“The Case Against ‘Whole Wheat’ and ‘Whole Grain’ Bread” plus 2 more Health

“The Case Against ‘Whole Wheat’ and ‘Whole Grain’ Bread” plus 2 more Health – TIME

The Case Against ‘Whole Wheat’ and ‘Whole Grain’ Bread
An Obamacare Repeal Could Hurt You Even If You Get Insurance Through Work. Here’s How
Only 10% of Men Get the HPV Vaccine

The Case Against ‘Whole Wheat’ and ‘Whole Grain’ Bread

Posted: 23 Jan 2017 10:36 AM PST

So you’re ready to include more whole grains in your diet, and you reasonably want to start with your daily bread (and crackers, and granola bars, and other grain-based snacks). When you consider that most U.S. adults only get half the recommended amount of daily fiber, opting for the bread that says “whole grain” or “high fiber” or “whole wheat” seems like a sage choice. And it is, if you know what to look for. The trouble is, it’s easy to get duped.

Not all whole grain foods are what they claim to be. Some contain only a small amount of actual whole grains and instead include refined flour—a pulverized version of what may, at some point, have been a whole grain. That’s a problem, because how much a grain has been milled or manipulated can also make a difference in how nutritious it is. Complicating matters is the fact that there’s no standard for telling people how much of a product — 50%, 100% — comes from whole grains.

“If you see the words whole grain on the label, that’s no guarantee that you are getting 100% whole grains,” says Bonnie Liebman, director of nutrition at Center for Science in the Public Interest, a nutrition advocacy group. CSPI petitioned the FDA in 2012 to address misleading whole grain claims and labeling and continues to publish research about potentially misleading claims on its website.

According to the Food and Drug Administration (FDA), which regulates nutrient and health claims about foods, a whole grain food must contain all components of a grain kernel. That includes the bran, the germ and the endosperm (the inner most part of the kernel). Whole wheat, oatmeal, brown rice, whole rye and quinoa are all examples of whole grains. Manufacturers take these whole grains and turn them into all sorts of products, from breads and crackers to pizza crusts, and that’s where the confusion sets in, since some of these products retain all three parts of the grain, while others do not.

To clear up confusion, here are the five things you need to know about whole grains.

1. “Made with whole grains” does not mean much.

“’Made with whole grains’ is the biggest scam out there,” says Liebman. “To many consumers that sounds like the bread or cereal or whatever is made only with whole grains when in fact, it usually is made with very little whole grains.”

The claim can hide the fact that while some whole grains are there, it’s mostly made of refined flours, which don’t contain the same nutrients and fiber that whole grains do, and can therefore contribute to weight gain and rising blood sugar levels.

What’s important is to find out what percentage of a product is actually made from whole grains, which isn’t always easy. If it says it’s made from “100% whole grains,” that’s a promising sign. If that’s not there, look at the ingredient list: products with whole grains listed first will contain more whole grains than a product where it’s not at the top of the list, but if the next two or three ingredients are refined flours, it’s probably not a very healthy choice.

2. The term “whole grain” doesn’t always refer to food of equal nutritional value.

This isn’t so much about the different types of grains — from wheatberries to bulgar to oats and more — but about what form they take in your food. There’s emerging evidence that the more manipulated a grain is, the more chances there are for nutrients and vitamins and fiber to drop out, leaving only a fraction of the original healthy nutritional content.

“Instead of being protected inside the grain kernel, which is a hardy, tough structure, it’s now disrupted so the grain’s vitamins and phytochemicals are oxidized and exposed to air,” says Dr. David Ludwig, director of the Optimal Weight for Life program at Boston Children’s Hospital and professor of nutrition at the Harvard T. H. Chan School of Public Health.

There are also studies that suggest that the body responds very differently to milled grains than to whole grains with the kernel intact. The idea is that the digestive system can absorb finely milled grains more quickly, and since grains are carbohydrates, that may send blood sugar levels spiking. That in turn puts a burden on the pancreas to churn out more insulin in a hurry, which over time can contribute to diabetes and weight gain. Whole grains that are less manipulated, however, may take longer to digest and therefore lead to more gradual rises in blood sugar. Ludwig did one of the first studies to reveal this effect: In a study of a dozen obese children, those who ate steel cut oats, a more unrefined form of oatmeal, were less hungry and showed more stable blood sugar levels compared with those who consumed instant oatmeal.

3. Fiber claims can be misleading.

You may think whole grains and fiber are equivalent, since the main reason why health experts recommend whole grains is to boost fiber intake, but that’s not always the case. For the most part, whole grains do contain more fiber, which can help to keep weight in check by making you feel full. But many products with whole grains that claim to be high in fiber contain added fiber, in the form of cellulose. Researchers still don’t know whether the health benefits of added fiber can mimic those of fiber gleaned from whole grains. “It’s somewhat questionable whether that fiber has the same functionality as that in whole grains,” says Alice Lichtenstein, professor of nutrition science and policy at Tufts University. “

4. “Multigrain” is another very tricky word.

It’s tempting to think multigrain products are better than whole grain ones, because more is better, right? Not exactly. Multigrain says nothing about whether the grains are whole vs. excessively milled, and it also doesn’t specify whether those grains are nutritious—some grains are, some grains aren’t. All it says is that the product contains more than one grain. Any secondary grains could be present in negligible amounts.

Ludwig suggests the simple visual test. “When you have it on your plate, does it look like a grain or no? If you’re eating wheatberries, bulgar wheat, quinoa, whole barley or brown rice, you can look down and see the grains and they look relatively whole,” he says. With the “wheat toast” you order at the diner with your egg white omelette, that’s probably not the case.

5. Not all whole grain foods are healthy.

It should now be clear that just because a food says it contains whole grains doesn’t meant it’s fiber-rich or even healthy. Foods like cereals and crackers that contain whole grains can also be loaded with sugar, salt and other artificial ingredients, and very little fiber. “Better for you doesn’t mean good for you,” says Ludwig about these foods.

An Obamacare Repeal Could Hurt You Even If You Get Insurance Through Work. Here’s How

Posted: 23 Jan 2017 10:08 AM PST

If you get your health insurance at work, you may have brushed off the fight over Obamacare as someone else’s problem. What you may not realize, though, is that the law added new benefits and protections to employer-based health insurance that you may have come to rely on.

President Trump and congressional Republicans have promised to repeal Obamacare, and both have made moves to begin unraveling significant parts of the law. The path forward is far from clear, but the GOP-controlled Congress is expected to go about dismantling portions of the law that deal with taxes and spending through a budget process, which requires only a simple majority vote. In addition, many of the law’s provisions can be revised without congressional action, and the administration has discretion about how to enforce many of its rules.

Here, a look at six benefits that employer health plans have gained under Obamacare — many of which could disappear if the rules are rolled back.

1. Free Preventive Services

Obamacare requires all new employer health plans to cover a range of preventive services at no charge to you when you go for care. This has been one of the most popular pieces of the law.

It’s estimated that 71 million Americans gained expanded access to services such as colonoscopy screenings, Pap smears and mammograms, well-child visits, and flu shots for both children and adults — all with no cost-sharing. In addition, most women with work-based health insurance have access to contraception with no co-pay, deductible or co-insurance.

Timothy Jost, a law professor at Washington and Lee University who is a leading expert on the Affordable Care Act, says Republicans could quickly propose regulations that begin to dismantle this part of the law — and that the requirement that insurers make women’s contraceptives available at no cost could be among the first items on the chopping block. “If and when that happens they could really hollow out the preventive services requirement and limit services,” Jost says.

2. No Waiting Period for Pre-existing Conditions

Before Obamacare became law, employers that offered health insurance could impose a waiting period before employees’ pre-existing health conditions were covered by the company’s health plan.

People who lost a job, weren’t able to afford COBRA, and went uninsured for 63 days or more could be forced to wait up to a year for benefits to treat an existing medical condition before the law was passed, notes JoAnn Volk, research professor with the Center on Health Insurance Reforms at Georgetown University Health Policy Institute. “Just the simplicity — that they cannot turn you down now or make you wait — is such a vast difference from the old world when … you were on this clock and had go through hoops to make sure you wouldn’t be denied coverage for a period of time,” Volk says.

The long-term prognosis for this benefit is gloomy, Jost says: “There’s a real threat that that could go away and we’d go back to the bad old days.”

3. Out-of-Pocket Limits

Obamacare set a cap on the total amount you have to pay each year toward medical expenses. For 2017, after an individual spends $7,150 — or a family shells out $14,300 — in deductibles, copayments, and coinsurance — your health plan will pick up the full cost of covered benefits.

In the pre-Obamacare world, there were no caps on how much you could spend in any given year, meaning that, even with good job-based health insurance, anyone being treated for a serious illness or injury was in danger of financial ruin.

Those annual caps are now under threat, Jost says.

4. A Bar on Lifetime Limits

Before Obamacare became law, insurers often placed limits on what they would spend on your care — either annually or over the course of a lifetime. It’s estimated that about 102 million people were in health plans with lifetime limits, generally of a few million dollars.

Though even a $1 million annual limit may sound high, one serious health diagnosis can change the equation. “Most people don’t realize that one bout of cancer before the law could cap out their insurance coverage, leaving them totally on the hook for all costs,” says Ron Goldstein, president of CHOICE Administrators Insurance Services.

The ACA barred plans from setting those limits — but Jost says that, under the Trump administration, we could very well see their return.

5. Parental Coverage for 20-somethings

The law allows parents to cover their adult children on their work-based health plans until they turn 26 — even if they’re married, are financially independent or live in another state.

Before Obamacare, young adults represented one of the fastest-growing groups of uninsured. According to the U.S. Department of Health & Human Services, 6.1 million young adults ages 19 to 25 have gained health insurance coverage because of the law.

President Trump and many legislators who oppose Obamacare have pledged to hold on to this provision. “That is not in the gun sights right now,” Jost says.

6. Right to a Review

Disagree with your health plan’s decision to deny a claim? Before Obamacare, people covered by many employer health plans had few options but to sue. Obamacare gave all patients the right to an external review by a third party, however. “You can question your insurance company saying no and win, and that represents huge savings,” Volk explains.

This provision may be safe for now, says Jost, who says a lot of health plans don’t actually mind external review: “I don’t see that as being a big controversy.”

Only 10% of Men Get the HPV Vaccine

Posted: 23 Jan 2017 07:23 AM PST

The vast majority of men who are eligible to get vaccinated against the human papillomavirus (HPV) do not, despite the fact that most men will get infected in their lifetimes, a new study shows.

Nearly all sexually active men and women in the U.S. get the HPV virus at some point during their lives, making it the most common sexually transmitted infection in the country. But men, especially, have been slow get the vaccine. A recent study published in the journal JAMA Oncology reveals that in a national survey of 1,868 men from ages 18 to 59, only 10.7% were vaccinated against HPV. The study also found that the prevalence of genital HPV among these men was just over 45%.

Typically HPV will go away on its own and will not cause any health issues. Most men and women clear the virus naturally six to 18 months after getting infected. In some cases, however, the virus can cause problems like genital warts or certain cancers, like cervical, vagina, penis or throat cancer.

Health authorities recommend all children ages 11 or 12 get two shots of the HPV vaccine, and the findings of the current study suggest the importance of early vaccination. Men ages 18 to 22 had an HPV prevalence close to 29%, and men ages 23 to 27 had an HPV prevalence of 46.5%.

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