Dos and don’ts for common colds

Many of the methods advised to ward off the common cold are based on pseudoscience rather than fact. David Robson looks at what works and what doesn’t

Covering your chest with brown paper and vinegar, soaking your feet in hot water, or wearing wet socks – the old cures for the common cold can seem laughable in light of modern medicine.

Yet the apparent benefits of many of the treatments we take for granted today – such as dosing up on vitamins or snorting salt water – evaporate under scrutiny. So what works and what doesn’t? BBC Future has sifted through the evidence to find out.

The first thing that many people will try is to supplement their diet with vitamins C and D,” says Michael Allan at the University of Alberta in Canada, who recently reviewed the evidence for the most popular remedies. “But the evidence is terrible for those.” Dosing up on vitamin C has been shown to mildly protect people under great physical strain– such as marathon runners – from falling ill, but for the average person it reduces your risk by just a 3%. “If an adult gets two colds a year, you’ll only avoid one cold in 15 years,” says Allan.

Zinc lozenges may have a firmer footing. Based on three clinical trials, Allan says that children taking regular zinc supplements will suffer roughly 1 to 1.5 fewer colds a year, on average – compared to the six to eight that is normal for school children. There is also some evidence that it can reduce the duration of a cold by a day or so. Given that zinc tastes unpleasantly astringent, and you would need to take it all year round for the full benefit, Allan is unsure if he would recommend it for general use.

Do enjoy a tipple… maybe

Perhaps we see it as a form of penance. It’s commonly held wisdom is that a night on the booze will weaken your body’s defenses and make you open to attack from viruses. The question has not been widely explored by doctors, but three independent studies suggest that regular (but moderate) drinkers are in fact less likely to catch a cold. Your tipple of choice seems to matter – wine helps whereas beer does not. Even so, this is only preliminary evidence and should be taken with reasonable scepticism, but it at least suggests that you need not blame self-indulgence for your suffering.

Don’t take antibiotics, but do consider cold relief pills

Put bluntly, there is no reason why antibiotics should help – since they target bacteria, whereas it is a virus that causes a cold. “There’s no real benefit from antibiotics, but they do increase the risk of adverse events like diarrhoea,” says Allan. Your best bet is to try to reduce your symptoms. Over-the-counter pills that combine antihistamines with decongestants or painkillers help relieve some of the nastier symptoms for adults (not children). But even then, the benefits are often modest and probably differ between people, and the particular types of infection they are suffering from, says Allan.

Do take a spoonful of honey (but beware other herbal remedies)

In general, herbal remedies – such as echinacea, or garlic tablets – fail to deliver the goods. The only one to show any promise is honey. A spoonful, taken straight before bed, was found to soothe a cough in three different studies, and proved better than other sugary drinks and cough syrups. Even so, the remedy has mostly been tested on children (although one study suggested that a combination of honey and coffee could help clear persistent cough in adults.) And the mechanism is far from clear. “But with good research [behind it], I think it’s reasonable to try,” Allan says.

Finally… ask for some TLC

The people that surround you may just determine how quickly you recover. Patients who report feeling greater empathy from their doctor seem to get over their illness more quickly, an effect that can be seen both in their own reports of the symptoms, and more objective measures of their immune activity. It’s not clear if the same is true of people closer to home, but in the absence of a miracle cure, a little compassion is not much to ask – and might just provide solace where the other remedies have failed.

More Cost of Health Care Shifts to Consumers

High-Deductible Insurance Plans Prompt Some to Delay Treatment

Doyle Lewis and his son, Ryan, at home in Minneapolis. The family has held off on some medical spending because of their high-deductible insurance plan. DAVID BOWMAN FOR THE WALL STREET JOURNAL

Americans increasingly have to dig into their own pockets to pay for medical care...

a shift that is helping to curb the growth in health spending by employers and the government.

The trend is being accelerated by the Affordable Care Act because many private plans sold by the law’s health exchanges come with hefty out-of-pocket costs, which prompt some people to delay or put off seeking care.

For the exchanges’ 2015 policies, which went on sale last month, “bronze-level” plans have an average deductible of $5,181 for individuals, up from $5,081 in 2014, according to a November report from HealthPocket, which publishes health insurance market analyses. Bronze plans generally cover 60% of consumers’ medical expenses.

While surveys show steeper out-of-pocket costs lead some people to defer even routine medical care...

economists say the trend brings an important upside: It is helping fuel a period of historically low growth in health-care spending, which eases the federal deficit.

The federal government said Wednesday that 2013 was the fifth consecutive year in which health spending grew at less than 4%. The 3.6% rate is the lowest since the government began tracking such spending in the 1960s. While economists initially credited the recession for the soft spending growth, the trend continued even as the economy improved.

A study published last year in the journal Health Affairs...

examined data covering more than 10 million workers at large employers where out-of-pocket costs increased. The study found that the employers’ health spending growth fell over the four years studied, and it attributed about one-fifth of that slowdown to steeper out-of-pocket costs.

“There has been a steady increase in deductibles and the main effect is to reduce use,” said Drew Altman, president of the nonprofit Kaiser Family Foundation. “The gradual shift to consumers having more skin in the game is encouraged as part of national policy, and it’s having an impact.”

Doctors such as David Holte, an orthopedic spine surgeon in Waconia, Minn., say they are seeing a change in peoples’ behavior as out-of-pocket costs rise.

“Patients are shopping around more,” said Dr. Holte of Twin Cities Orthopedics. “Back when everything was covered, they would get tests done and also get stuff done they didn’t need. Now they’re having cost discussions and putting off knee and hip replacements.”

One in three Americans said they or a family member delayed medical care because of costs in 2014, according to a report last month by survey company Gallup. That is the highest percentage since Gallup began asking the question in 2001.

One of the largest assessments of high-deductible insurance found...

the plans significantly cut health spending. The study by Rand Corp., published in 2011 in the American Journal of Managed Care, looked at more than 800,000 families across the U.S. When people shifted into plans with high deductibles, their health spending dropped an average of 14% compared with families in plans with lower deductibles, according to the report.

The historically low growth rates in health costs aren’t expected to last forever. Federal spending forecasters project U.S. health spending will increase 5.6% in 2014, in part because millions of uninsured gained coverage this year.

More cost-sharing with patients doesn’t explain the spending slowdown in Medicare, where beneficiaries pay just a sliver of the costs and their share has held steady in recent years. Spending growth for the program for seniors and the disabled slowed to 3.4% in 2013 from 4% in 2012, according to the Centers for Medicare and Medicaid Services. That is partly attributed to slower growth in enrollment and to beneficiaries’ lower use of services.

Economists point to other drivers behind the overall health-spending slowdown, including the sluggish economic recovery, as well as other components of the federal health law such as efforts to cut health-care fraud and provide more preventive care.

“No one is saying the entire change is due to the Affordable Care Act, but we shouldn’t infer that the ACA hasn’t done anything,” said Jason Furman, chairman of President Barack Obama’s Council of Economic Advisers.

Source: The Wall Street Journal, More Cost of Health Care Shifts to Consumers

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Growth In U.S. Health Spending In 2013 Is Lowest Since 1960

National health spending grew 3.6 percent in 2013, the lowest annual increase since the Centers for Medicare and Medicaid Services (CMS) began tracking the statistic in 1960, officials said Wednesday.

Spending slowed for private health insurance, Medicare, hospitals, physicians and clinical services and out-of-pocket spending by consumers. However, it accelerated for Medicaid and for prescription drugs, according to the report, published online by the journal Health Affairs.

Health care spending has grown at historically low rates for the past five years...

which is consistent with declines generally seen during economic downturns, such as the Great Recession that crippled the U.S. economy at the end of 2007. Looking ahead, “the key question is whether health spending growth will accelerate once economic conditions improve significantly; historical evidence suggest that it will,” noted the authors, who are from the CMS Office of the Actuary.

They also pointed out, however, that in the near term, the health sector will “undergo major changes that will have a substantial impact” on consumers, providers, insurers and sponsors of health care. These are the result of the health law’s creation of online marketplaces, its expansion of Medicaid, a shared federal-state health care program for the poor and disabled, and restraints the law made to the Medicare program, the analysts found.

“The balance of these and many other factors over the next few years will determine how the historically low health spending growth from 2009 to 2013 is viewed: as the temporary aftermath of the great recession or the beginning of a new era,” the authors wrote.

The study found that health care spending rose to $2.9 trillion, or $9,255 per person, in 2013. As a share of gross domestic product, health care remained at 17.4 percent, the same share since 2009, the CMS researchers found.

The 3.6 percent spending growth for 2013 tracks a CMS estimate from September and is 0.5 percentage point lower than 2012.

The growth in Medicare per-enrollee spending was relatively flat

increasing 0.2 percent after a growth rate of less than 0.1 percent in 2012. The authors credited younger and healthier baby boomers entering the program.

Medicaid spending increased 6.1 percent in 2013, following growth rates of 2.5 and 4 percent, respectively, in 2011 and 2012. A variety of factors, including increases in hospital care – which accounts for 36 percent of Medicaid spending — contributed to the cost increase. The federal government and state and local governments spent $449.4 billion in 2013 on Medicaid, accounting for 15 percent of total national health expenditures.

Medicaid enrollment grew 2.7 percent during that time frame, the first acceleration since 2009. Some of the 2013 increase was due to new beneficiaries who enrolled as part of the health law’s provision that allowed states to expand their Medicaid programs ahead of the 2014 expansion.

Other key takeaways from the report include:

Nearly 190 million people – or 60 percent of the population – were covered by private health insurance in 2013.

Premiums grew 2.8 percent, compared to an increase of 4 percent in 2012. Low overall enrollment growth, greater usage of high deductible plans and other benefit design changes and the health law’s medical loss ratio and rate review provisions contributed to the decline, CMS found. Private health insurance enrollment increased 0.7 percent last year, the third straight year of growth.

Consumer out-of-pocket spending...

including co-payments and deductibles or payments for services not covered by a consumer’s health insurance, was $339.4 billion in 2013, or 12 percent of national health expenditures. The 2013 growth was down from the 3.6 percent growth in both 2011 and 2012.

Spending for physician and clinical services

grew 3.8 percent in 2013 to $586.7 billion, a slowdown from 2012 when spending grew 4.5 percent. Expenditures for hospital care increased 4.3 percent in 2013, slower than the 5.7 percent rate of growth in 2012. Total spending growth for retail prescription drugs rose 2.5 percent last year, compared to 0.5 percent in 2012. Drug spending growth increased in 2013 for several reasons, among them higher prices for brand-name and specialty drugs.

HealthCare.gov Gets 222,000 New Sign-Ups in First Week

Health Secretary Calls Number a ‘Solid Start’ for Sign-Up Period

HealthCare.gov, which opened for its second enrollment period Nov. 15, has gotten off to a far better start than last year, figures show.

About 222,000 people made new sign-ups for insurance in the site’s first week of selling health coverage for 2015, while some 240,000 people renewed plans they bought on the federal insurance exchange last year, administration officials said Wednesday.

Technical problems plagued the site at its launch last year and only about 106,000 people were able to sign up in its first month of operation, which tarnished President Barack Obama ’s signature health-care law.

But the latest numbers also signal steep challenges ahead as the government tries to meet enrollment goals. Federal officials said Wednesday they are continuing to encourage millions of people to come back to the site to review their coverage and make any changes—while ensuring the site’s technical side can handle the heavy traffic.

The deadline for signing up for coverage is Feb. 15, but current policyholders have only until Dec. 15 to make changes to their coverage for the new year.

If those policyholders don’t come back to HealthCare.gov to see the latest offerings, the government automatically will renew their existing plans.

“We’re now one week into open enrollment, and we’re off to a solid start,” said Health and Human Services Secretary Sylvia Mathews Burwell. “It’s still early, and we have a long way to go.”

HealthCare.gov, set up under the 2010 health-care overhaul...

erves 37 states that were unable or unwilling to set up their own exchanges. Picking a plan is the final step on the website to obtain insurance. Consumers who picked a plan still have to pay their first month’s premium to their insurance carrier before they have coverage.

HHS also reported that the site had about 3.7 million visitors in the first week, with about 1.6 million using the window-shopping tool to browse plan prices.

HHS had come under criticism for not releasing detailed sign-up numbers for the law’s first enrollment period, or for the first few days of the latest round, especially since some states running their own exchanges already have done so.

Federal officials also made an embarrassing disclosure last week...

saying that 6.7 million people had paid for coverage through mid-October—not the 7.1 million it had earlier said. Ms. Burwell said her agency planned to release weekly reports on enrollment numbers going forward and that she was determined to find out what had gone wrong in earlier numbers.

As many as five million people picked plans through HealthCare.gov last year. Prices for many popular plans have increased, at the same time an influx of lower-priced plans could decrease the value of tax credits people get to offset their premiums.

Officials are banking on more people coming back to the site closer to the deadline for making changes to coverage...

raising the prospect of a crush of users on the site in the next 2½ weeks. Insurers will also have to sift through information they get from the site to make changes to people’s coverage in the days between Dec. 16 and New Year’s Day.

Andy Slavitt, principal deputy administrator for the Centers for Medicare and Medicaid Services, the HHS unit in charge of implementing the law, said Wednesday that the site had been built to withstand 250,000 concurrent users, with additional capacity that could be deployed. He said officials had made a conservative guess that up to four million out of the five million people would come back to the site.

The federal government is also working toward a back-end fix that would send insurers updates when their enrollees switch to plans offered by rivals, according to two insurance industry officials. That would reduce the risk that a person who bought a plan on the exchange for 2014 and switched to a different insurer for 2015 could end up enrolled in two plans, with bills for both, in January—a scenario that insurers feared would play out if they weren’t told about plan-switchers. Another industry official cautioned that it was too soon to know how any new solution would work.

At the same time it is juggling people renewing coverage, the Obama administration is aiming to increase the number of people who gain insurance through the health exchanges across the country.

Ms. Burwell has said she expects to see that number grow to nine million next year. Her target is significantly lower than a previous projection by the Congressional Budget Office, which estimated 13 million people would use the exchanges to have health plans for 2015.

HHS officials said Wednesday they had reached agreements with Westfield Shopping Centers, the trade association representing community pharmacists and the XO Group Inc., parent company of The Knot, The Nest and The Bump websites, to promote the law.

—Anna Wilde Mathews contributed to this article.

Source: WSJ:HealthCare.gov Gets 222,000 New Sign-Ups in First Week

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Answers to Every Possible Thanksgiving Health Question For 2014

Source: Fan favorites and responses from
James Hamblin at The Atlantic

This is going to be an okay Thanksgiving. 
Here's what everyone is asking.

Does turkey really make you sleepy, or does that just happen because we're all fatties and eat too much at Thanksgiving dinner? —Delaney Chambers, Washington, DC

Overeating and boredom and a paradoxical response to stress lead to sleep. The turkey-tryptophan story is one of the greatest lies ever in all of history.

What's all this about spatchcocking? —Sam Wells, Flint, MI

It lets you cook a turkey in 45 minutes, and all you have to do is remove the spine. Why is anyone not doing this? Spatchcocking got really popular in 2012, but it's been around a lot longer.

What's a good recipe for pumpkin pie if I'm on the Paleo diet? —Chet Woodhaul, Hammond, IN

None. You either eat like a real caveperson or you eat pumpkin pie, but you don't get to do both. Not this time.

How much turkey do I have to consume to absorb the drinks I need to survive Thanksgiving, and not get "too drunk"? —Tanvi Misra, Washington, DC

The protein and fat in turkey will slow the absorption of alcohol more than carbs will. You could also just drink less and eat less? But then! It wouldn't be a holiday, now, would it. [Cackles]

If I eat my Thanksgiving meal over the course of two hours instead of 10 minutes, is that healthier? Will I gain less weight and have fewer heart attacks? —Alana Semuels, New York, NY

Yes. If you eat more slowly you'll probably eat less. How many heart attacks are you having right now?

Has your stance on Tofurkey changed? I know the company sent you a big box of Tofurkey after you made fun of their name last year.—Steve Perkiss, Hillsboro, KY

It's just such a terrible word. I really can't eat it without telling like 10 people "I had Tofurkey for lunch" and then laughing like a weirdo. Hearing that demon word come out of my own mouth just shakes my whole sense of who I am as a person, my sense of ease and safety in my own body. But it's actually not terrible stuff.

For purposes of plate balancing, pumpkin pie counts as a vegetable, right? —Carl Johnson, Washington, DC

For purposes of plate balancing, yes.

Are there any health concerns I should be aware of when my children cover every one of their fingers with black olives? —Alan Taylor, Boston, MA

Only the health concern of that being too adorable! And the possible development of another serious health condition I won't get into here.

If you accidentally forget to remove the plastic bag filled with giblets from inside your turkey, and cook the whole thing, will the toxic plastic fumes ruin the whole bird, or can a simple airing-out make things both palatable and healthy? —Alan Taylor, Boston, MA

This one I looked up before: According to the FDA, if you forget to take out the bag of giblets, and it melts "or changes shape in any way," you shouldn't eat the turkey. I got a sort of similar question from Rose, too:

What is the relative risk of getting food poisoning from cooking stuffing inside the bird compared to the relative risk of having not-as-tasty stuffing when it's cooked outside the bird? —Rose Eveleth, New York, NY

The CDC says you can cook it inside of the turkey, as long as you put a thermometer into the stuffing and make sure it gets to 165 degrees Fahrenheit to kill the bacteria. Also, you guys know that the USDA has a "meat and poultry hotline"? 1-888-MPHotline. Who knew that poultry wasn't meat?

The best part of green bean casserole is the strange mini-onion-ring topping. How unhealthy is that part of the casserole, or is it balanced out (along with the cream of mushroom soup) by the massing of green beans? Also, what a weird dish, when you think about it. —Alan Taylor, Boston, MA

Alan, I love your questions. Next year let's do the whole thing between you and me. You can do the answers, too. I'll just watch. Okay, so, the green beans in green bean casserole never did anything for anyone. If the topping is your favorite part, just make sure you sit close to the casserole and then scrape off a few big spoonfuls before you pass it.

If I run a Turkey Trot in the morning can I eat the turkey skin?—Sophie Gilbert, Washington, DC

You know I am pro skin, even gravy-filled skin bowls. I thought my town was the only one with a Turkey Trot! I didn't know that was a thing. Yes, that's how exercise and food work.

Is it better to eat earlier in the day (say, 1:00 p.m. versus 5:00 p.m.) so that there's more time to burn off calories, or is that offset by the inevitable scrounging for leftovers around 7:00 p.m.? —Libby Bawcombe, Washington, DC

Don't worry about calories, but, yes a later meal is better because anticipation is such a valuable thing.

People are always nervous their family members will say something embarrassing. Could anxiety be good for digestion? —Derek Thompson, New York, NY

It's actually terrible for digestion. Your bowels are just an extension of your brain. Good luck!

All about that baste...

Calorie count to appear 
with many prepared foods

Calories don’t count on holidays. Apparently, the FDA didn’t get the memo since yesterday, it served up rules for nationwide nutritional information labeling. The rules apply to all US restaurants and movie theaters with more than 20 locations. That also includes grocery stores and places where take-out-meals are sold. And no, your cocktail isn’t safe. The new standard also applies to alcoholic drinks listed on menus. My eyes! My eyes! These rules have been a long time coming – menu labeling became a requirement in 2010 as part of the Affordable Care Act, but the final rules were delayed after pizza and movie theater chains put up a fight. The new rules (cough, the end of blissful ignorance, cough) will be go into effect within a year.

Wait... there's more

WASHINGTON (AP) — "Americans eat and drink about one-third of their calories away from home, and people today expect clear information about the products they consume," FDA Commissioner Margaret Hamburg said.

WHERE YOU'LL 

SEE THE LABELS

Calorie content will appear on menus and menu boards in chain restaurants, bakeries, coffee shops, pizza delivery stores, movie theaters, amusement parks and any other locations that are part of a larger chain and serve prepared foods. They will also apply to some prepared foods in supermarkets and convenience stores.

The idea is that people may avoid that burger and fries if they add up the calories — and retailers may make their foods healthier to keep calorie counts down.

The menus and menu boards will tell diners that a 2,000-calorie diet is used as the basis for daily nutrition, noting that individual calorie needs may vary. Additional nutritional information beyond calories, including sodium, fats, sugar and other items, must be available upon request.

WHY THE RULES 
WERE DELAYED

Calorie labeling became law as part of health overhaul in early 2010, almost five years ago. Hamburg says writing the rules was challenging because of the need to navigate concerns of the varied establishments that sell food. Supermarkets, convenience stores and pizza deliverers lobbied hardest against the rules.

Restaurant chains went along with the rule as a way to dodge an uneven patchwork of local rules and pushed for the other establishments to be included.

GROCERY 
STORE CONFUSION

Representatives of supermarkets have said the rules could cover thousands of items in each store, far more than restaurants. To address that, FDA excluded prepared foods that are typically intended for more than one person to eat and require more preparation, like deli meats, cheeses or bulk deli salads. But a sandwich sold in a grocery store would have to have a calorie label.

In some cases foods will have to be labeled in one part of the store but not in another. Cut fruit would be labeled in a salad bar, for example, but not in a container for sale, because that is generally meant to take home and eat over a period of time. The FDA says the idea is to label calories of foods that are meant to be eaten at the store or as takeout, rather than for further preparation at home.

Leslie G. Sarasin, president and CEO of the Food Marketing Institute, said the group is extremely disappointed in the rules, which she said will affect stores' offerings of "fresh, minimally processed, locally produced items" such as cut cantaloupe, mixed salads or steamed seafood.

BOOZE INCLUDED

One surprise in the final rules is that alcoholic drinks will have to be labeled if they are listed on menus. Alcohol had been exempted in rules proposed three years ago.

Nutrition advocates say customers often don't realize how many calories they are drinking when they order beverages like margaritas and ice cream drinks. Drinks ordered at the bar won't have to be labeled if they aren't on a menu.

WILL IT WORK?

New York City was first in the country to put a calorie-posting law in place, and other cities and states have followed. McDonald's and other restaurant chains already put calorie labels on menus and menu boards. The labels are popular with many, but it's too soon to know whether they'll affect obesity rates.

A recent Agriculture Department study found the diets of people who use nutritional information are markedly better than those who don't, and healthy eaters had more interest in the labels. The USDA paper concluded that it "may be too optimistic" to expect that those who don't use nutrition information will adopt healthier diets if exposed to it.

WHAT'S NEXT

Even before the new rules were announced, some Republicans in Congress had expressed concern that they would be too burdensome.

Sen. Roy Blunt, a Missouri Republican, introduced a bill in the Senate earlier this year that would narrow the scope of the labeling. He said in a statement Tuesday that the regulations could hurt job growth and impose unnecessary costs on some businesses. He said he would "continue to push back" on the rules.

Source: All about that baste: theSkimm- November 26th, 2014; Chron- Calorie count to appear with many prepared foods

Lung cancer awareness month

November is lung cancer awareness month.

According to the American Lung Association, lung cancer is the nation’s top cancer killer.

Most lung cancer is found in its later stages when it may be treatable but is not curable.

People at high risk for lung cancer should be screened.

High risk criteria includes people between the ages of 55 and 74, who have smoked within the past 15 years, are healthy enough to tolerate cancer treatment if lung cancer is found, and smoked for at least 30 pack years. Pack years are calculated by multiplying the number of packs smoked each day by the number of years someone has smoked – for example, 2 packs a day for 15 years equals 30 pack years.

In 2015, many private insurers will be required to cover lung cancer screening in this high risk group.

Also, recently the U.S. Centers for Medicare and Medicaid Services, or CMS, proposed that lung cancer screening be covered by medicare in this group as well. A final determination is expected in the next few months.

While screening may catch lung cancer early, quitting smoking to prevent lung cancer in the first place is best.

It’s common for small lung nodules to turn up in a lung cancer screening scan which can lead to additional procedures, scans and emotional distress.

That’s why only those at highest risk show the most benefit from screening.

Source: WWSB My Suncoast Health Lung Cancer Awareness Month