The amazing technological game changer is here

And it is talking combined with trusted social engagement.

Medicare recently authorized a creative new diabetes prevention benefit that leads to better health results and significantly lower costs.  The core technological driver is talking and coaching at the YMCA.  The Incidental Economist/New York Times has details:

That feeling shifted last week when Sylvia Mathews Burwell, the secretary of health and human services, announced that Medicare was planning to pay for lifestyle interventions focusing on diet and physical activity to prevent Type 2 diabetes. It’s an example of small-scale research efforts into health services that have worked and that have expanded to reach more people….

The Diabetes Prevention Program grew out of extensive research on weight managementand behavioral learning. More than 3,200 patients age 25 to 75 with pre-diabetes were randomized to one of three groups. The first group was given an intensive lifestyle intervention. By focusing on a low-fat, low-calorie diet with the addition of exercise through brisk walking or a similar intensity activity, it encouraged people to lose at least 7 percent of their body weight and maintain that over the course of the trial.

The backbone of the intervention involved 16 one-hour face-to-face meetings that helped each individual participant set and achieve goals to improve health habits. The second group was treated with metformin, a medication that can lower blood glucose, and the third was the control group, provided with a placebo medication.

The trial was ended early because the results were so compelling. Those in the medication arm had a 31 percent reduction in the risk of developing diabetes. More important, those in the lifestyle intervention saw a 58 percent reduction in their risk. Moreover, if you were 60 or older at the beginning of the study, your reduction was 71 percent. A later meta-analysis confirmed that these results for lifestyle interventions were replicable across numerous different studies….

the behavioral expert, Mr. Marrero worked with the Y to reshape all 16 core intervention lessons and several maintenance lessons into a group-based format led by instructors who were Y employees. The new intervention was about $205 per person, a fraction of the original cost.

They estimate that if the Y program were expanded to all Medicare beneficiaries, the government might save about $2,650 per participant over 15 months, much more than the program cost.

This is a big deal. And the core component of the program is frequent coaching sessions by a trusted coach who gives actionable feedback and course correction guidance.

Talking and trusted coaching is the killer app of population health management, not a new set of pills or ever more doctoral level providers, although doctors are critical as they are the most trusted information conduit. Payment reform is part of the package but it is just an enabling feature. Payment reform without trusted coaching to achieve behavioral change is massively insufficient.

My employer is working on a coaching initiative that is showing very significant results in terms of health improvement and cost avoidance. We had tried for years to have a call center staffed with nurses and nutritionists and pharmacists to harass people into making behavioral changes. The problem was the probability of someone staying on the phone for more than fifteen seconds after the caller identified themselves as coming from the insurance company.  We were getting a lower retention rate than cold-callers selling steak knives.  However as soon as primary care physicians were told to write an actual prescription to call the insurance company for help, response rates quadrupled and preliminary results are showing some awesome (and statistically significant) changes.

Under the old fee for service model, good health coaching made no economic sense for the primary care provider.  A good health coach provided by an outside entity meant office visits avoided, it meant tests avoided, it meant hospitalizations avoided.  Those are all great things for the patient, those are all great things for the payer.  They are bad things for the primary care physician’s revenue.  However the movement towards accountable care organizations and risk adjusted capitation means these are opportunities for better member health and better profits for the doctor.  They don’t have to see their frequently visiting patients as often or at as high level of care, they are ordering fewer tests and seeing fewer hospitalizations.  Since they are getting a flat fee for their entire practice and their more expensive patients are getting cheaper to manage because they are getting healthier, they make more money and more importantly according to a few focus groups I’ve observed, they’re happier practicing medicine instead of writing scrips.

From a system perspective, a significant fraction of healthcare costs, especially for the Medicare population, have roots in modifiable behaviors. Changing those behaviors through trusted talking and coaching is usually more effective and efficient than prescribing brand name prescriptions or in-patient admissions. We’ll see more talking and less cutting in the future.






150 replies
  1. 1
    BGinCHI says:

    Was hoping for jetpacks.

    Another broken promise from my childhood…..

  2. 2
    raven says:

    We have an RN from the local hopsital at our Y a couple of days a week and she brings in a bevy of nurses to do health screenings for folks on a regular basis.

  3. 3
    Cermet says:

    A recent study has shown that raising ones Vit D levels from under 20 ng/dl to above 45 ng/dl can lower across the board cancer risks over one’s life by 67%! That is amazing considering over 90% of the population is well under 20 ng/dl. Come on people – this is too simple and easy not to do! Cancer is ugly, so why not lower your risk by a huge margin? Especially woman with their huge breast cancer risk (1 in 7 woman will develop that cancer)!

  4. 4
    Baud says:

    a significant fraction of healthcare costs, especially for the Medicare population, have roots in modifiable behaviors

    Like too much blog reading?

  5. 5
    Poopyman says:

    @BGinCHI: Saw the latest version of a flying car on the new PopMech cover. It looks like an overgrown drone, with unprotected 4 ft rotors. Yeah, that’ll fly with the lawyers.

    But let us not hijack a thread with some BFD news. It seems completely obvious on the face of it, which is one reason it’ll be resisted. I suspect another is that Very Serious People will find that kind of $$$ payback hard to believe.

  6. 6
    Gin & Tonic says:

    @Baud: Reading is benign. Posting is malignant.

  7. 7
    Poopyman says:

    @Baud: Actually, yes in my case. If I took a walk for every time I logged on to BJ I’d probably knock my BP down 10-15 points. I seem to have won the gene lottery in weight control, fortunately, but I’m becoming unnaturally (for me) sedentary.

  8. 8
    guachi says:

    Reduce diabetes risk with this one weird trick!

  9. 9
    WereBear says:

    @Cermet: I’m a serious serious Vitamin D fan. Especially since I live in the Frozen North.

    they’re happier practicing medicine instead of writing scrips

    As they should be. Most people are not aware that we lose a lot of physicians to suicide. If they want to be healers, let them heal people.

  10. 10
    debbie says:

    @WereBear:

    I’m a serious serious Vitamin D fan

    Me too. It’s been shown to help with calcium absorption for osteoporosis and with autoimmune diseases like fibromyalgia, just to name a couple things. You have to be careful not to overdo it on the dosage though.

  11. 11
    Cermet says:

    @debbie: @debbie: Don’t forget K-2 (MW 7 and above)! If K-2 levels are low, bones will get less calcium and artery walls get more!!!!

  12. 12
    Cermet says:

    @debbie: @debbie: To o-d on Vit D is difficult but as long as levels are less than 125 ng/dl all should be well. That would require over 10,000 IU for most people. Taking 2000-3000 IU should get one above 45 ng/dl but keep one well below 125 ng/dl even if one has heavy sun exposure.

  13. 13
    WereBear says:

    @Cermet: I do take some, but also indulge in pasture raised butter. The most awesome tasty stuff.

    My only complaint about the program described above is that low fat does not work for everyone. A considerable cohort is carbohydrate sensitive, and fat is their friend.

  14. 14
    Cermet says:

    @WereBear: @WereBear: Low fat is an illusion if one replaces it with refined carbs. These (and ESPECIALLY standard sugar and high fructose sugar) are converted into triglycerides (always) which are the backbone of cholesterol which, besides heart disease, adds to cellular fat development when calories exceed need. Never understood the pointless low fat; rather, I would think it is better to avoid process foods with high fat and red meat. Also, one really bad source of fat: soybean oil

  15. 15
    Zinsky says:

    A pretty long read… I can be much more succinct: There is no better way to live a longer, happier, more disease-free life than one hour of vigorous exercise at least five days a week.

  16. 16
    Benw says:

    First healthy school lunches, then promoting fitness, now this! When will the Obama administration’s totalitarian regime to make us healthier and feel better ever end! Comrades, to the wildlife refuges! Bring snacks!

  17. 17
    wag says:

    @Cermet:

    Provide a link to the study, then maybe I’ll believe it. Otherwise you’re just another Ponce de Leon spouting Fountain of Youth BS

  18. 18
    WereBear says:

    @Cermet: A wonderful book, Death by Food Pyramid, explains how our ancestors adapted to what they ate, and we inherited their enzymes. I can’t live on a vegetarian diet; and I spent months trying, once. It’s because I don’t have the enzymes to extract protein from vegetable sources.

    But I get along fine with red meat, seafood, high fat dairy products, measured amounts of vegetables. I don’t do fiber; it doesn’t agree with me.

    Basically, every single strategy nutritionists urged upon the nation for the past few decades was exactly the wrong thing for me to be eating. Once I got a grip on that, my health got much better.

    But yes, soybean oil is not good for anyone!

  19. 19
    BR says:

    @WereBear:

    I’m not sure I buy the notion that it’s not possible to get protein from non-meat sources. I used to eat meat, but have been vegetarian for about 10 years now, and even when I a lot of strenuous work I still feel fine with my usual sources of protein (dairy, eggs, tofu, legumes).

  20. 20
    WereBear says:

    @BR: Hey, maybe it doesn’t work that way for YOU.

    All I’m saying is what happened to ME.

  21. 21
  22. 22
    Wapiti says:

    @OP, for a while when we lived in California we were covered by Kaiser Permanente. Kaiser, as the insurer and provider had a nurse hotline for their covered population. They also had a inch-thick medical guide they sent to their people. It was basically a first aid book: if you have this symptom, you can treat it at home with this cheap solution. If you have this symptom, you need to see a doctor – here is the number. Ten years and a couple of moves later, that book is still a trusted source.

  23. 23
    BR says:

    Richard, I like this post because it’s a great reminder that “technology” doesn’t have to be “high-tech” to be effective, and lots of “high-tech” technology is totally useless.

    I’m reminded of a quote in a different context — fighting climate change — and the false technological solution thinking that accompanies it among “bright green” environmentalists:

    If a machine were invented that scrubbed carbon from the atmosphere and turned it into useful food, construction materials, animal feedstocks, and fibers, all while rebuilding topsoil, it would be on the cover of every tech magazine in the world and its inventor would be a celebrity millionaire. Yet I’ve never seen a tree on the cover of Wired.

  24. 24
    Cermet says:

    @wag:All my data is from referred journals done by PhD or MD’s. See this link for the latest short take on this very topic (by the way, learn how to google topics and read for yourself; it is your health, by the way.) https://www.sciencedaily.com/releases/2016/04/160406165254.htm

  25. 25
    Cermet says:

    Make that refereed; but I am referring, though ….

  26. 26
    laura says:

    I’m partnering with a friend who is struggling with prediabetes. We’re doing the 5:2 fasting and are on week three. 5:2 is two non consecutive days that allow 500 calories per day and five days of normal eating. The fast days take some planning, but otherwise pleasant.
    If anyone is interested in the effects on weight/blood work after a couple of months, just say so.

  27. 27
    WereBear says:

    @BR: That’s an awesome quote. And so true.

  28. 28
  29. 29
    Hillary Rettig says:

    Richard –

    Great post. A couple of books may be of interest:

    Tina Rosenberg’s Join the Club is a good overview of the many way people are coming together to create positive change in the world and their lives. It does talk significantly about fitness alternatives.

    David Shipler’s The Working Poor. A great book overall but the part where your plan cleverly had drs. write scrips for insurance co. intervention reminds me specifically of the section where doctors at Boston Medical Center(?) got so sick and tired of seeing poor kids with asthma that the hospital hired a lawyer to go after landlords of debilitating (moldy, etc.) housing.

    Also, many vegan groups hold events specifically to help people manage diabetes. My group is holding one in a couple of weeks – a discussion by a vegan chef who himself suffers from Type 1 Diabetes (formerly juvenile diabetes):

    http://www.meetup.com/Vegan-Ka.....229224571/

    Vegan is a good preventative / cure because it’s very low fat and so increases insulin sensitivity. Also if you’re a good vegan and not a “pastaterian” (I’m often guilty), you’ll eat your whole grains and veggies, and that will also naturally stabilize blood sugar levels.

    A lot of local vegan groups would be thrilled to be called by any insurance company or doctor who would like help and support in getting patients to eat better. (We do workshops, have buddy-mentor programs, etc.) We have an analogous problem to the one you described – we reach out to doctors all the time and never get a callback.

  30. 30
    Hillary Rettig says:

    also – grammar nerd alert – I’m quite excited to see the word “actionable” used as quoted. We need that word! My understanding is that it still means only “something that will get you attacked by a lawyer.” But if the meaning has broadened so it now means “information you can actually do something with” that would be excellent news for my Friday.

    Anyone know?

  31. 31
    Cermet says:

    @laura: Confused – eating a diet high in sugar and/or refined carbs isn’t gonna work on the problem just because one cut back for a few days. Yes, average AC-1 sugar blood levels will drop a bit but then one gets rebound during normal eating and are still eating the same bad diet for five days, as well. Rather, I would think, eliminating the majority of refined carbs (and replacing with non-refined) and using low calorie sugar (wood alcohol derived) or sugar subs and eating a normal level of calories would appear to be a better bet; both for long term change and short term gain.

  32. 32
    Gin & Tonic says:

    @Hillary Rettig: Is the word “useful,” um, no longer useful?

  33. 33
    Hillary Rettig says:

    This will also be of interest:

    http://www.theguardian.com/soc.....ohn-yudkin

    And if anyone hasn’t seen Dr. Lustig’s anti sugar talk you should watch it.

    Cermac – I’m pretty obsessed about “evolutionary mismatch” diseases myself – the diseases caused by a mismatch between the way our species has evolved for 6MM or so years, and how we’ve started to live in the past 10,000 years.

  34. 34
    Rob in CT says:

    Just speaking for me here, but what works for me is a relatively high fat/protein, low(er) carb mix. I still eat lots of carbs, but less than I used to and certainly less of the worst carbs. I replaced them with more veggies and meat/dairy/nuts.

    The result was not only ~30 lbs of weight loss but also large drops in my blood sugar, triglycerides and cholesterol, plus a nifty improvement in the ratio of my ldl & hdl. I went from “we may have to start medicating you” to “huh, why is there a note in your file about medicating you, you’re nowhere near needing that” in a year.

    Exercise is great for other things but on the weight loss front not so much in my experience. I did start walking more during the period where I lost the weight, but it was a very minor factor. It was almost all diet. Since then, I’ve more or less held steady but been exercising much more. This is good obviously, but it hasn’t helped me drop that last 10 lbs I want. To do that, I probably have to largely give up beer/wine (*sob*).

  35. 35
    Hillary Rettig says:

    @Gin & Tonic: useful = a bit more generic. actionable means “a piece of advice I can get started on right now!” that advice is really valuable, so an adjective describing it would also be very valuable.

  36. 36
    Joel says:

    Just don’t overdo it with the Vitamin D supplements.

    One thing to keep in mind is that D is not a vitamin in the conventional sense, but a hormone. The primary function of this hormone is maintaining calcium levels in your body. If you have too much, you can get hypercalcemia, which can lead to a whole host of problems, not the least of which being kidney stones.

  37. 37
    Hillary Rettig says:

    @Rob in CT: Wonderful result! Congratulations.

  38. 38
    Alain the site fixer says:

    Interesting discussion! Anyone notice the new “HTML tips” buttons under “Leave a Comment”? Do they work for you?

  39. 39
    low-tech cyclist says:

    Richard – the tricky part, I’d guess, is scalability. Not so much whether a coaching program like this can be scaled, because I can’t see a reason why it can’t, so much as the danger of trying to scale it up faster than you can train successful coaches, and winding up with a lot of crappy coaches who discredit the program through their lack of success.

  40. 40
    WereBear says:

    @Alain the site fixer: I wanted you to know I love the new look! Thanks for drawing my attention to the wild expanded functionality.

  41. 41
    Baud says:

    @Alain the site fixer:

    Anyone notice the new “HTML tips” buttons under “Leave a Comment”? Do they work for you?

    Let’s see.
    Headings and horizontal lines

    Baud! 2016!
    Baud! 2016!
    Baud! 2016!
    Baud! 2016!
    Baud! 2016!

    ETA: Nope.

  42. 42
    Alain the site fixer says:

    @WereBear: Thanks! I’m a technical writer/trainer/client service person at heart, so I like to document and help others make better use of the tools they have. Now, back to things that folks complain about!

    Post categories and # of comments moving down in a few and 2-3 size tweaks after the move and I think we’re pretty much done.

  43. 43
    Alain the site fixer says:
    1. list test line 1
    2. line 2
    3. line3
    • list test line 1
    • line 2
    • line3

    Ordered list then unordered list.

  44. 44
    Alain the site fixer says:

    wtf ul formatting is facacta

  45. 45
    Alain the site fixer says:

    This is text


    this is more text



    last text

  46. 46
    Alain the site fixer says:

    h1 test

    h3 test

  47. 47
    Baud says:

    Ordered lists

    The three things I would accomplish as president:

    World peace.
    Economic justice
    . . . Oops

    ETA: No list numbers.

  48. 48
    Alain the site fixer says:

    @Baud: You did something wrong.
    bracket h1> your text bracket /h1>
    bracket hr> makes a line

    Substitute < for the "bracket "

  49. 49
    Baud says:

    @Alain the site fixer: I think you have special html tagging privileges that we proles do not get.

  50. 50
  51. 51
  52. 52
    Hillary Rettig says:

    @low-tech cyclist: valid point. one model would be Weight Watchers and there are probably some others. Of course, this is another one of those projects that enrich the masses and not plutocrats (similar to teaching, infrastructure repair, and green building) so I’m sure we can’t possibly find money for it…

  53. 53
    Chyron HR says:

    @Alain the site fixer:

    These are boobies:

    (. Y .)

  54. 54
    Alain the site fixer says:

    @Baud: to make an ordered list
    bracket ol> bracket li>list item 1 bracket /li> bracket li>list item two bracket /li> bracket /ol>

    Switch ul for ol to make an unordered list.

  55. 55
    zzyzx says:

    I was diagnosed with Type II three years ago. I started going low carb with 30 minutes of intensive cardio exercise every day. I then added lifting to that. Now my numbers are almost always within the normal range and I went from being last place in slow man races to being in the top 20 percent of finishers in 10ks and half marathons. It does work!

  56. 56
    Rob in CT says:

    @Hillary Rettig:

    Thanks.

    Of course, different approaches work for different people. My best friend also lost a bunch of weight (~80 lbs) and largely did it by eating whatever he wanted and exercising like mad.

    Meanwhile, a relatively of mine did more what I did, but took it to an extreme – some kind of super Atkins type diet (utilizes ketosis) where he eats nearly zero carbs and ridiculous amounts of fats. It’s basically a fat-based diet with occasional greenery thrown in. The dude has lost over 100lbs (~300lbs -> 185lbs).

    So I’m in the middle. Fewer carbs, but still quite a few. More veggies but also more animal fats. Smaller portions for sure. Some exercise but not all that much. My results are also more moderate. Rather than losing ~1/3 of my bodyweight, I lost ~1/6.

    It was funny in that we were all doing this at the same time, with different approaches and all getting pretty eye-popping results. And we’re all keeping the weight off, because the changes we each made are sustainable changes. I couldn’t go the exercised-based route (mentally *or* physically), or the no carbs at all route (zero pasta? awful low carb beer occasionally? no crackers ever with my cheese? Not a chance in hell). But the mix I chose works because I like it. I eat yummy things in moderation and have given up only things that I find I don’t miss a lot.

  57. 57
    Alain the site fixer says:

    @Chyron HR: Booby

  58. 58
    Alain the site fixer says:

    @Baud: Try this.
    Ordered list
    <ol> <li>List item 1 </li> <li>List item two </li> </ol>
    Unordered list
    <ul> <li>List item 1 </li> <li>List item two </li> </ul>

    Unordered list needs formatting work but at least it makes a list! :lol

  59. 59
    Baud says:

    @Alain the site fixer:

    Copied and pasted:

    Ordered list
    List item 1 List item two
    Unordered list
    List item 1 List item two

  60. 60
    Alain the site fixer says:

    @Baud: Perhaps. I will use Edge which isn’t logged in and see. New nym coming

  61. 61
    Gelfling545 says:

    @raven: the church I used to belong (ELCA Lutheran) to back when I did that stuff and still have some contacts with hired a parish nurse to help members – mostly elderly- with addressing health issues. It’s been quite successful. The feeling seems to be that she’s someone who knows you and who is solely concerned with your welfare so she is trusted more that the various physicians one gets shuttled around to.

  62. 62
    Baud says:

    Why am I not surprised that the powers that be want to silence my html headings? They don’t want you to know the truth.

  63. 63
    WereBear says:

    @Rob in CT: And we’re all keeping the weight off, because the changes we each made are sustainable changes.

    Exactly. These have to be things you can do, and be happy with, long term.

  64. 64
    Bob the site tester says:

    Ok so now I’m not logged in and have no privileges.
    ordered list
    list item 1list item 2

    unordered list
    list item 1list item 2

  65. 65
    Baud says:

    @Bob the site tester:

    Bob the site tester

    LOL.

  66. 66

    @Bob the site tester: Not from Portland, are you?
    In Soviet Tunchland, site fixes you.

  67. 67
    Alain the site fixer says:

    @Baud: Indeed. Baud is right. Baud is good. Baud is right for your neighborhood.

    Bet you didn’t know I write campaign slogans too? That’ll be $150, PayPal please.

    Looks like folks can’t use many of the html codes that us admins, etc. can which isn’t quite right. So I’m going to remove that stuff for now. I’ll test what can be done by mere mortals and then re-enable. Sorry for the confusion and thanks to all!

  68. 68
    Alain the site fixer says:

    @schrodinger’s cat: Damn I so should have chosen a different nym for my alternate tester!

    I’ve used “bob” as a throwaway name for such things since I labeled a porn movie “Bob’s Interesting Day” for a special teacher-free high school A/V club Friday meeting! To clarify, I attended an all-boy school from 4th-12th grades.

  69. 69
    Steeplejack says:

    @Alain the site fixer:

    I think you should disable some of those tags. I can see no good coming from excitable commenters throwing headline tags into the word salad. Maybe ditto for the list tags, because, based on long experience reading this blog, I see a lot of screwed-up HTML in our future.

    Keep in mind that you’re dealing with a readership that has trouble doing HTML with the automated buttons, for chrissakes.

  70. 70
    Rob in CT says:

    @WereBear:

    Righto.

    Problem for me with the last 10-12 lbs I want to lose is that the changes I need to make to get there might not be sustainable. I’ve been 4-5 lbs lighter than I am now before, but that’s where I’ve repeatedly bottomed out. Every time I approach or hit it, I bounce back up. I know exactly why, but knowing is only 1/2 the battle. I have a certain amount of willpower reserve and when I deplete it everything goes to shit. If I’m “good” enough to get down to my (to date) low point, it means I’ve been running a willpower deficit for a few weeks and the result is an internal rebellion which results in me putting a few pounds back on.

  71. 71
    Steeplejack says:

    @Alain the site fixer:

    Jesus, no! Just no.

  72. 72
    Baud says:

    @a href=”#comment-5747032″>Steeplejack: That’s so un

    fair

    .

  73. 73

    @low-tech cyclist: The YMCA program had been scaled up to a national YMCA model and now Medicare is trying to take it nationally. I think it should scale reasonably well… as a side note, this should prompt very aggressive recruiting of diabetes patients into Medicare advantage plans if it comes to scale as it should be a short term risk adjustment gold mine as the RA factors lag sharp discontinuities in pricing

  74. 74
    wag says:

    @Cermet:
    Interesting study. Small, only including only about 2500 people for a fairly short time (3 years), but suggestive of a possible effect. Th real question is whether Vitamin D is cause of the lower rate of cancer or is a marker for better baseline health. Vitamin after vitamin has been touted as the Fountain of Youth (FoY), but after well done randomized clinical trials have been shown to be either neutral or harmful. Example, vitamin E was touted as an antioxidant cancer preventing miracle supplement, but when subjected to a couple of well performed RCT’s against placebo was found to INCREASE the risk of lung cancer in smokers instead of decreasing the risk. Same thing with vitamin A/beta carotene. Vitamin C doesn’t do much one way or the other. Folic acid, same.

    Every 5-10 years a new vitamin gets the crown to the the new FoY. It’s Vitamin D’s turn. Stay tuned for the real answer. Maybe I’ll be surprised. Give the past history of miracles from vitamins, I’m doubtful. And here’s a counter argument to your article.
    http://www.thelancet.com/pdfs/.....0165-7.pdf

  75. 75
    Steeplejack says:

    @Alain the site fixer:

    Don’t get sidetracked on the chrome trim and tail fins when there are still functional problems with the site that need to be tidied up.

    And I think it is true that front-pagers are able to deploy certain features and tags that are unavailable to us mere commenters.

  76. 76
    wag says:

    And as far as the project described in the post, I am thrilled that MC may start following the long standing excellent clinical evidence and finally begin to cover these interventions for prevention of DM II.

  77. 77
    Steeplejack says:

    @Baud:

    I rest my case.

  78. 78
    Cermet says:

    @Rob in CT: You hit a key piece of advice – finding what works; that said, low calorie almost always fails because hunger can’t be controlled by 99+% of the people. However, reducing cancer risk across the board by adding a small amount of Vit D (not really available in the diet) of 2000 – 3000 IU (utterly safe) is amazing. It also will massively reduce colds/flu and shorten length if one does get a cold. It also improves the bodies ability to fight infections. It is beyond stupid not to take extra Vit D. Of course, becoming a Vit D over dose nut will cause issues but considering the abysmal low rates of 95% of amerikans, that just isn’t the issue – duh!

  79. 79
    WereBear says:

    @Rob in CT: Yes, we actually deplete our brain chemicals with that willpower thing. Which is why it always fails.

  80. 80
    Cermet says:

    @wag: That is one study, yes. There have been many more, and in the case of Finland, over 100 K people were enrolled and followed. Vit D does reduce many cancers (specific cancers. A number of amerikan studies have shown it reduces breast cancer.) This study was interesting because of its board nature of risk reduction. Big Pharm has far smaller samples and claims far greater results for massively expensive drugs. So, the sample size here is farly large for a medical study,

  81. 81
    wag says:

    @Cermet:

    personally I blame the Dermatologists instilling fear of the sun for our low levels of vitamin D.

  82. 82
    Rob in CT says:

    @Cermet:

    Well, my doc mentioned vitamin D deficiency at my last physical (2 1/2 years ago), noting that something like 90% of the population is apparently low on D. I have been taking a supplement ever since. I’ve also been better about taking my multivitamin, which has some vitamin D in it. I need to get off my butt and go have a physical this year and when I do I’ll see what my levels look like now.

    That said, I’m with those saying “oh, that’s the new miracle substance is it? Sure…” Maybe, but probably not.

    Re: colds – I have seen no difference in them since taking vitamin D, in frequency, duration or severity.

  83. 83
    Alain the site fixer says:

    @WereBear: Apparently, that may not be true. Recent research was published which blew a big hole into the whole “willpower is a finite resource” construct. See for more detailed info (first semi-reputable article i could find)

  84. 84
    JustSomeChick says:

    Sorry to be off-topic and depressing, but .. I was just reading an article on Sander’s gun control position and thought, “Hmm. I haven’t heard about a big mass shooting in the last few weeks.” Like it was a weather event or something. Just something to be expected. Then I realized there were real actual human beings somewhere in this country, minding their own business, who would be dead in a couple days or weeks. Whenever some idiot with a gun snaps. And for no other reason than that. As I was thinking that depressing thought, a red alert about an active shooter at Lackland AFB popped up on the screen. This country makes me sad sometimes.

  85. 85
    WereBear says:

    @Cermet: Scandinavians and Inuit have heavy consumption of oily fish, which made life with low sunlight possible.

    Remember cod liver oil?

  86. 86
    wag says:

    @Rob in CT:

    Any time a “normal” level is set to a point that 90% of the population is deficient, I have to believe that the set point is wrong.

  87. 87

    @Alain the site fixer: It fixes you and then it tests you!

    I went to an all girls school too, from kindergarten to 10th grade.

  88. 88
    WereBear says:

    @wag: You assume the population is normal.

    I question that assumption.

  89. 89
    Cermet says:

    @wag: Read the abstrat: there sup levels were rather small and they made no attempt to reach/exceed 45 ng/dl. A rather critical level for seeing results.

  90. 90
    wag says:

    @Cermet:

    And as far as the study that I linked to only being “one study”, it was actually a meta-analysis looking at date from 290 separate cohort studies and 172 different randomized controlled clinical trials involving far more patients than your study, increasing the power of its findings. The only cancer that it suggests might be reduced by vitamin D is colon cancer.

  91. 91
    Cermet says:

    @wag: Since this is based on random studies done over the years, yes, one is forced to use extrapolation – duh. Show me one medical study ever done in history of the US that uses the majority of the population of the US. Since that is your criteria, you obviously will never believe anything, so why post at all?

  92. 92
    scav says:

    @wag: There are other definitions of normal than the mere statistical. What is normal for a healthy human may not match the statistical norm for a population sitting on their butts in dark rooms with nothing but fast-food wrappers in the bin.

  93. 93
    Rob in CT says:

    @wag:

    Oh, there’s a plausible story here. So many of us spend most of our time inside, it totally makes sense that you could have widespread vitamin D deficiency.

    But I think skepticism is warranted. Meanwhile, I am taking the D supplement (hoping that it actually contains what it says it contains, which is a whole other issue!).

  94. 94
    Cermet says:

    @wag: And again, their levels of supplements sighted was too low. Neither does their study in any manner counter this study nor previous studies. They selected studies that fit their criteria and analysed it. So?

  95. 95
    Cermet says:

    @WereBear: OK; exactly what is your point?

  96. 96
    Ella in New Mexico says:

    I love the idea of health coaching and mentoring. I think it could make huge differences–life and death differences–over people’s lives. I hope that if this becomes Medicare eligible, it ends up expanding to the rest of us out there not on Medicare.

    And the carrot on the stick of saving money is a great way to get the provider/insurer side to buy in. But that cannot and should not be the only motivation. And without specific mandates, It won’t sustain change, and within a short time, will actually water down these efforts so as to make them worthless in our current system.

    Unless we as a society reduce the for-profit motive as the only driver in healthcare, great ideas like these will once again become ways to make money, not ways to keep people healthier. And from what I’ve seen, when that happens, when the excitement dies down and the promises start to fade, we end up with yet another abuse of a great idea by businesses who only care about squeezing the last little bit of profit out of what they do.

    Right now in this country, after so many promising mandates from ACA were supposed to make the overall quality of care for patients better and more accountable, and improve the ongoing efforts to keep patients from expensive hospital readmissions for chronic conditions, I’m disappointed. In all but the best and most advanced hospitals and healthcare systems–in other words, in your average town and city– we have overloaded doctors with too many complex patients and too much documentation and accountability work, hospitals with the nurse-to-patient ratios ramping up to unsafe levels resulting in serious errors and injuries, and and case managers who are tasked with fixing the entire post-hospitalization experience of hundreds of complicated patients given a handful of resources and less than optimal training in the field. Everyone I know in healthcare right now is this close to total burnout.

    The common thread to all their burnout is that they simply don’t have enough minutes in the hour accomplish successfully what they’re supposed to be doing with their patients, and all of them have to spend way too much time on some computer somewhere entering redundant documentation proving they ARE doing what they do manage to do. They are literally expecting healthcare folks to be in 5 places at the same time and do everything they’re tasked with doing at 100%–or else.

    Why? Because the entities they work for–hospitals, physician practice groups, contracting provider companies, insurance companies doing case management and follow up–all want to cash in on all the new kinds of yummy reimbursements available without hiring enough people to do them right. It’s burning them all out, and the patient’s are not getting the effective interventions and follow ups that make a difference. But the entities at the top are making buck like they never have.

    And the sad thing is, healthcare entities make lots of promises to patients, fail to follow through, and then wonder why they the patients, also fail to follow through.

    LIke everything in this country right now, the pendulum has swung too far towards corporations and big businesses interests in healthcare, and needs to swing back towards the needs of providers and patients. Without specific mandates regarding provider-patient ratios and a shift in the reimbursement towards quality over quantity of patients care, all these great ideas will pretty much stall out.

  97. 97
    scav says:

    What I mean to say is, there are other reasons to suspect wonder-food claims, but I’m not sure that particular statistical normal flag chosen is anything but a tentative heuristic at best, especially as health studies may also suffer from the same WEIRD bias as psychology.

  98. 98
    Gin & Tonic says:

    @Alain the site fixer:

    Anyone notice the new “HTML tips” buttons under “Leave a Comment”? Do they work for you?

    I see no such buttons, just the old b, i, link, quote. Chrome 49.0.something in Windows 7.

  99. 99
    🌷 Martin says:

    Great, now we have death gyms.

    Thanks, Obama.

  100. 100
    wag says:

    @Cermet:
    And you will cherry pick from small poorly performed studies to support your position. We all have different level of evidence that convinces us of our preconceived biases. You and I have different set points for evidence.

  101. 101
    wag says:

    and now I’m going to go out on my bike and prevent diabetes.

  102. 102
    Steeplejack says:

    @Gin & Tonic:

    He has removed those within the last hour, I think because he realized that many of the advanced HTML tags are unavailable to commenters.

  103. 103

    @WereBear: What do you mean by normal?
    Are you asking whether it can be approximated by a normal distribution? It is if it is a sufficiently large population.

  104. 104
    WereBear says:

    @Cermet: Cod liver oil is one of the few dietary sources of Vitamin D. Essential for low sunlight areas.

  105. 105
    Gin & Tonic says:

    @Steeplejack: Oh, OK. I guess I’m slow.

  106. 106
    WereBear says:

    @schrodinger’s cat: It is if it is a sufficiently large population.

    But if that population is sick, it can’t be a guideline for what constitutes well.

    The Guardian just published this article: The Sugar Conspiracy

    It explains the incredible increase in diabetes over the last several decades. We can’t say diabetes is the norm in our population. For certain health markers, our population is sick.

  107. 107
    🌷 Martin says:

    @wag:

    Any time a “normal” level is set to a point that 90% of the population is deficient, I have to believe that the set point is wrong.

    You need to consider time. What if 90% of the population wasn’t deficient prior to 10 years ago, but now is due to environmental reasons?

    You’re making essentially the same argument that the climate deniers make – that even though global temperature is now well off of historical norms that perhaps those norms were wrong and the current temperature is what it ought to be.

    And it’s reasonable to believe that it is an environmental effect – we spend vastly more time indoors than we used to and when we go outside we are increasingly covering up because we have internalized the risks of excess sun exposure for skin cancer. The side effect of those changes is vitamin D deficiency.

  108. 108
    Helmut Monotreme says:

    @BGinCHI: in case no one has posted it already, Here you go: a real honest to god jetpack Next up, flying cars.

  109. 109
    🌷 Martin says:

    @Helmut Monotreme: 10,000+’ ceiling, 10 minute flight time. What could go wrong?

  110. 110
    JustRuss says:

    @Steeplejack:

    Keep in mind that you’re dealing with a readership that has trouble doing HTML with the automated buttons, for chrissakes

    Speak for yourself,

    buddy!

  111. 111
    WereBear says:

    @JustRuss: Okay, I lol’d, but that’s exactly what I feared would happen :)

  112. 112
    trollhattan says:

    @Chyron HR:
    Really wish I was 13 again because I’d so use that today.

  113. 113
    Uncle Cosmo says:

    @WereBear: +1000 for the link to that article, which answers a skeptical question I’ve been asking for years with precisely the train of logic that occurred to me:

    [I]t is a biological error to confuse what a person puts in their mouth with what it becomes after it is swallowed.

    Furthermore,

    The human body, far from being a passive vessel for whatever we choose to fill it with, is a busy chemical plant, transforming and redistributing the energy it receives. Its governing principle is homeostasis, or the maintenance of energy equilibrium ….

    Cholesterol, present in all of our cells, is created by the liver. Biochemists had long known that the more cholesterol you eat, the less your liver produces.

    And yet everyone is admonished to eschew the consumption of egg yolks because “they’re high in cholesterol.”

    One of the most nutrient-dense, versatile and delicious foods we have was needlessly stigmatised.

    Looks like the yolk was on us, peeps…

  114. 114
    Helmut Monotreme says:

    @🌷 Martin: The same things that can go wrong with parachutes, hang gliders, paragliders, powered parachutes, and ultralight planes? I mean, sure, it’s dangerous as hell. But what about strapping jet engines and some quantity of jet fuel to one’s body and going for a quick spin around the sky is supposed to be safe? A safe jetpack is pretty much impossible. Once you add a bunch of safety features and their added weight, you don’t have a jetpack anymore, you have an airplane or a helicopter, that still isn’t particularly safe. I don’t think the point of developing a jet pack was to make something that is ‘safe’ per se. Even in it’s current state of development, that jetpack could save lives. Imagine if every person in a skyscraper had access to a jetpack they could us to get to safety in case of fire. Perhaps a fire department could have dozens or hundreds of them they could land on the roof of a skyscraper in that scenario. The added control might make them safer to use than parachutes. Sure, some of the potential victims would hurt themselves trying to get to safety, but isn’t that better than the certainty of dying in a fire? Yes, it’s dangerous, yes, people are going to die, but that’s what happens in flight research. In another decade or two, jetpacks will be more reliable, with longer range and capable of carrying more payload, if that company gets to continue it’s development and not get shut down by risk averse insurance companies.

  115. 115
    Grumpy Code Monkey says:

    Don’t see any HTML tips buttons. Gonna try an experiment.

    ETA: Experiment failed. Was playing with the <hr> and <sup> tags, neither render for me on Win 7 Chrome.

  116. 116
    Prescott Cactus says:

    Blood sugar control
    It’s fun to stay at YMCA
    No diabetes

  117. 117
    Mnemosyne says:

    @Rob in CT:

    Most of the information I’ve seen is that exercise isn’t very helpful for weight loss but it’s absolutely vital for weight maintenance. It’s good to start some exercise while you’re losing so you get into the habit and develop good associations with exercise, but it won’t help your loss (and sometimes even stops weight loss if you’re doing a lot).

    Exercise is absolutely vital to help keep the weight off after you get to your goal.

  118. 118
    Amir Khalid says:

    @Helmut Monotreme:
    After what I’ve seen of jetpacks over the years. I tend to think of them as flying Segways. Way cool, but nowhere near a serious mobility or transportation solution.

  119. 119
    Mnemosyne says:

    @🌷 Martin:

    IIRC, a lot of it depends on geography. A dark-skinned person living in the northern part of the US needs to keep a careful eye on their Vitamin D levels. I live in So Cal and get called “sharkbait” if I show up at a beach, so my Vitamin D levels are fine with incidental sun exposure.

    And genetics can’t be ignored. If you have the BRCA 1 or 2 breast cancer gene mutation, Vitamin D is not going to magically overcome that.

  120. 120
    scav says:

    @Amir Khalid: Better still, they could be flying hoverboards. Crashing and the risk of explosions — Xtreme! All we had were skateboards with no helmets and riding loose in the back of station wagons. How sheltered an upbringing.

  121. 121
    Detroit Adam says:

    @Uncle Cosmo:

    @WereBear: +1000 for the link to that article

    I want to second this sentiment. Thank you @WereBear for that link.

  122. 122
    MomSense says:

    @WereBear:

    I messed myself up eating soy. I’ve been a pescetarian but I’m seriously considering adding lean poultry and meat to the mix. My cholesterol is still too damned high!

  123. 123
    🌷 Martin says:

    @Helmut Monotreme:

    The same things that can go wrong with parachutes, hang gliders, paragliders, powered parachutes, and ultralight planes?

    Well, not really. All of those other things have lift characteristics that in the event of propulsion failure can allow you to return safely to the ground. In other words, there is no race against the clock with your fuel system.

    But a jetpack leaves you as a ballistic object in the event of propulsion loss. It has no glide characteristics unless you have a parachute to deploy. The failure modes on a jetpack are significantly worse than for most flying craft. This is why flying cars are a thing. When your car breaks down you may get stranded in the road. When your flying car breaks down you plummet to your death.

    And flying cars will also never be a thing (at least in the forseeable future) because the point of a ‘car’ is that it’s egalitarian. Not everyone is equipped with the abilities to pilot a plane, so the fact that they are limited in reach is necessary. By the necessity of what a flying car is intended to be, everyone would need to have the abilities to deal with it in an emergency. That’s never going to work until these can operate fully autonomously, and we can do that now, but there’s no economic argument for doing it. Those problems are more inexpensively solved with a host of other solutions.

  124. 124
    The Golux says:

    @Uncle Cosmo:

    And yet everyone is admonished to eschew the consumption of egg yolks because “they’re high in cholesterol.”

    As a (fairly recently diagnosed) Type I diabetic, if I couldn’t eat a couple of eggs a day, it would make it much more difficult to maintain a suitable diet. Especially when it comes to breakfast, which for most Americans is a carbohydrate bomb.

    I’ve always been extremely skeptical of the idea that consuming cholesterol caused increased blood cholesterol. My HDL (the good kind) has always been much higher than my LDL.

  125. 125
    Mnemosyne says:

    Also, as someone who’s benefited a lot from
    psychotherapy, I have to say, sarcastically, “Therapy helps support people? Who knew?”

  126. 126
    Uncle Cosmo says:

    @Helmut Monotreme:

    Even in it’s current state of development, that jetpack could save lives. Imagine if every person in a skyscraper had access to a jetpack they could us to get to safety in case of fire.

    Yeah, that would last until the first time a bunch of trapped people panicked, strapped on a jetpack & killed themselves trying to fly to safety as the fire was being successfully extinguished.

    Perhaps a fire department could have dozens or hundreds of them they could land on the roof of a skyscraper in that scenario.

    If ‘copters could be controlled well enough in the updrafts from the blaze to land jetpacks on a skyscraper roof, it would be simpler & safer to use a squadron of them to lift people to safety. Or to land personnel to anchor skylines to nearby buildings with harnesses to zip victims over & down to rescue teams waiting there.

    The added control might make them safer to use than parachutes.

    You’d have to have a helluva lot of non-overridable control built in to keep neophytes from killing themselves–at minimum, microprocessor with GPS reception plus some kind of 360-scanning capability (acoustic &/or IR) for location & closing speed of nearby hazards & obstacles including other flyers…

    Meh. Sounds like KoolTek(TM) looking for a use to justify itself.

  127. 127
    Cermet says:

    @wag: I do not pick just read and compare. I could care less if a given idea is disproved. If it is, I accept that and read more. Facts are what matter. If they disprove studies, then I take notice. Studies that fail to prove something do not determine the answer alone. Once needs to show why other studies that did prove it are wrong. So far, I have seen little to no proof the other studies are wrong. Also, secondary issues like most all cells in a human have Vit D receptors – not true of most other substances. Many unrelated studies (to Vit D) that found correlations that people with higher levels of Vit D had significantly higher recover rates for a given cancer (maybe correlated, maybe not but as these events are repeatedly demonstrated, I take notice.)
    A single overview article that picks studies does not, alone, prove very much until they find why the studies that are positive made errors. Again, studies must add up. In the case of Vit D and cancer reduction link is strong but may be nonsense. However, Vit D has been absolutely proven to increase bone health, is cheap and extremely safe. So, no down side unlike Vit E.

  128. 128
    Cermet says:

    @The Golux: It has been shown in many studies that limitation of consumption of cholesterol does not decrease ones innate serum blood cholesterol. Can eggs raise cholesterol? Absolutely in some people. Does avoiding eggs lower cholesterol for most people? I don’t think that has ever been shown.

  129. 129
    Mnemosyne says:

    @The Golux:

    It’s kind of fascinating that at least some of the “boom in Type 2 diabetes!” turned out to be due to late-onset Type 1 being more common than previously thought.

    If you’ve been diagnosed with Type 2 over the age of 30 and your blood sugar levels are not leveling off with diet and exercise changes, have your doctor re-check and make sure it’s not late onset type 1.

  130. 130
    WereBear says:

    @MomSense: Why lean protein? There’s a rare few people who need to avoid certain kinds of animal fat, but for most people, they are extremely beneficial.

    We were way oversold on soy. Small amounts of it fermented (as in Asian cooking) is nothing like the vast amounts we are fed now.

    See, cholesterol is not the problem. Inflammation is the problem.

    Cholesterol is just what shows up to try to help the inflammation. We might as well say firefighters are the cause of fires!

  131. 131
    Ruckus says:

    @🌷 Martin:
    Have a friend who worked on the original jet pack. Actually a rocket pack but still. The fuels they used and the risks they took were horrendous but they didn’t know that until years later. If I remember he said they built 2 of them. Very costly at the time and if you think falling out of the sky was the dangerous part, you’d be wrong. Of course this was decades ago when people did risky things all the time, like go to work, etc.

  132. 132
    Mnemosyne says:

    @WereBear:

    Lean protein because most Americans eat too-large portions and are inactive. If you eat 3 to 4 ounces (cooked) of high-fat protein per meal and are very active, the fat content probably doesn’t matter as much.

    Also, it turns out that it’s the nitrates in smoked and preserved meats that are killing us, so while a nice fresh steak is okay, bacon is still bad for you.

  133. 133
    Mike J says:

    Trump Vodka, marketed in Israel as “Kosher for Passover,” turns out not to be kosher for Passover:
    http://www.jpost.com/Not-Just-.....her-450568

  134. 134
    WereBear says:

    @Mike J: Why am I completely and utterly unsurprised?

  135. 135
    Trollhattan says:

    @Ruckus:
    Hydrazine, perhaps?

    Nasty stuff, that, although I hear it’s rich in vitamin D.

  136. 136
    Cacti says:

    O/T but today marks the 700th day of John Boehner/Trey Gowdy’s ridiculous select committee on Benghazi.

    That’s more days than were spent investigating:

    The 9/11 attacks
    The Pearl Harbor attacks
    The Kennedy assassination
    The Watergate break-in and cover up
    The Iran-Contra scandal

  137. 137
    Trollhattan says:

    If it’s not Florida, it’s Texas.

    A shooting at a US Air Force base in Texas has left at least two people dead, police say. Officials have told US media that an airman shot his commander in an apparent murder-suicide. Police responded to reports of a shooting at Joint Base San Antonio-Lackland around 09:00 local time (15:00 BST), a spokesman said.

    Two bodies were found in a room at the base, and authorities believe the gunman is one of the dead. The Bexar County Sheriff’s Office said they continued to search the buildings after finding the people who were killed.

    “There are no indications that this was a terrorist attack,” an Air Force statement said.

    Shorter Air Force: “Whew, just another angry white guy.”

  138. 138
    Trollhattan says:

    @Mnemosyne:

    bacon is still bad for you.

    Be thou gone, devil woman!

    Mmmmm, bacon….

  139. 139
    Ruckus says:

    @Uncle Cosmo:
    @Mnemosyne:
    This.
    We really are nothing more than chemical factories. But each one of us has subtle differences in how we function. Broadly speaking we fit into groups, say all humans, or all women, but without the complete blueprints how each one of us works, how each one of us turns what we consume into the building blocks of our bodies, we have to generalize what works and what doesn’t. People with genes that may express a disease or a deficiency of some hormone or an unknown exposure to a toxin or bad eating habits as a young child (or an adult) may have different results from the same input as someone with different sets of internal operating controls. And like a refinery, sometimes the smallest thing going wrong can wreck havoc.
    But overall it works. Better for some, worse for others. What we do know is that reasonable diet and exercise is better for us than sedentary. And we know that what is reasonable is different for different people.

    Weight loss. Decent diet, fewer calories in than out and TIME. You didn’t put it on in one month, you won’t take it all off in one month. It takes time to adjust that chemical factory to a new way of production. And the last bit that you want to lose? That’s always the hardest. The last 10% of any project always is the most difficult and time consuming.

  140. 140
    Cermet says:

    @WereBear: Inflammation is a big issue for health and hard to prevent. Interesting that Wag’s cited reference study did show that increase Vit D was a benefit in reducing inflammation. As for its value relative to cancer studies, they looked at only 11 (not the two hundred plus he cites – that was for other health issues.) Again, the current studies show good results but science is science and results with people cannot do true controlled studies on humans and as such, all studies must be taken with a grain of salt (which, except for salt sensitive people, does not have the ill effects many think.)

  141. 141
    scav says:

    @Mike J: That makes me laugh on sooo many little details. He nearly sued his own vodka.

  142. 142
    Ruckus says:

    @🌷 Martin:
    I’m sure you’ve also noticed that airplanes need much more distance between them to avoid nasty stuff. There isn’t enough airspace to fly even half the cars, let alone getting people to actually fly them and land them. It’s an asinine concept in a world with this many people, a not surprising number of whom can’t reasonably drive a car on solid ground.

  143. 143
    Ruckus says:

    @Trollhattan:
    Hydrogen peroxide, pressurized. And not that diluted stuff that you get in the drug store.
    Rocket Pack

  144. 144
    Trollhattan says:

    @Ruckus:
    The stuff of dreams. What kid in the ’60s wouldn’t have lined up for a try? The landing bit was always a little murky to me.

  145. 145
    pseudonymous in nc says:

    There’s a real cultural issue in the US about coaching / long-term healthcare management; fee-for-service plus DTC marketing plus medical drama plus the parasitic unregulated snake-oil ancillary market creates a belief in quick fixes and miracle cures and this-will-make-it-better. (See also: medication preferred over therapy.)

    I’m not sure how you bootstrap alternatives within the current system, given how fee-for-service is still mostly how doctors get paid and how patients expect to be treated.

  146. 146
    Rob in CT says:

    @Mnemosyne:

    I can stay at a weight level w/o much exercise (I do walk 2 miles a day Mon-Fri after lunch, but that’s pretty light exercise!). For me, both loss and maintenance are 90+% about diet.

    Still trying to keep exercising (at least when my back isn’t flaring up like it did this week) for other reasons.

    Also, it turns out that it’s the nitrates in smoked and preserved meats that are killing us, so while a nice fresh steak is okay, bacon is still bad for you

    Boooo! Bacon & eggs for breakfast on the weekends or Rob goes something something. Also, Salami is awesome.

    I have my self-improvement limits.

  147. 147
    The Golux says:

    @Mnemosyne:

    …have your doctor re-check and make sure it’s not late onset type 1.

    Yep. When I was diagnosed, close to ten years ago, it was assumed it was type 2, even though I had few, if any, of the attributes of the typical type 2 patient. Blood tests eventually confirmed that I had antibodies of the sort that damage the pancreas. It took a while before my insulin production went to zero; I didn’t start taking insulin until about five years later.

  148. 148

    @WereBear: I am not passing a value judgment just asking you to define what you mean by population. The term normal has a specific meaning in statistics.

    Normal as in following a Normal or Gaussian distribution which is shaped like a bell.

  149. 149
    Helmut Monotreme says:

    @Uncle Cosmo: the autopilot problem for a “rescue jetpack” scenario seems hard, until we remember that autonomous drones are getting better every day, 99% of the programming and sensors that would be required are standard equipment on many quadrotor drones sold today. At this stage of development, jetpacks are undeniably an iffy solution in search of a problem. And I don’t know what the problem is, that a jetpack would be the ideal solution to. And it might even be wishful thinking or technophilia to think that there will ever be a use for them. I think they will eventually find that use though.

    As far as failure modes go, they aren’t any worse than a structural failure would be for any light or ultralight aircraft. No, they can’t glide. Neither can an aircraft with structural failure of the wings or rotors, and we accept that those things can and do happen (albeit not as often as engine failure)

  150. 150
    rikyrah says:

    you should get a blogger award for your Healthcare coverage.

Comments are closed.