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“BRAIN FOG”

One mysterious, lingering symptom of COVID-19 catches the attention of top health officials & perplexes doctors, sufferers alike.

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“If you talk to a significant number of people, they will tell you that, for anywhere from weeks to months and possibly longer, that they have symptoms that are characterized by fatigue and a thing that they refer to as brain fog, which really means the difficulty concentrating.”

Dr. Anthony Fauci revealing during an interview with '60 Minutes' one of his concerns over the long-term impact of the virus that causes COVID-19.
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“It’s all related. The fact that people are losing their sense of smell, the fact that people are losing their sense of taste, and the brain fog — all this whole system is neurological.”

Stanford researcher Dr. Kari Nadeau leads an ongoing Stanford study on long-term immunity to SARS-CoV-2. Patients recovering from COVID, across age groups and gender, have described "brain fog" (a lack of mental clarity, confusion) since early in the pandemic.
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“Everything in my brain was white static … I was sitting on the edge of the bed, crying and feeling ‘something’s wrong, I should be asking for help,’ but I couldn’t remember who or what I should be asking. I forgot who I was and where I was.”

31-year-old Erica Taylor who says her "brain fog" after COVID-19 became so debilitating she was forced to take a temporary leave from her job.
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What Do We Know:

“It’s subtle, but it is very real.”

  • The “dysfunction” some have experienced usually won’t surface during a brain scan, according to neurologist Dr. Joanna Hellmuth at University of California, San Francisco.
  • Hellmuth says she sees the impact on cognitive tests, consistent with other viruses that can impact cognitive health.
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Why?

No one knows 100%.

Here’s some early thinking:

  • Brain cells *can* (though rarely) become infected with COVID-19.
  • Inflammation of the body can lead to issues including small, subtle strokes.
  • Low oxygen levels in the blood can have an impact.
  • An exhausted immune system could play a role.
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One encouraging note: Doctors and those recovering from COVID-19 say this fog can "lift" - that it's not permanent. A reminder: This week marks 9 months since the first diagnosed case of COVID-19 in America; research on the impact of COVID - both mentally and physically - remains limited.

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The Sniff Test

A testing method for COVID-19 puts the spotlight squarely on man’s best friend.

Can Dogs Save The World?

 

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BACKSTORY

  • The Theory: Diseases have unique “odorprints.”
  • Past research has shown dogs can “sniff out” diabetes, malaria and different forms of cancer.
  • Early in the pandemic, researchers started studying dogs to see if they can detect COVID. Preliminary research shows promise for detecting cases *before* symptoms emerge.
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“As far as we know, no other airport has attempted to use canine scent detection on such a large scale against COVID-19.”

Director of Helsinki Airport, Ulla Lettijeff, where a recently launched pilot program is using COVID-sniffing dogs. Dogs do not sniff people directly but a wipe given to passengers (to wipe their skin, i.e. neck or wrist) and dropped in a cup. Dogs respond in 10 seconds. Preliminary research from COVID-sniffing dogs used in Dubai's airport shows over 90% accuracy.
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“With covid detection, you are not recognizing the virus. You are recognizing the volatile byproducts of cells dying because they have been infected with the virus.”

Professor of chemistry Kenneth Suslick, University of Illinois, invented an electronic nose to sniff out explosives and diseases. He says research in this area continues to expand. What do dogs actually smell? Chemicals omitted in our sweat, saliva, and breath.
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“Their noses work very differently than ours. We breathe in and out through the same passages. But dogs breathe in one passage and out another so they can separate out the odor that they want to focus on.”

Founder of BioScent K9, Heather Junqueira, a U.S. nonprofit training beagles and beagle-basset hound mixes to sniff out COVID-19. She says ideally a "positive" detection by a dog will be followed with an instant saliva test.
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Those optimistic think dogs may be more accurate than current testing, offering a powerful surveillance tool for returning communities back to "normal" by working at schools, stadiums and airports. Critics say training dogs is too expensive and time consuming to scale effectively.

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A new study sheds light on the increased frequency of alcohol consumption amid the COVID-19 pandemic.

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″We’ve had anecdotal information about people buying and consuming more alcohol, but this is some of the first survey-based information that shows how much alcohol consumption has increased during the pandemic.”

RAND Corporation's Michael S. Pollard, PhD, one of the authors of a new study showing Americans' alcohol intake frequency increased by 14% during the COVID-19 pandemic.
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ABOUT THE STUDY

  • Published as a research letter in the journal JAMA Network Open.
  • 1,500+ U.S. adult participants, aged 30 – 80, were asked about their drinking habits during the spring of 2020 compared to the spring of 2019.
  • On average, the 14% increase reported translates to 75% of adults consuming alcohol 1 day more per month.
  • Study’s authors note that results are based on participants’ self-reporting.
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The alcohol consumption increase was most notable among two groups:

  • Females, with 17% reporting drinking alcohol more frequently
  • Those aged 30 to 59, with 19% reporting drinking alcohol more frequently

Additionally, women reported a 41% increase in heavy drinking (i.e., drinking 4 or more drinks within 2 hours).

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WHY IT MATTERS

  • In April, the World Health Org. recommended that people currently restrict their alcohol consumption b/c of its negative impacts, incl. on mental health & potential to compromise people’s immune systems.
  • The study’s author echoed similar concerns, noting the results suggest “another way that the pandemic may be affecting the physical and mental health of Americans.”
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Why are women drinking more frequently? This study doesn't say. Separately, a UK study found those with the greatest increase in mental distress during the pandemic included young adults (18-24), women, and those with small children.

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COVID-19 &
Your Workout

New research on COVID-19 infections from exercise classes as states weigh whether to reopen gyms.

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KEEP IN MIND

  • CDC: COVID-19 spreads “mainly” person-to-person via respiratory droplets released when someone talks, sneezes, or coughs.
  • CDC: Questions remain about how effectively the virus spreads on surfaces. Hard, non-porous materials – like metal – in high traffic areas pose a risk for transmission (ex. touching an infected handle on an exercise bike and then wiping sweat from your eyes).
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The Latest Science

  • New study on COVID-19 spread among fitness class attendees in South Korea.
  • 27 instructors attended a February 15 workshop before returning to 12 different gyms; unknowingly 8 instructors were infected w/ COVID-19.
  • In the following weeks, 57 of the 217 class attendees developed COVID-19.
  • Additionally, 38 family members and 17 co-workers / friends developed COVID-19. Total infections: 112.
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“Because of the increased possibility of infection through droplets, vigorous exercise in closely confined spaces should be avoided during the current outbreak, as should public gatherings, even in small groups.”

The study's authors hypothesized high-intensity workout classes held in small spaces with moist, warm air and many participants can lead to COVID-19 transmission. They noted infected instructors *appear* to not have spread the virus in yoga or pilates classes.
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THE LATEST: USA

  • Gyms are open in 25+ states under new rules requiring precautions like social distancing, masks & reduced capacities.
  • Ohio: judge ruled state’s health dept “criminalized lawful businesses” by closing gyms & health clubs, allowing them to reopen as long as they comply w/ safety requirements.
  • Maine: delayed reopening of gyms after seeing the new study out of South Korea highlighted by CDC.
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Unlike other industries (ex: schools, restaurants, places of worship), the CDC has not issued specific reopening guidance for gyms. Check out the CDC's guidance for other industries on our source page.

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One of America’s oldest companies will stop selling one of its most iconic products.

WHY?

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WHAT TO KNOW

  • Johnson & Johnson (J&J) will stop selling its talc-based baby powder in the US and Canada.
  • Thousands of lawsuits challenging its safety have led to mixed outcomes. J&J currently faces approx. 19,400 lawsuits over the product.
  • J&J has lost more lawsuits than it won, but the appealed losses have been reduced, overturned or are working their way through the system.
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Talc-Based Baby Powder

  • Talc is a naturally-occurring mineral.
  • Asbestos, also a naturally-occurring mineral, is often found near & can contaminate talc mining sites.
  • Crushed talc is in many personal care products, like makeup, deodorant, and one formula of Johnson’s Baby Powder.
  • Concerns about talc & asbestos cross-contamination began in the 1930s.
  • Questions about links between talc and ovarian cancer date back to the 1960s.
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Is Talc Dangerous?

  • A World Health Org. agency: talc containing asbestos is “carcinogenic” (potential to cause cancer) when inhaled.
  • American Cancer Society: studies have been mixed, but notes “some suggestion of a possible increase in ovarian cancer risk.”
  • FDA: no studies have proven a conclusive link between talc and ovarian cancer.
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“Demand for talc-based Johnson’s Baby Powder in North America has been declining due in large part to changes in consumer habits and fueled by misinformation around the safety of the product and a constant barrage of litigation advertising.”

J&J in a statement, noting it remains "remains steadfastly confident" in the safety of its product, citing "decades of scientific studies by medical experts around the world."
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“Today’s victory means that children and families no longer will be endangered by this baby powder.”

Rep. Raja Krishnamoorthi (D-IL), the Chair of the Subcommittee on Economic and Consumer Policy, led a 14-month investigation into the health risks of asbestos in talc-containing products & said J&J "knew for decades that its product contains asbestos, and the company fought to keep using a testing method that never would have allowed it to be detected."
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Not Just The Powder: Johnson & Johnson says it decided to cut 100 products, including talc-based baby powder, after assessing its product line in light of COVID-19. J&J will continue to sell its cornstarch-based powder, but will keep the talc-based product on market shelves until it is sold out. Will you continue using it?

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New Questions About
COVID-19 & Children As a Rare Set of Symptoms Surface

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The Backstory

Monday: NYC Health Dept. issued alert after flagging 15 children with similar symptoms hospitalized since mid-April.

Patients: Aged 2-15 years old; some tested positive for COVID-19 (or antibodies) while others tested negative.

Symptoms: Similar to toxic shock and/or “Kawasaki disease” (an illness that causes inflammation), persistent fever.

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“We want to reassure parents – this appears to be uncommon.”

Dr. Jane Newburger, Dir of the Kawasaki Program at Boston Children’s Hospital, in a statement released by the American Heart Association on Wednesday. The group says, though rare, "some children are becoming very ill extremely quickly" and list symptoms as "persistent fever, inflammation & evidence of single or multi-organ dysfunction" and "may or may not test positive for COVID-19."
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Why It Matters:

This bulletin from NYC is corroborated by reports from doctors in Europe and the U.S, (mainly on the East Coast) and notably in areas with high COVID-19 infection rates.

Health officials have been baffled at the low rates of COVID-19 among children — this raises questions about a more nuanced, rare response in otherwise healthy children.

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Something To Consider

The number of confirmed COVID-19 cases among U.S. children remains low. However, children are not extensively tested.

According to the most recent CDC data, about 21,000 Americans under 18 tested positive for COVID-19, a small percentage of the 1M+ cases.

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For context - the 2019-2020 flu season was particularly deadly for children under the age of 4 (CDC reported 170 deaths), and had historically-high hospitalization rates for those under 18 years old.

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“HIGHLY POWERED”

The results of a drug trial provide an important clue to treating COVID-19.

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What To Know:

Nat’l Inst. of Health’s Dr. Fauci shared the results today of “the first truly high-powered randomized placebo control trial” on a drug used to treat COVID-19.

  • Drug: remdesivir (rem-des-a-veer)
  • NIH sponsored the trial that began in February and included 1,000+ hospitalized patients across the globe
  • Reduced recovery time of patients from 15 days to 11 days, or roughly 30%
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Why It Matters:

There are no *proven* therapeutics to specifically treat COVID-19.

Dr. Fauci: “What it’s proven is that a drug can block this virus…We think it’s really opening the door to the fact that we now have the capability of treating.”

This will encourage further research, testing, and innovation on remdesivir and other therapeutics.

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How It Works:

Remdesivir blocks an enzyme used by the virus to gain strength or replicate.

Administered through an IV.

Interesting to Note: Though tested for treating SARS & MERS (coronaviruses), leading to positive results for shortening disease and symptoms in animals, remdesivir has NOT been approved anywhere in the world.

 

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“It’s active against every coronavirus that we’ve ever tested. It was very hard for the virus to develop resistance to remdesivir. That means the drug would likely be effective over longer term use.”

Vanderbilt University’s Dr. Mark Denison who has studied the drug's impact on different coronaviruses dating back to 2013. Additional information is needed about its use on COVID-19, including whether or not it can be safe & effective treating less severe cases of COVID-19.
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Something To Consider

In a separate study on remdesivir in China, the drug did not lead to shorter recovery times. Patients receiving the drug vs. placebo did not experience any significant benefit.

The study was smaller and ended early. Researchers wanted more than 450 people enrolled, but ended up with just over half of that, due to decreasing number of COVID cases.

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Dr. Fauci says the drug's impact on COVID-19 mortality is TBD. Initial data reflects a trend that those treated with remdesivir have lower mortality rates but a lot more information is needed. That said, the FDA says its already working with the drug-maker to secure availability of the treatment *if* approved.

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How COVID-19 impacts what you and your family are able to buy, cook & eat.

 

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THE STAKES (& STEAKS)

  • The U.S. is the world’s largest food exporter.
  • The U.S. is the world’s largest beef producer & consumer in the world.
  • The U.S. is the world’s largest poultry producer. It’s also a major egg producer & the second largest poultry exporter.
  • Meat byproducts (ex: gelatin, wool, lanolin) also contribute to many commonly used household products.
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What’s the Problem?

The U.S. food supply chain is impacted by COVID-19 in these two ways:

  • Distribution: Restaurants, cafeterias, closed, immediately halting demand.
  • Human Power: When plants shut down due to illness/sick leave, fewer workers can process food.

Why It Matters: Livestock farmers have too much product & nowhere to send it.

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THE LATEST

  • The U.S. gov’t considers livestock, agriculture workers “critical.”
  • Large processing plants employ a lot of people working in close quarters.
  • Outbreaks have halted production. U.S. meat industry workers have reportedly died from COVID-19.
  • This has led to the closure of major U.S. meat processing plants, potentially impacting meat supply nationwide (and beyond).
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“As pork, beef and chicken plants are being forced to close, even for short periods of time, millions of pounds of meat will disappear from the supply chain… Farmers across the country will not have anywhere to sell their livestock to be processed, when they could have fed the nation… The food supply chain is breaking.”

Tyson Foods chairman John Tyson in a full-page ad published in various newspapers over the weekend.
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“They say, ‘How dare you throw away food when so many people are hungry?.’ They don’t know how farming works. This makes me sick, too.”

A U.S. farmer, speaking on the condition of anonymity, about disposing of their product. Some farmers have been forced to euthanize livestock because they have nowhere to keep or sell the animals.
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What This Means For You

Even if individual families buy more at the grocery store, we can’t make up for the large, bulk purchasing power of restaurants, corporate cafeterias, event catering and beyond.

Some economists believe the disruption in the supply chain (lower supply due to closed processing plants) will lead to higher prices for all in the weeks and months ahead.

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Currently, meat produced for food-service (like restaurants) cannot be repackaged and sold in grocery stores, or donated easily. The USDA has set up an emergency network to try to coordinate oversupply, funneling it to places of need.

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What Are We Learning?

A closer look at the CDC’s newest report on the sickest COVID-19 patients in the U.S.

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90% of adults hospitalized had one or more pre-existing condition

The CDC looked at hospitalizations across 14 states in March. The most common preexisting conditions among the sickest COVID-19 patients were hypertension (high blood pressure), obesity, chronic lung disease, diabetes, and cardiovascular disease. On Wednesday, the White House COVID-19 coordinator Dr. Debroah Birx noted that asthma is also a pre-existing condition.
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African Americans may be disproportionately affected 

African Americans accounted for 33% of those hospitalized with COVID-19, but just 18% of the population in the 14 states examined by the CDC. Caucasians made up 45% of those hospitalized and accounted for 59% of the population in the 14 states examined by the CDC.
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More than half of adults hospitalized are male

The overall COVI9-19 hospitalization rate for Americans in the 14 states examined by the CDC was 4.6 per 100,000 people. The rate was 5.1 for males compared to 4.1 for females. Hospitalization rates increased with age, with the highest rates among those 65 and older.
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“… the potential impact of both sex and race on COVID-19-associated hospitalization rates, need to be confirmed with additional data. “

The CDC says the latest data emphasizes "the importance of preventive measures (e.g., social distancing, respiratory hygiene, and wearing face coverings in public settings where social distancing measures are difficult to maintain) to protect older adults and persons with underlying medical conditions, as well as the general public."
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Why It Matters: We’re getting a more complete picture of serious cases in America, but we still need more data to understand why certain people are more like to be affected than others.

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COVID-19: Sero Tests

Why serological surveys are the key to understanding the full scope of the outbreak and opening America back up again.

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BACKSTORY

Current data on COVID-19 is limited.

The U.S. gov’t reports how many people have been tested, how many test positive or negative, and total deaths.

We don’t know how many people have COVID-19 but have minor or no symptoms (asymptomatic).

Bottom Line: We have an incomplete picture of COVID-19 in America.

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Why Sero Tests Matter

“We can test people to see if they’ve been exposed, immune, and go back to work.  And a combination of that kind of test with the current kind of tests we have now is how America opens back up again.”

Admiral Girior MD, Assistant Secretary for Health at the U.S. Department of Health and Human Services (HHS) during a COVID-19 Task Force briefing.
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Sero Tests 101

Serological (aka “sero”) tests or surveys are blood tests that measure specific antibodies produced by your immune system in response to an infection.

The antibody is evidence that a person has been exposed to an infection (whether or not they ever showed symptoms) – and *may* have immunity.

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Why It Matters

  • Current knowledge of COVID-19 is *largely* based on people who test positive – they tend to be the most sick.
  • If more people than previously thought had prior exposure to COVID-19, it may help relax public health measures, e.g. social distancing.
  • If fewer people had exposure to COVID-19, it may increase the need for public health measures until there’s a clinically tested treatment or vaccine.

 

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“…someone who’s recovered from the virus and doesn’t have the virus in their system at all, you can take plasma…that plasma contains the proteins in the blood that have the antibodies against the virus.  You can take that, process it, and then give it to someone who’s ill.  And so that allows you to transfer that immunity.”

FDA Commissioner Dr. Stephen Hahn on a potential treatment for COVID-19 - another reason why sero tests matter.
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A Warning

Members of the COVID-19 Task Force have warned about the reliability of sero tests currently on the market.

Dr. Birx warned Americans against purchasing sero tests on the internet.

Admiral Girior referenced a report that the UK purchased millions of tests that may not work.

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The FDA granted emergency use authorization to one serological test. Results are available within 15 to 20 min. On Monday, Adm. Giroir M.D. said he expects to have millions of antibody tests available by May, but he wants to ensure the tests are accurate before widespread use.

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BAD RAP?

We’re eating more tree nuts than ever…and they may have FEWER calories than we thought.

 

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BACKSTORY

  • BACKGROUND: The USDA and most food manufacturers rely on a century-old formula (1 gram of protein = 4 calories; 1 gram of fat = 9 calories) to calculate a given food’s calorie content.
  • RECENT: That formula might not apply when it comes to certain tree nuts because they aren’t broken down (digested) like other foods, and therefore our bodies don’t absorb as much energy (calories).
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About The Studies

  • 2011: USDA researchers began studying how almonds, walnuts, & pistachios are digested in human “waste.”
  • Using those samples, researchers calculated how much fat, protein, carbohydrates, & calories were absorbed by the participant.
  • Results: Nuts had fewer *digestible* calories vs. calorie counts on labels: almonds (-32%), walnuts (-21%) & pistachios (-5%).
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WHY?

“If they’re not digested, then maybe the calorie content is not correct.”

Dr. David Baer, one of the USDA researchers involved in the studies.
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Also Worth Noting

  • Researchers found the more the nut is cooked (or processed), the more calories digested. Example: Almond butter has more calories than roasted almonds, but roasted almonds have more calories than raw almonds.
  • U.S. Department of Agriculture’s Agricultural Research Service unit conducted the studies. Nut producers and organizations contributed funding.
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BIG PICTURE

“We can create synthetic DNA and clone animals but we still know incredibly little about the stuff that keeps us alive.”

Prof. Tim Spector, Kings College in London, on nutrition science: "No other field of science or medicine sees such a lack of rigorous studies." Food manufacturers create their own nutrition labels. Research has raised questions about accuracy of labels & whether counts can be "one-size-fits-all."
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Kind Bars recently announced it's cutting the calorie counts of its nut bars by 10-30 calories per bar because of the new research. Are chocolate-covered nuts next? DON'T COUNT ON IT! Mars, which owns a share of Kind, isn't planning on lowering its calorie counts for M&M’s with almonds.

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MASKS: ON OR OFF?

How To Stay Healthy

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BACKGROUND

  • “Coronavirus” ~ a family of viruses causing a range of illnesses from the common cold to severe acute respiratory syndrome (SARS).
  • *New* coronavirus detected in Wuhan, China in December 2019.
  • Spread to at least 24 countries.
  • World Health Organization declared a global health emergency.
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Coronavirus: China

  • Reported cases has multiplied rapidly.
  • Number of deaths in China has already exceeded suspected deaths during the SARS outbreak.
  • Passengers arriving in the U.S who traveled to China within the last two weeks are diverted to 11 airports where they are screened, and if necessary quarantined.
  • The State Dept. and Centers for Disease Control advise against travel to China.
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Coronavirus In U.S.

  • Declared a public health emergency.
  • Twelve people infected (most, if not all are travel-related & their spouses) in six states (AZ, CA, IL, MA, WA, & WI).
  • More than 300 suspicious cases tested negative; 60+ cases still pending (representing people in 37 states).
  • CDC: “…it’s unclear how easily or sustainably this virus is spreading between people.”
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DO YOU NEED A MASK?

“There really is no need to wear a mask right now…Exactly what you do to protect against influenza, applies to protecting against coronavirus – and that does not include wearing a mask.”

Nat'l Institute of Allergy & Infectious Diseases Dir. Dr. Anthony Fauci
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Something To Consider:

  • Majority of respiratory illnesses spread either through tiny airborne germs or droplets.
  • Airborne germs can easily spread simply by being in close proximity with someone who is ill, like the measles.
  • Right now, the CDC believes the new coronavirus is spread via droplet; touching infected surfaces, or having someone sneeze/cough near you from 3-6 ft may spread the disease.

 

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Practical Advice

“Wash your hands really well. Use a paper towel to turn off the faucet and open the door. Use your elbow to touch an elevator button and try not to touch high-traffic surfaces…All those things that help protect us from the flu, will also help protect us from the coronavirus.”

Dr. Darria Long Gillespie, MD MBA, author of "Mom Hacks."
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For context: the CDC estimates 10,000 people have died from the flu since October, and 180,000 were hospitalized (comparable to past years). The CDC just announced coronavirus diagnostic test kits are now available to doctors & will provide results in 4 hrs.

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