per 100,000 for the 12 months ending in the second quarter of 2018. That figure isn’t final, and it shows only a modest downturn in drug deaths, but it’s still an encouraging sign after decades of snowballing substance use.

Read more at Time

The cost of health care affects every aspect of the U.S. health care system. It dominates political discussions on health care, impacts decisions about insurance coverage, and ranks at the top of things Americans worry about. It also plays a significant role in the patient experience from decisions on whether or not to get care to the impact of medical bills after receiving care. This data note summarizes the most recent Kaiser Family Foundation polling on the public’s experiences with and worries about health care costs. Main takeaways include:

Health care costs dominate public and personal discussions on health care. Americans consistently put health care costs at the top of their list when it comes to health care issues they want the government to address and for political candidates to talk about and recent KFF polling indicates health care costs now occupy a tier of their own on the public’s list of pressing health care issues. Health care costs also top the list of household expenses the public worries about affording.

Some insured adults report difficulty affording the routine costs of health insurance. While majorities of those with health insurance report that it is easy (either “very easy” or “somewhat easy” for them to afford to pay the routine costs of health insurance like premiums and deductibles, some insured adults (at least one-fourth) say it is difficult for them to afford these routine costs. In fact, one-third (34 percent) of insured adults say it is either “very difficult” or “somewhat difficult” for them to afford to pay their deductible.

Health care costs stop people from getting needed care or filling prescriptions. Half of U.S. adults say they or a family member put off or skipped some sort of health care or dental care or relied on an alternative treatment in the past year because of the cost, and about one in eight say their medical condition got worse as a result. Three in ten of all adults (29 percent) also report not taking their medicines as prescribed at some point in the past year because of the cost.

Difficulty paying medical bills can have significant consequences for U.S. families. About one-fourth of U.S. adults (26 percent) say they or a household member have had problems paying medical bills in the past year, and about half of this group (12 percent of all Americans) say the bills had a major impact on their family. Medical bill problems also disproportionately affect sicker populations like individuals living in households with a serious medical condition.

Individuals with employer-sponsored insurance coverage are not immune to problems with health care costs. Many problems associated with the cost of health care coverage and services in this country are frequently attributed to the share of the population who are uninsured or buy their own coverage. Yet, KFF polling finds that even individuals with employer-sponsored insurance, especially those in high deductible plans, have difficulty affording their health care or health insurance, or report problems paying medical bills.

Some populations experience the most difficulty with affording the cost of their health care and health insurance. Individuals living in households where someone has a serious medical condition, the uninsured, and those with lower-incomes are more likely to struggle with medical bills and report putting off care because of cost.

Read more at KFF

Five years ago, a study of death certificate data attracted notice for suggesting that states that passed medical marijuana laws saw 25 percent fewer opioid overdose deaths on average than states that barred medical cannabis.

The authors were careful to point out that this finding was only a correlation, an intriguing hint at something that needed further exploration. There was no way to establish whether the availability of medical cannabis in some states protected against overdosing on harder drugs, even if some people used marijuana for pain.

Nevertheless, the cannabis industry took up the study to help win passage of medical cannabis laws in more states, even as medical experts expressed skepticism. In a 2018 report, for example, Maryland’s medical marijuana commission found “no credible scientific evidence” that marijuana could treat opioid addiction.

Now comes a study from Stanford University School of Medicine showing that when researchers looked at a longer period of time, states that introduced medical marijuana actually had 23 percent more deaths from opioid overdoses.

Read more at The Washington Post

SATURDAY, June 8, 2019 (HealthDay News) -- The kind of foods you eat, and even the order in which you eat them can affect your odds of developing type 2 diabetes, three new studies suggest.

The studies -- being presented to the American Society for Nutrition -- found:

Switching to a mostly plant-based diet (but one that could still include meat and dairy) could reduce the risk of type 2 diabetes by as much as 60%.

Eating greater amounts of vitamins B2 and B6 was linked to a lower risk of type 2 diabetes, while getting more B12 in the diet seemed to be associated with a higher risk of type 2 diabetes.

The order that you eat your foods appears to matter. People who ate vegetables before having meat or rice had lower blood sugar levels, along with positive changes in their hunger hormones.

Dr. Rekha Kumar, an endocrinologist at NewYork-Presbyterian and Weill Cornell Medical Center in New York City, reviewed the findings.

"Emphasizing fruits and vegetables and whole foods is a very practical and easy way to manage type 2 diabetes," she said. "Half your plate should be green, even at breakfast, when you could have an egg white omelet with spinach for example."

As for the sequence of eating, Kumar said vegetables, high-fiber foods and even protein take longer to leave the stomach, which slows down the rise in blood sugar levels.

"Theoretically, changing the order you eat foods could have implications on weight and appetite control," she said.

Read more at HealthDay