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H. Robert Silverstein Discusses Preventative Care and Geography
H. Robert Silverstein is Medical Director of The Preventive Medicine Center, a non-profit organization that offers advice on living healthier. He has had articles published by Self Health Networker and the American Journal of Cardiology. Maximum Healing: Improve Your Immune System and Optimize Your Ability to Heal, his 2007 book, offers suggestions on how to treat and prevent various diseases. Silverstein received his B.A. from University of Michigan, Ann Arbor and his M.D. from Ohio State University, Columbus.
H. Robert Silverstein: You’re talking system wide change. You’re talking about a revolution in healthcare here in the . . . here in what we call the civilized world – ranging from Russia to South America, and including the Orient. By the way, the Orient sort of used to do this, and now they’re becoming as westernized as we are. I can remember seeing an article on (25:49) children in Beijing having a weight problem. There’s an old adage that goes, “You never saw a fat Chinaman, did you?” And the answer is now you see them all the time in China. So calorie restriction would be one of the major, major things. Again if I had one thing to say that would be most important is I wanna see clear lines of definition and demarcation on the abdomen, because that means an absence of fat under the skin on the abdomen, which correlates with an absence of fat everywhere else. No I am not recommending anorexia nervosa. I’m recommending common sense at every step. We need a diet that is as simple as saying brown rice, vegetables and beans with anything once in a while. Oh I know I left out the fruit, and the nuts, and the seeds. And I am not excluding the occasional pizza, or ice cream, or cheeseburger. But the fact of the matter is the average daily diet should be grains, vegetables and beans, and then you can have some fruit and so on. The animal size . . . The palm sized serving of animal protein that is wild . . . for a simple word, “wild game”. I don’t care whether it’s fish, or chicken, or meat or whatever. Wild game two to three times a week. And that would change . . . Of course no smoking. Limit alcohol to four times a week, and we’re back to a list that I’ve already given you. So those would be the major things. I could spell it out in five minutes to the physicians of the United States and to the American public. Remember it always takes two to tango, so the American public needs it just as much in the request sense as physicians need to be doing it in the delivery sense. It is a partnership.
Question: Are certain societies getting it right?
H. Robert Silverstein: There are portions of societies that get it right, and those societies that are less westernized than we are. For instance a lot of talk recently about the Mediterranean diet. So now we’re talking not so much Athens, but more the little bit of the back woods of Greece and the back woods of Italy and so on. They have a much more physical life. They have a much more family life. They have a much less smoking life. Smoking I think is more concentrated to the cities than the countryside. But their diet is more organic, unprocessed, whole foods. They probably consume more alcohol than I recommend. They’re probably heavier than I recommend. But when you do what I call “put it all together”, there is so much more in this direction. You know every now and then people talk about bringing the Mediterranean diet to the United States. The Mediterranean diet, as best as I understand it, is more of an organic, unprocessed, whole foods diet than we will ever be able to deliver here in the United States on a broad basis. And yet it is widespread in those Mediterranean countries – Crete, Greece, Italy, and Spain and so on.
Question: Why is health such a challenge in America?
H. Robert Silverstein: It’s the commercial unwillingness, I think. And yet if you wanted to know who you . . . If you had sway, you could either get me to the potentates in government, or you could get me to the potentates in food industry and even restaurant industry. If I could get to those people to have a single entrée on the daily menu . . . For instance I just ate at Blue Water Grill here in Manhattan and I ordered two side dishes. I ordered the spaghetti squash and the broccoli __________. That was it for lunch. No fish, no chicken. Their white flour bread was really pretty tasty, and I did use the smallest dab of butter on it. But you can get mostly vegetables – organic, unprocessed, whole foods. It may or may not have been organic. It didn’t say so. But you can get mostly vegetables and beans. And you can go into restaurants now and get _________ and brown rice. So it . . . The information is out there, but who to reach would be, as I said before, the food industry from the commercial sense; restaurants; and growers; and the governmental officials who could make incentives for this.
The Preventive Medicine Center's Robert Silverstein discusses global health patterns.
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Gender and sexual minority populations are experiencing rising anxiety and depression rates during the pandemic.
- Anxiety and depression rates are spiking in the LGBTQ+ community, and especially in individuals who hadn't struggled with those issues in the past.
- Overall, depression increased by an average PHQ-9 score of 1.21 and anxiety increased by an average GAD-7 score of 3.11.
- The researchers recommended that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders—even among those with no prior history of anxiety or depression.
Study findings<p>For the study, <a href="https://link.springer.com/article/10.1007/s11606-020-05970-4" target="_blank">published in the Journal of General Internal Medicine</a><em>, </em>Flentje and her team evaluated survey responses from nearly 2,300 individuals who identified as being in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Most of the participants were white, while nearly 19 percent identified as a racial or ethnic minority. Multiple genders were represented with cisgender women (27.2 percent) and men (24.6 percent) making up a majority of the participants. Sixty-three percent had been assigned female at birth. For the most part, participants identified their sexual orientations as queer (40.3 percent), gay (36.5 percent), and bisexual (30.3 percent).</p><p>The JGIM study participants were recruited from the 18,000-participant <a href="https://pridestudy.org/" target="_blank">PRIDE Study</a> (Population Research in Identity and Disparities for Equality), which is the first large-scale, long-term national study focusing on American adults who identify as LGBTQ+. It conducts annual questionnaires to understand factors related to health and disease in this population. </p><p>Participants filled out an annual questionnaire (starting in June 2019) and a COVID-19 impact survey this past spring. Flentje noted that on an individual level, some people may not have experienced a big change in anxiety or depression levels, but for others there was. Overall, depression increased by a <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9 score</a> of 1.21, putting it at 8.31 on average. Anxiety went up by a <a href="https://www.mdcalc.com/gad-7-general-anxiety-disorder-7" target="_blank">GAD-7</a> score of 3.11 to an average of 8.89. Interestingly, the average PHQ-9 scores for those who screened positive for depression at the first 2019 survey decreased by 1.08. Those who screened negative for depression saw their PHQ-9 scores increase by 2.17 on average. As for anxiety, researchers detected no GAD-7 change among the study participants who screened positive for anxiety in the first survey, but did see an overall increase of 3.93 among those who had initially been evaluated as negative for the disorder. </p>
Risks among gender and sexual minorities<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fc3fd1ae68b77bbbf58a6995638d6d65"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EnUqDjCqg0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The LGBTQ+ community is a vulnerable population to mental health concerns because of their fear of stigmatization and previous discriminatory experiences.</p> <p>Previous research by the Human Rights Campaign has found "that LGBTQ Americans are more likely than the <a href="https://medicalxpress.com/tags/general+population/" target="_blank">general population</a> to live in poverty and lack access to adequate medical care, paid <a href="https://medicalxpress.com/tags/medical+leave/" target="_blank">medical leave</a>, and basic necessities during the pandemic," said researcher Tari Hanneman, director of the health and aging program at the campaign.</p> <p>"Therefore, it is not surprising to see this increase in anxiety and depression among this population," Hanneman said in the release. "This study highlights the need for <a href="https://medicalxpress.com/tags/health+care+professionals/" target="_blank">health care professionals</a> to support, affirm and provide <a href="https://medicalxpress.com/tags/critical+care/" target="_blank">critical care</a> for the LGBTQ community to manage and maintain their mental health, as well as their physical health, during this pandemic."</p>
What should health care providers do?<p>The authors of the study recommend that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders in members of that community—even among those with no prior history of anxiety or depression.</p><p>As cases of COVID-19 continue to mount, the sustained social distancing, potential isolation, economic precariousness, and personal illness, grief, and loss are bound to have increased and varied impacts on mental health. Effective treatments may include individual therapy and medications as well as more large-scale coronavirus support programs like peer-led groups and mindfulness practices. </p><p>"It will be important to find out what happens over time and to identify who is most at risk, so we can be sure to roll out public health interventions to support the mental health of our communities in the best and most effective ways," said Flentje.</p>
What we know about black holes is both fascinating and scary.
- When it comes to black holes, science simultaneously knows so much and so little, which is why they are so fascinating. Focusing on what we do know, this group of astronomers, educators, and physicists share some of the most incredible facts about the powerful and mysterious objects.
- A black hole is so massive that light (and anything else it swallows) can't escape, says Bill Nye. You can't see a black hole, theoretical physicists Michio Kaku and Christophe Galfard explain, because it is too dark. What you can see, however, is the distortion of light around it caused by its extreme gravity.
- Explaining one unsettling concept from astrophysics called spaghettification, astronomer Michelle Thaller says that "If you got close to a black hole there would be tides over your body that small that would rip you apart into basically a strand of spaghetti that would fall down the black hole."
The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
A new study looks at what would happen to human language on a long journey to other star systems.
- A new study proposes that language could change dramatically on long space voyages.
- Spacefaring people might lose the ability to understand the people of Earth.
- This scenario is of particular concern for potential "generation ships".