Question: We’re hosting a holiday party and are concerned about alcohol consumption. Any tips on how to handle things responsibly?

Answer: You are smart to be concerned about this for many reasons. The coordination needed for driving is compromised long before you show signs of intoxication and your reaction time is slowed. Plus, the sedative effects of alcohol increase your risk of nodding off or losing attention behind the wheel. During an evening of drinking, it’s easy to misjudge how long alcohol’s effects last. For example, many people believe that they will begin to sober up—and be able to drive safely—once they stop drinking and have a cup of coffee. The truth is that alcohol continues to affect the brain and body long after the last drink has been finished. Even after someone stops drinking, alcohol in the stomach and intestine continues to enter the bloodstream, resulting in impaired judgment and coordination for hours. Here are some tips to help manage alcohol consumption at your holiday party:
Offer a variety of alcohol-free drinks—water, juices, sparkling sodas. Alcohol-free drinks help counteract the dehydrating effects of alcohol. Also, the other fluids may slow the rate of alcohol absorption into the body and reduce the peak alcohol concentration in the blood.
Provide a variety of healthy foods and snacks. Food can slow the absorption of alcohol and reduce the peak level of alcohol in the body by about one-third. Food can also minimize stomach irritation and gastrointestinal distress the following day.

Help your guests get home safely—use designated drivers, Ubers and taxis. Anyone getting behind the wheel of a car should not have ingested any alcohol.

Set a good example. Especially if you are a parent, understand and observe the underage drinking laws.

Got a Question? Send it to drw@weiszconciergemedical.com and, if it is of general interest, Dr. Weisz will provide an answer in an upcoming issue of the Concierge Connection.

Source: AARP.org, April 15, 2022

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Muscle Loss May Lead to Dementia

A new study has shown that older individuals with skeletal muscle mass loss are at greater risk of developing dementia. People with smaller jawbone muscles had nearly 60% greater risk of developing dementia than people who had a larger muscle mass. These jawbone muscles are linked to whole-body skeletal muscle mass .

After more than 5 years of follow-up, about 3.5% of participants with low muscle mass showed signs of dementia compared with 2.5% of those with larger jawbone muscles according to researchers at Johns Hopkins University School of Medicine in Baltimore. This is the first study to suggest skeletal muscle loss may be related to future dementia, the researchers pointed out.

“As we age, we develop loss of muscle mass, and interestingly, muscle mass is often observed among those people with dementia,” stated the head of the research team. “This observation led us to ask: Could there be a direct link between muscle loss and development of dementia?”

Age-related skeletal muscle loss, which is potentially modifiable, is often seen in older adults with dementia, the researchers noted.

“Thus early detection of the causes of muscle loss, such as lack of physical activity or nutritional support, might potentially prevent or slow down muscle loss and that may also reduce the risk of developing dementia. We believe this offers a new avenue for early intervention strategies in the fight against dementia.”

Establishing cause and effect is difficult, however. It is hard to know if muscle loss is truly a risk factor for dementia or the consequence of the processes that lead to dementia. In general, having a healthy lifestyle with appropriate exercise is beneficial in many ways, including maintaining one’s muscle mass.

The researchers examined MRI scans from 621 participants age 70 or older (mean age 77) without dementia. The team manually segmented the bilateral temporalis (jawbone) muscles and calculated the sum cross-sectional area of these muscles. Based on the cross-sectional area, participants were categorized into two distinct groups: 488 people with small and 131 people with large cross-sectional area.

Over a median follow-up period of 5.8 years, the group followed patients for dementia onset, changes in cognitive function and performance, and brain volume alterations.

People with smaller temporalis muscle mass were more likely to develop dementia, after adjusting for other known risk factors like age, gender, education, and body mass index.

“They also showed greater decline in memory, functional activities, and brain volumes over time,” the research team leader said. The study showed that the low muscle mass group had greater decrease in memory composite score, functional activity questionnaire score, and structural brain volumes.

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Source: Moradi K, et al “Skeletal muscle loss is associated with increased risk of dementia-related outcomes: Longitudinal observational study using ADNI brain MRIs” RSNA 2024.

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Are 1 or 2 Workouts a Week Really All You Need?

Well, yes — but there’s a “But”…

Note that the weekend warriors in a new study didn’t get all their activity in one to two days, just the bulk of it. And if you choose to get most of your exercise in such a small window, you’d better be willing to put the “warrior” in weekend warrior, working out for longer than you would in a typical exercise session. “It did appear that many in the regular group did a greater amount of activity overall,” said the study co-author, conducted at Massachusetts General Hospital. The regular exercisers logged about 400 minutes of moderate-to-vigorous activity, on average, while the weekend warriors got slightly less than 300. “This shows that if you work out every day, it’s easier for you to get your numbers up.” The study also had some notable limitations. The researchers didn’t gather any information on people’s lifestyles, specifically what kind of exercise they were doing, or exactly how intense it was. They also tracked people for only one week. While the researchers said that should be predictive of how they lived the other 51 weeks of the year, they admitted that it’s possible that some of the participants upped their game when they got their accelerometers strapped on and then did more activity than they normally would, potentially skewing the results. There’s also a question of safety. A 2014 study found that of participants who had a severe injury, 55% did so working out on weekends. Since weekend warriors like to get as much in when they can, it’s conceivable that they might push themselves harder and could get hurt as a result. However, the research team claimed that their study didn’t show an increased risk of musculoskeletal injury. On the contrary, “the literature supports that exercise is good for musculoskeletal conditions,” they said, “such as chronic back pain. Looking at a population of almost 90,000 people, the benefit is so much stronger that we didn’t see a risk, but that’s not to say injury isn’t possible.”

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Source: Sean Tyson. WebMD. Oct. 17, 2024. Shaan Khurshid, MD, MPH, cardiac electrophysiologist, Massachusetts General Hospital. Shinwan Kany, MD, cardiologist, Massachusetts General Hospital.

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Mediterranean Diet Helps Older Adults Live Longer

Following a Mediterranean diet can help older adults significantly decrease their risk of cardiovascular mortality, according to a recently published report.

The Mediterranean diet, named after the traditional eating habits of Greece and Italy, is based on whole grains, fruits, vegetables, legumes, nuts, seeds and olive oil. While it primarily focuses on plant-based options, it permits fish, seafood, poultry and dairy products to be eaten occasionally. Definitive data on the Mediterranean diet’s impact on older adults’ health are unclear because traditional studies focusing on older adults have small sample sizes. This study was based on a sample size of nearly three quarters of a million patients. The researchers in this instance explored data from 28 different randomized clinical trials that covered nearly 680,000 participants from all over the world. All participants were older than 60 years old. Overall, closely adhering to a Mediterranean diet was associated with a 23% decrease in the risk of death by all causes, a 25% decrease in the risk of cardiovascular events, and a 27% decrease in the risk of cardiovascular deaths The death by all causes decline was also seen when only tracking patients over the age of 70. “These results confirm previous findings indicating a reduced risk of all-cause mortality among individuals with a high adherence to the Mediterranean diet and extends them to older people,” the authors wrote. The researchers concluded that following a Mediterranean diet “may contribute to better overall health and a lower likelihood of cardiovascular-related health issues in older individuals.”

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Source: Furbatto, M.; Lelli, D.; Antonelli Incalzi, R.; Pedone, C. Mediterranean Diet in Older Adults: Cardiovascular Outcomes and Mortality from Observational and Interventional Studies—A Systematic Review and Meta-Analysis. Nutrients, November 14, 2024.

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The Sickest Patients Are Fleeing Private Medicare Plans

A Wall Street Journal article has revealed that Medicare Advantage patients in their final year of life are significantly more likely to switch to traditional Medicare, often due to difficulties accessing necessary care in the private plans. From 2016 to 2022, the rate of switching was double for those in their last year compared to other enrollees. This switch resulted in a substantial cost shift, with the federal government covering the high costs of hospital and nursing-home care that were previously borne by private insurers.

The analysis found that 300,000 patients left Medicare Advantage in their final year, avoiding an average of $218 per day in medical costs, which is much higher than typical Medicare expenses. As a result, Medicare Advantage insurers saved over $10 billion in medical costs, with the government paying about $3.5 billion in premiums for these patients. These patients often left because of care denials or restrictions in the private plans, such as the need for prior authorizations or limited provider networks, which are less common in traditional Medicare.

Despite insurers’ claims that their oversight improves care quality, the Journal’s investigation found that the high denial rates for services like nursing home stays and rehabilitation prompted many patients to transition to traditional Medicare, which offers more flexibility. These patients’ care in traditional Medicare often costs much more than it would under Medicare Advantage. This pattern raises concerns about the quality of care under Medicare Advantage, especially for those with the most intensive medical needs.

The article highlights the challenges faced by patients who attempt to navigate Medicare Advantage’s bureaucratic hurdles, including high denial rates for essential services, and the financial strain when switching to traditional Medicare later in life. It also touches on the complicated choices patients must make, such as the high costs of Medigap coverage and the logistical difficulties of changing plans.

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Source: By Anna Wilde Mathews Christopher Weaver and Tom McGinty, The Wall Street Journal, Nov. 11, 2024

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A Dose of Healthy Holiday Humor

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Anti-Inflammatory Ginger & Turmeric Carrot Soup

Searching for an elegant vegetarian offering for a festive holiday meal?

This delicious ginger and turmeric carrot soup is as comforting as it is healing. Packed with strong flavors like garlic, fennel, and ginger, and full of anti-inflammatory ingredients, this is the perfect winter soup and a great choice for Christmas, Hanukkah, New Year’s or anytime a delicious vegetarian dish is called for.

The recipe yields four servings.

Ingredients

  • 1 tablespoon olive oil
  • 1 leek , cleaned and sliced
  • 1 cup chopped fennel (1 small head)
  • 3 cups chopped carrots
  • 1 cup chopped butternut squash (or more carrots)
  • 2 garlic cloves , minced
  • 1 tablespoon grated ginger (about a 2-inch piece)
  • 1 tablespoon turmeric powder
  • Salt & pepper to taste
  • 3 cups low-sodium vegetable broth
  • 1 can lite coconut milk (14.5 ounces)

Preparation

  • Cook the veggies. Heat the olive oil in a large pan or dutch oven. Add the carrots, squash, fennel, and leeks, and sauté until the veggies start to soften. This should take 3-5 minutes. Then add the ginger, garlic, turmeric, salt, and pepper, and sauté for 2-3 more minutes.
  • Add the liquid. Pour in the vegetable broth and coconut milk. Bring the soup to a boil, then lower the temperature, cover, and simmer for 20 minutes.
  • Blend. Add the soup to a blender, and blend until it is smooth and creamy.
  • Season. Taste the soup and adjust the seasonings as necessary. Then serve!
  • Tips and Tricks: Here are some tricks and tips for making the best anti-inflammatory winter soup.
  • Make your own broth. As with most soup recipes, this ginger and turmeric carrot soup is excellent with a nice store-bought vegetable broth. But you can turn the soup into something truly special with your own homemade broth. I like to use Instant Pot mushroom vegan bone broth for this recipe.
  • Go light on the salt. When making soup, it’s a good idea to only use a little bit of salt at the start. The reason for this is that different vegetable broths, whether store-bought or homemade, have different sodium levels. And the saltiness of your soup will depend on how much you cook it down. Start small with the salt, and adjust the seasonings at the very end.
  • Add some fun toppings. I love to top this soup with some vegan coconut yogurt and fresh parsley. But you can have lots of fun with the toppings of your choice. This ginger and turmeric carrot soup would be delicious topped with croutons, lemon or orange zest, vegan crème fraîche, crispy shallots, or fresh basil.

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Source: By: Alyssa Published: February 3, 2023 Updated: May 17, 2023. https://www.simplyquinoa.com/anti-inflammatory-ginger-turmeric-carrot-soup/

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