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Pineapple pizzagate forces Iceland president to back off ban

Hawaiian pizza is not for everyone. It’s a decadent, tasty treat to some, but for others ham and pineapple are the worst topping choices ever created.

Iceland’s president waded into the fray last week when a student asked him a question about pineapple on pizza. (Ham wasn’t mentioned, by the way.)

>> Read more trending news  

 Guðni Th. Jóhannesson said he found the combination “completely disgusting,” USA Today reported, and would ban it if he could.

By Tuesday Jóhannesson was forced to back down from his remarks on banning it after a social media storm, dubbed pizzagate, erupted.

“I like pineapples, just not on pizza,” he posted on Facebook. “I do not have the power to make laws that forbid people to put pineapples on pizza.”

“Presidents should not have unlimited power. I would not want to hold this position if I could pass laws forbidding what I don’t like. I would not want to live in such a country,” he said.

Dear President Guðni Th. Jóhannesson,We cant believe you.  Poor Iceland. However, we forgive you because our guess is...Posted by Homegrown Tap & Dough - Arvada on Wednesday, February 22, 2017

Instead, Jóhannesson, made his own recommendation for the best topping.

“For pizza, I recommend seafood,” he wrote on Facebook.

Jóhannesson is Iceland’s youngest president ever at 48. He was sworn into took office last August.

Guðni Th. Jóhannesson: people should try fish on their pizza!Posted by Farerskie kadry on Tuesday, February 21, 2017

Popular Charity Heart Screenings For Teens May Cause More Problems Than They Solve

Dozens of not-for-profit organizations have formed in the past decade to promote free or low-cost heart screenings for teens. These groups often claim such tests save lives by finding abnormalities that might pose a risk of sudden cardiac death.

But the efforts are raising concerns. There’s no evidence that screening adolescents with electrocardiograms (ECG) prevents deaths. Sudden cardiac death is rare in young people, and some physicians worry screening kids with no symptoms or family history of disease could do more harm than good. The tests can set off false alarms that can lead to follow-up tests and risky interventions or force some kids to quit sports unnecessarily.

“There are harms that I don’t think a lot of people realize,” said Dr. Kristin Burns, who oversees a two-year-old registry at the National Institutes of Health of sudden deaths in people under 20. It’s one of several efforts aimed at gathering better data about cardiac abnormalities in kids.

Studies using limited data have found between one and four sudden cardiac deaths occur annually per 100,000 kids between ages 1 and 18. By comparison, 22 out of 100,000 U.S. teens are killed in accidents, including those involving motor vehicles, and nine out of 100,000 commit suicide, according to the Centers for Disease Control and Prevention.

Some screening advocates believe sudden cardiac deaths are underreported and not enough is being done to spare families from the fate of losing a child. “We have to acknowledge that every kid who drops dead, they’ve been failed by the current system,” said Darren Sudman, who founded Simon’s Fund, a screening effort in greater Philadelphia in memory of his infant son, who died of an arrhythmia.

Screening programs say they’re educating parents about the risks. “What we want to emphasize is, make sure your kid is heart-safe,” said Dr. Jonathan Drezner, a sports and family medicine specialist in Seattle at UW Medicine and medical director of the local Nick of Time Foundation.

Enthusiasm for ECGs, which measure the electrical activity in the heart to detect abnormalities, grew after a 2006 study showed they lowered death rates among athletes in Italy. But research in other countries has not yielded similar results, and the Italian researchers recently were accused of refusing to share their data so it could be evaluated independently.

Some 60,000 to 70,000 U.S. teens were screened in 2016, most by foundations created by families who lost a child to sudden cardiac death, said Darren Sudman, who runs an online directory, Screen Across America. It’s unclear whether high school athletes face higher risk than non-athletes, so screening programs usually invite everybody.

Screenings typically are held in high schools and overseen by volunteer cardiologists, with funding from individuals and businesses including hospitals. A handful of hospitals and for-profit companies also run screenings.

It may be presumptuous to claim ECGs save lives, but parents often believe they do, said Sudman. “If I find a heart condition, I promise you there are parents who are thanking me for savings their kid’s life.”

That perception is stoked by tragic stories in the media of children who died suddenly after never reporting a symptom. Meanwhile, the drawbacks of ECGs are seldom depicted. As many as 1 in 10 ECGs detects a potential abnormality, and the emotional and financial toll of such a finding can be significant — especially when they turn out to be wrong.

Following a screening ECG and echocardiogram last fall, Daniel Garza, 16, a talented sophomore basketball player in San Antonio, was told he had hypertrophic cardiomyopathy, a thickening of the heart muscle and the most common cause of sudden cardiac death in young people. He was advised to quit all exercise, at least temporarily.

“We were shocked, just shocked,” said his mother, Denise. She said her son became depressed when he couldn’t play the sport he enjoyed and excelled at. “He came home and cried himself to sleep. He said, ‘Mom, why did God give me this gift to take it away?’”

The Garzas traveled to the Mayo Clinic in Rochester, Minn., where further tests indicated his enlarged heart was a benign condition known as athletic heart, a result of intense training. His mother estimates that correcting the misdiagnosis cost more than $20,000, including medical costs, travel and lost work.

Daniel has returned to the basketball court. Still, Denise Garza said the emotional toll was rough. “It was one of the hardest things my family has ever endured.”

Several cardiologists said they often see cases like this or worse. Even after follow-up testing, it can be unclear which cases are life-threatening, so kids with low risk could be restricted from exercise or given life-altering interventions such as implantable defibrillators, surgery or anti-arrhythmic medications.

Medical groups have wrestled with the issue. The American Heart Association and the American College of Cardiology recommended in 2014 against mass ECG screening, noting that sudden cardiac death is rare in teens and false positives generate “excessive and costly second-tier testing.” ECGs also miss at least 1 in 10 cases of hypertrophic cardiomyopathy and more than 9 in 10 cases of congenital anomalies, the second-most-common cause.

But their expert panel accepted voluntary screening “in relatively small cohorts” if there’s physician involvement, quality control and a recognition of unreliable results and ancillary costs.

By contrast, there’s broad support for automated external defibrillators, which have been shown to prevent deaths at schools and other public places. Some foundations focus their efforts on disseminating the defibrillators.

One problem with ECGs is a lack of good data.

“There’s no evidence we have that ECG screening saves lives,” said Dr. Jonathan Kaltman of the NIH’s National Heart, Lung, and Blood Institute. “There’s never been a controlled clinical trial, which is the only way to answer that question.”

Efforts are underway to improve the accuracy of the screening programs. Some are adding echocardiograms, which use ultrasound to produce images of the heart, to verify potential abnormalities. Advocates say false positives have dropped as a result of better interpretation guidelines, known as the Seattle Criteria, which are expected to soon be endorsed by cardiology societies in revised form.

But the criteria are not perfect, and there’s a “giant gap” in training cardiologists to use them, said Drezner, one of the developers. He’s also a medical adviser for Parent Heart Watch, a consortium of foundations. “If I was a parent, I’d want to know about the experience of the (cardiologists) and what they’re going to do to help my kid if they have a positive screen.”

At the urging of screening advocates, the NIH partnered with the Centers for Disease Control and Prevention to rigorously track cardiac deaths as part of a Sudden Death in the Young Case Registry. So far a handful of states and counties have joined the effort, which helps local health departments collect better data. The goal is to standardize death investigations and get a firm handle on how often kids die from heart abnormalities as well as the role of factors such as genetics. Initial findings are expected to be available in about two years. The NIH is also funding three university-based research groups to answer key questions about sudden cardiac death in the young.

Some screening organizations are getting behind a nascent initiative with the Cardiac Safety Research Consortium to harness their own screening data for research. It would require standardizing their practices and tracking outcomes, which organizations aren’t now equipped to do.

“Screening is happening. We can’t avoid that,” said Dr. Salim Idriss, director of pediatric electrophysiology at Duke University and co-chair of the initiative. “We have a really good opportunity to get the data we need to make it better.”

Separately, the UT Southwestern Medical Center in Dallas recently began a four-year pilot study involving athletes and band members at eight high schools to determine the feasibility of a full-scale randomized controlled trial.

A valid finding on the overarching question of whether ECG screening saves lives could require at least 800,000 participants and a cost of $15 million, said Dr. Benjamin Levine, a cardiologist and the lead researcher.

The pilot is partly a response to legislation that would mandate ECGs for student athletes in Texas. A similar bill was also introduced in South Carolina. Both bills failed, but it’s expected there will be more attempts to mandate ECGs, leaving state legislators looking for better guidance.

“We’re not going to solve this by having more debates, but by having more data,” Levine said.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

7 Dessert Recipes With Zero Added Sugar (Seriously, Not Even Honey)

By now we know that most of the world consumes way too much sugar. But it’s not like our sweet tooth cares—when a dessert craving hits, it hits bad. Many turn to alternative ways to satisfy it, using less-refined sugars like agave, honey, and coconut sugar, but we’re going a step further this time, with treats that use no added sweeteners whatsoever. From tarts to mousse, these sugar-free recipes still manage to make dessert even sweeter.

1. 2-Ingredient Homemade Peach Ice Cream Photo: Yuriel Kaim This fruity treat doesn’t just come without added sugar, it also uses a simple food processor instead of a fancy ice cream maker. If that wasn’t enough, there are only two ingredients in here (neither of which involves dairy), and it takes a mere five minutes to whip up. It doesn’t get much better than that. 2. Sugar-Free Apple Tart Photo: 52 New Foods Want to impress guests without stressing yourself out? This apple tart should do the trick; it looks fancy, but a premade pastry crust, a simple layering pattern, and unsweetened applesauce make it super simple to put together. 3. Healthy Extra Moist Chocolate Cake Photo: Del's Cooking Twist Chocolate cake without sugar? When puréed dates and unsweetened baking chocolate are involved, it’s possible. Mixed with eggs and coconut oil, these naturally sweet ingredients make for fudgy results that taste anything but sugar free. 4. Gluten-Free Date Bars Photo: Vitamin Sunshine There’s a reason dates are called “nature’s candy”—they lend so much sweetness without any added sugar. These gooey bars make the most out of the chewy fruits, using them for both the crust and the top layer, while a touch of sea salt adds a slightly savory element, and walnuts provide a complementary crunch. 5. Creamsicle Chia Pudding Photo: Fed and Fit While regular creamsicles are almost too sweet, this thick and fluffy pudding goes for a much more subtle flavor. The rich coconut milk and the clementine segments add just enough natural sugar. 6. Chocolate Avocado Mousse Au Chocolove Photo: Blissful Basil Who needs heavy cream and sugar when dates and avocados can do just as good a job of producing a killer chocolate mousse? With zero added sweeteners and a good amount of healthy fat, this isn’t just a perfect dessert, it could pass off as a filling breakfast too. 7. No Added Sugar Cinnamon Spice Raisin Cookies Photo: Avocado a Day Nutrition Make sure your raisins and nut butter have no added sugar to make these cookies totally free of sweeteners. Almond meal keeps them gluten-free, while coconut oil instead of butter and eggs means they’re completely vegan too.

Video shows moment Harrison Ford flew over plane before landing on taxiway

New video released by a Southern California airport shows the moment that actor Harrison Ford flew his private plane over a jetliner and mistakenly landed on a taxiway.

>> PREVIOUS STORY: Harrison Ford is under investigation after being involved in a passenger plane incident

The incident occurred about noon Feb. 13 at John Wayne Airport near Orange County.

>> Watch the video here

New footage shows Harrison Ford's recent near miss, flying over an airliner to land on a taxiway instead of a runway https://t.co/2CUiJLbMMs— Sky News (@SkyNews) February 22, 2017

Ford, 74, was supposed to land his Aviat Husky on the runway, but landed on the taxiway instead, E! News reported. He flew over an American Airlines Boeing 737 with 110 passengers and a six-person crew on board. The Dallas-bound aircraft was still able to take off minutes after the incident.

According to People, Ford asked air-traffic control, "Was that airliner meant to be underneath me?"

>> Read more trending news

Ford was not injured.

The Federal Aviation Administration is investigating the incident. If Ford is found at fault, he could lose his pilot's license.

I've Spent 10 Years Helping People Lose Weight… Here Are My Best Tips

For 10 years, I’ve been the force behind MyBodyTutor.com, which simplifies the weight-loss process into practical, sustainable behaviors that help you lose weight and actually keep it off. It hasn’t always been easy, but I believed enough in my program to quit my comfortable job for it. I’ve since made a career out of working with clients who have "tried everything" but just haven’t managed to keep the weight off. One client had attempted 16 different programs before finding success with me.

The truth is, you can lose weight with almost any program, but sustaining that weight loss is a different story altogether. My program has been a success because clients can fly the nest after acquiring the necessary skills—I don’t want anyone to come back as repeat business. Here the top weight-loss strategies that make my clients so successful.

1. Schedule fun for yourself.

Tension relief is one of the top reasons we overeat and make poor food choices. When something causes us to feel tense, we seek to alleviate that feeling… often with overly indulgent food and drinks. As we get older, we make less time for fun, which leads to burnout.

What defines fun for you? Consider signing up for art classes, salsa lessons, volunteering, board games, meditation, yoga, even cooking healthier spins on your favorite foods. Focusing on fun might sound trite, but there's a good reason my most successful clients create time for it: The more fun we have, the less we'll rely on food and drink to create it for us.

2. Learn that food isn’t what you’re really craving...

...what you’re craving is avoidance. When we indulge, we’re after the experience of eating—the escape and distraction. So when you want to eat an entire pint of ice cream, what you’re really after is that sense of reward. But food won’t give you what you're truly looking for, so when you’re craving something that will hamper your goals, ask yourself: "If I could use a magic button to change something in my life right now, what would I use it for?" This will help you identify what’s really bothering you. For example, if you’re unhappy with your career, or you’re seeking a better relationship with your partner, identifying these issues will help you map out a plan of action instead of covering up a desire with temporary relief in the form of dessert.

3. Understand that 80 percent of weight loss is diet.

You know how some people can work their butts off in the gym—even with a trainer—and they don’t end up looking any different? You can't out-exercise a poor diet; what you do between exercise matters most. While exercise is the key to energy and a better mood, diet is the key to weight loss.

4. Plan and prepare meals ahead of time.

We often have to battle between our short-term, irrational mind and our long-term, rational mind. When we’re hungry, stressed, or tired, it’s harder to make good choices. Besides, when was the last time you were "in the mood" for grilled chicken and vegetables when you felt ravenous? Sure, you might not always follow through with your healthy-eating plans, but the chances you’ll do so increase dramatically when you actually have a plan in the first place. You don’t get any bonus points for using heroic willpower rather than simple planning, so why not make it easier on yourself? My most successful clients always have healthy food ready to go in the fridge—this just makes good choices easier.

You might also like {{displayTitle}} READ 5. Choose a truly sustainable path.

This might sound like common sense, but it’s not common practice. You can’t expect to stick with a plan that won’t work in the long run, but people keep attempting absurd fad diets. Forget about them! You can only follow a cookie, shake, grapefruit, cabbage, no-carb, and no-fun diet for so long—and my most successful clients avoid these diets. Before you start any weight-loss program, ask yourself, "Can I see myself eating like this in five years from now?" If the answer is no, then the diet you’re thinking about starting isn’t going to work. Give yourself a chance to succeed from the start.

6. Determine if you’re actually hungry before you eat.

One of the top reasons people are overweight is because they eat when they're emotionally hungry, not physically hungry. Physical hunger comes on gradually and can be satisfied with any food. It passes what I call the "Broccoli Test."

Emotional hunger comes on suddenly. It feels urgent and is marked by specific food cravings. You can have snack after snack, and nothing hits the spot. This is because you're not hungry for food—you're hungry for something else. So when you’re about to eat, pause and ask yourself, "Am I hungry or am I eating to change the way I feel?" This will allow you to catch yourself if you're about to eat for emotional reasons, not out of true hunger.

7. Plan your indulgences.

I’ll never forget when a client told me that before starting one of her many failed diet attempts, she was told to sign a contract stating she’d never indulge in any of her favorite desserts again. If only it were that easy—that’s like saying "Don’t be sad" to someone who’s depressed. It’s ridiculous. Never indulging again isn’t sustainable... or even desirable.

You should eat treats when they’re special to you. My rule is that your special indulgence should pass the "Will I remember this in two weeks?" test. Most of the indulgences we eat aren’t remarkable—they’re bags of chips or boxes of stale-tasting cookies from a convenience store. The idea is to make the most of routine meals and indulge when it’s truly worth your while. Wait for a memorable treat like a high-quality pastry from your favorite shop.

The real secret to sustainable weight loss is that there is no secret. It's about eating well, exercising… and doing these consistently. Understanding what gets in the way of consistency—and how to be more steady in your efforts—is the only way to stick with a plan and get the results you really want.

Adam Gilbert is the founder of MyBodyTutor.com, an online program that solves the lack of consistency faced by chronic dieters. You can follow Adam on his blog, Instagram, and Twitter.

23 Healthier Ways to Get Your Cookie Dough Fix

When it comes to cookie dough, most traditional versions come with a “look but don’t touch” warning, thanks to the raw egg and flour posing a pretty scary salmonella risk.

So for those of us who used to relish (or be deprived of) licking the batter bowl as kids, the search for edible cookie dough remains real. Sure, sticking a spoon into a pint of Ben & Jerry’s Half Baked is a possibility, but that kind of sugar intake isn’t exactly an everyday solution to our cravings.

We’ve rounded up 23 healthier and safer ways to enjoy the chewy, gooey deliciousness of unbaked cookies. From dips and bars to cupcakes and smoothies, these recipes let you have your cookie dough and eat it too.

Dips, Doughs, and Balls 1. Pumpkin Pie Cookie Dough Energy Balls Photo: With Salt and Wit There’s always one more thing to pumpkin spice-ify! Give your healthy cookie dough some festive flair by adding some of the canned veggie into the mix, with vanilla protein powder for more staying power. We’re thinking this could work great as a pre- or post-workout snack, even when the holidays have long passed. 2. Sugar Cookie Dough Dip Photo: Living Well Kitchen Dates and chickpeas aren’t your average snickerdoodle ingredients, but thanks to these unconventional healthy swaps, you can enjoy sugar cookie flavor without butter, flour, or any actual sugar. 3. Vegan Chocolate Chip Peanut Butter Cookie Dough Balls Photo: Yummy Mummy Kitchen Once they’re out of the oven, gluten-free cookies can run the risk of tasting like cardboard. Solution? Just don’t bake 'em! This recipe uses almond flour, flax, and peanut butter to give you all the chewiness of a good cookie, without the health hazards of raw egg. 4. Skinny Red Velvet Cookie Dough Dip Photo: With Salt and Wit Turn heads with this dip variation of a classic cake. With nut butter instead of oil, maple syrup instead of sugar, and a hint of dark cocoa powder, it may not be your traditional red velvet recipe, but it takes a fraction of the time to make, and it’s healthy enough to eat every day. Good enough for us! 5. Chocolate Chip Funfetti Cookie Dough Bites Photo: Amy's Healthy Baking Using smaller amounts of refined flour, butter, and brown sugar, this recipe is all about that authentic cookie dough flavor, but the bite-size packaging makes it easier to stick to portion sizes. It’s the perfect way to indulge in moderation when “healthified” variations won’t cut it. 6. Chocolate Chip Cookie Dough Truffles Photo: 24 Carrot Kitchen Make cookie dough even more irresistible by dunking balls of it into melted chocolate. Once chilled, you’ll have a crispy outer shell and a perfect, chewy center. Nobody needs to know that the inside is made up entirely of heart-healthy cashews! 7. Greek Yogurt Chocolate Chip Cookie Dough Photo: Hungry Healthy Happy Trying to find a way to warm up to the tang of Greek yogurt? Turning it into cookie dough should help. Almond butter, honey, and dark chocolate cut the tartness, add even more protein, and can be eaten as dessert for breakfast or breakfast for dessert. 8. Healthy Gingerbread Cookie Dough Dip Photo: Sinful Nutrition Who says you can only indulge your gingerbread cravings during the holidays? Healthier than your average homemade cookie and so much better than the store-bought snaps, these richly spiced bites come with many classic ingredients like molasses and nutmeg, but the chickpea and peanut butter base (plus the dash of chili powder!) makes them extra special. Brownies and Bars 9. Vegan Cookie Dough Cheesecake Bars Photo: Le Petite Eats Cookie dough and cheesecake in a single dessert sounds anything but light, and while these bars are plenty rich, the nut-based crust, coconut oil, and maple syrup makes them much healthier as far as ingredients are concerned. As a bonus, there’s no baking involved—just chill the mixture until it’s set enough to be sliced into. 10. Chocolate Peanut Butter Cookie Dough Bars Photo: Feasting on Fruit You’re getting two recipes in one with these bars; one version uses regular peanut butter, while the other opts for peanut flour to cut down on the fat while maintaining that nutty flavor. The one thing that’s not negotiable? Chocolate chips. Skimp at your own risk. 11. Vegan Cookie Dough Brownies Photo: Vegan Richa If you thought chickpeas were a nontraditional dessert ingredient, your jaw may drop further at the idea of using red lentils to fulfill your cookie dough craving. But the high-protein legumes are actually key players in these brownie-bottomed bars. You’ll want to make this recipe just to believe it! 12. Chocolate Chip Cookie Dough Snack Bars Photo: Laura Fuentes Calling for fewer than five healthy ingredients and no baking time, these make getting your cookie dough fix a breeze. The hardest part is waiting for them to set before you can cut them into bars—we don’t blame you if you polish off half the dough long before it’s ready. 13. Chocolate Chip Cookie Dough Brownies Photo: Rosanna Davison Nutrition You’ll need a few special items like brown rice flour and gluten-free baking powder to whip up these squares, but the ooey-gooey results are totally worth it. In fact, it might be useful to have those ingredients on hand all the time, since it’s likely you’ll be making these very often once you’ve tasted them. Cookies, Muffins and Pies 14. Vegan Cookie Dough Pie Photo: Vegan Richa A no-bake, gluten-free cookie dough crust. A homemade, dairy-free ice cream. Lots of chocolate shavings on top. This frozen dessert will make even healthy dessert skeptics drool. 15. Vegan Cookie Dough Muffins Photo: Upbeet and Kaleing It While grabbing a handful of actual cookie dough isn’t an option, you can always reach for one of these muffins instead. Slightly doughy in the center and crisp around the edges, these gluten-free babies are cookie dough perfection. 16. Healthy Chocolate Mousse Pie With Chocolate Cookie Dough Crust Photo: B Sweet Dreaming Added cocoa powder gives the crust a welcome hint of chocolate, which goes perfectly with the chocolaty, tofu-based filling. With all that chocolate going on, you won’t believe that each slice of this silky mousse has only seven grams of sugar. 17. Chocolate Egg Muffins Stuffed With Cookie Dough Photo: Food Faith Fitness This blogger describes this recipe as cookie dough “hugged” inside chocolate muffins. Given that they have six grams of protein per serving, a peanut butter drizzle, and plenty of chocolate chips, we want to hug her for creating it. 18. Vegan Chocolate Cookie Dough Cupcakes Photo: Beaming Banana If chickpeas can be used to make cookie dough dip, chickpea flour works just as well to make cookie dough cupcakes. Both the whole bean and its pulverized version are used in these fudgy treats, where cookie dough dip is stuffed inside the baked muffin and slathered on top. Other Goodies 19. Chocolate Chip Cookie Dough Nice Cream Photo: Rawberry Fields Banana “ice cream” has been a thing for a while now. But add some peanut butter to the mix and cram it with chunks of homemade, peanut buttery, chickpea-based cookie dough, and you’ll have a whole new appreciation for how amazing it can be. 20. Healthy Cookie Dough Milkshake Photo: Sprouted Routes You can use any milk you prefer for this recipe, but we recommend going with coconut for the proper milkshake experience. Almond butter and vanilla give it that distinct cookie dough flavor, while cacao nibs (or chocolate chips) add a sweet crunch to every sip. 21. Chocolate Chip Cookie Dough Protein Smoothie Photo: The Seasoned Mom Refueling post workout with cookie dough sounds almost too good to be true, but this smoothie makes it possible. Packed with protein, plus healthy carbs from the oats, it’s the most delicious way to re-energize and treat yourself. 22. Healthy Cookie Dough Cheesecake Photo: The Pancake Princess Greek yogurt replaces half the cream cheese and adds the perfect amount of tang to offset the sugar in this super-smooth cake, while oat flour and ground flax make up the base of the cookie dough that’s hidden throughout the batter. If this is what a healthier dessert looks like, it’s easy to eat well. 23. Oatmeal Cookie Dough Smoothie Photo: In It 4 the Long Run Instead of putting yourself through the work (and the potential mess) of baking cookies from scratch, just throw your ingredients into a blender and call it a day. The oats, almond butter, and protein powder make this smoothie super thick and filling, while bananas and dates add sweetness without sugar.

A New Diagnosis: ‘Post-Election Stress Disorder’

Wally Pfingsten has always been a news junkie. But since President Donald Trump was elected, he’s been so anxious about the political tumult that even just having the TV news on in the background at home is unbearable.

“It’s been crippling,” said the 35-year-old San Mateo, Calif., resident and political moderate who has supported both Democratic and Republican candidates in the past. “I feel angry, really, really angry, far more angry than I expected to be.”

He’s tried hard to quell his anxiety. First, he shut down his Facebook page to limit his exposure to the daily soaking of news from Washington. But not knowing the goings-on made him anxious, too. He found himself sneaking onto the Facebook account he made for his dog. “I felt like I was cheating,” he said.

Pfingsten is not alone in his politics-induced anxiety — it’s so common it’s been given an unofficial name: Post-Election Stress Disorder. Mental health professionals around the country, especially those working in Democratic strongholds, report a stream of patients coming in with anxiety and depression related to — or worsened by — the blast of daily news on the new administration.

In the past, therapists say it’s been fairly uncommon for patients to bring up politics on the couch. “It is big money to talk about politics with me ― that is not what we do!” said Maria Lymberis, a psychiatrist in Santa Monica, Calif.

But that was before “fake news,” “alternative facts,” “repeal and replace,” contested confirmations, travel bans, protests and suits over travel bans, suspicions about Russian influence and the departures of the acting attorney general and the new national security adviser. Among other things.

Requests for therapy appointments to Talkspace, an online therapy portal based in New York City, tripled immediately following the election and have remained high through January, according to the company. In particular, Talkspace has seen a steady increase in requests from minorities, including Muslim-Americans, African-Americans, Jews, gays and lesbians.

“In my 28 years in practice, I’ve never seen anything like this level of stress,” said Nancy Molitor, a psychologist in the Chicago suburbs. She says the vast majority of her patients — from millennials to those in their 80s — are bringing up politics in their therapy sessions. “What we’re seeing now after the inauguration is a huge uptick in anxiety.”

Many of her patients say they are having trouble sleeping and focusing at work or are fighting more with family members, she said.

[caption id="attachment_225567" align="alignright" width="370"] Mental health professionals around the country, especially in Democratic strongholds, report a stream of patients coming in with anxiety and depression. (Andrew Harrer/Bloomberg via Getty Images)[/caption]

“I have people who’ve told me they’re in mourning, that they’ve lost their libido,” Molitor said. “I have people saying the anxiety is causing them to be so distracted that they’re blowing through stop signs or getting into fender benders.”

The anxiety appears to be widespread. Fifty-seven percent of Americans report that the current political climate is a very or somewhat significant source of stress, and 40 percent say the same about the outcome of the election, according to an online survey of 1,019 adults conducted by the American Psychological Association after the inauguration. Between August 2016 and January 2017, the overall average stress level increased significantly for the first time since the Stress in America survey began 10 years ago.

And it’s not Democrats: a quarter of Republicans report that the outcome of election is a significant source of stress for them.

“I’m seeing lot of anxiety and anger on both sides,” says Elaine DuCharme, a psychologist in Glastonbury, Conn. “People who are Republicans are afraid to tell anyone. They’re afraid that everybody thinks that every Republican thinks exactly as Trump does, and support every single thing he does.”

She says some of her patients are particularly concerned about maintaining civil relationships with friends and loved ones who have different political opinions. “People are walking on eggshells,” DuCharme said.

Karri King, 56, who lives in Buckeye, Ariz., and voted for Trump, says her experiences on social media have left her feeling sad and hopeless. “There’s so much negative from all these stupid Facebook posts acting like the world is going to end. And it’s false. And I can’t do a thing about it.”

King said she’s tried to engage civilly with people online who disagree with her, but “every time [Republicans] turn around, we’re bashed.”

When you say “a bunch of idiots” voted Trump in, “you’re talking about half of all Americans! We were hopeful at first, and now we’re angry and tired of being blamed,” said King. “Nobody wants to listen anymore, and that’s where my sadness comes from.”

Of course, in some parts of the country, especially those that are overwhelmingly Republican and outside big cities, people seem relieved if not uplifted by the new president’s flurry of executive orders and appointments.

Kristin Addison-Brown, a psychologist in rural Jonesboro, Ark., says before the election, some of her patients were voicing concerns about a possible Clinton victory. But since then, “it’s pretty much been crickets for my patients. They got their guy, so they’re not stressed anymore.”

Nancy Cottle, a Trump supporter in Mesa, Ariz., has been riding high since the election. “We got to go to the inauguration, and, oh, it was a wonderful experience! We got to go to the Trump hotel and have breakfast and then lunch there, and it was just great. The inauguration itself was very inspiring.”

Cottle, 64, has been struggling to understand the public outcry about Trump. “It’s like the sky is falling ― but a lot of that is just drama,” she said. “I feel encouraged, I feel hopeful. I can’t wait to wake up and see what the day’s going to bring and what else is going to happen.”

That same daily dose of news ― and the uncertainty of what will happen next ― rattles many Trump opponents.  But, like Pfingsten, they can’t seem to quit their news consumption cold turkey.

“Part of the brain wants to know what’s going on, and you’re drawn to watching CNN or reading the news. And then the other part of you is saying no, no, this isn’t good for me!” says Molitor, the Chicago psychologist. “It’s unfortunately like driving by a car accident ― they know it’s not good for them [to gawk], but it’s hard to stop.”

Molitor recommends patients stay engaged but limit the time they spend on Facebook or watching the news. Focus instead on other things you enjoy, she advises ― calling a friend, taking a walk or reading a book.

“I never read the Harry Potter books, so I’m reading Harry Potter,” says Matthew Leal, a 34-year-old San Francisco resident who found himself sinking into a depression after the election. “Someone could see this and say I’m being totally escapist right now, but I feel like it’s kind of what I need.”

GOP Fix To Insurance Markets Could Spike Premiums For Older Customers

Dale Marsh has not been enamored with his health insurance since the Affordable Care Act took effect. Premiums for Marsh, 53, and his wife, Tammy, rose, their deductibles grew, and they gave up access to their regular doctors to keep costs down. This year, facing monthly premiums of $1,131 — a 47 percent increase from four years before — they decided to go without coverage.

“It’s useless insurance,” said Marsh, who owns a software company with Tammy, 52, in Graford, Texas. “We’re praying for the best, that neither one of us need insurance, that we don’t have to go the hospital.”

Yet, a new premium spike may be in store for those in their 50s and 60s. As Republicans consider how to bring down costs for younger people, lawmakers are considering relaxing or eliminating the restrictions on how much more insurers can charge older consumers.

Middle-aged Americans already face the highest premiums in the health care markets for individuals who don’t get coverage from their workplace or the government. Plans are permitted to charge three times as much for a 64-year-old as for a 21-year-old. Last year 3.3 million consumers ages 55 through 64 bought insurance on the marketplaces. That was a quarter of all those covered, more than any other age group tracked by the federal government, data show.

The GOP has not unified behind a single plan, but one proposal last year by House Speaker Paul Ryan (R-Wis.) would let insurers make older people pay five times more than young adults. Another plan offered by Department of Health and Human Services Secretary Tom Price when he was a Georgia congressman would do away entirely with age restrictions and instead give tax credits that increase by age. House Republican leaders embraced a similar concept of tax credits this month.

The politics for Republicans are precarious as older voters are such an important part of their support. More than half of consumers who bought insurance on the federal exchanges last year in Iowa, Ohio, Pennsylvania and Wisconsin — all important states in the presidential election — were 45 or older, according to a Kaiser Health News analysis. Insurance purchasers in Florida and Michigan also trend older than in most states.

Many older customers think current prices are not fair. “I’m in excellent health, I don’t live at the pharmacy,” said Susan Finney, a 59-year-old commercial real estate broker in Chesterfield, Mo. “I’m a walker, four miles a day.”

Finney said her monthly premiums have risen from $490 to $793 since 2015. “The health insurance companies are out of control,” she said.

Before the health law, insurers selling policies to individuals could base their premiums on several factors, including age, gender and health history. That meant many states allowed ratios of 5 to 1 or even higher.

The insurance industry favors relaxing the age rules, arguing it will allow them to reduce rates for younger consumers, who are coveted because they tend to be healthier and thus use fewer medical services. Last year 2.2 million people ages 26 to 34 obtained coverage on the markets — a third fewer than purchasers ages 55 and over. The imbalance between young and older consumers is one reason premiums jumped in many markets this year.

Two studies predict changing the age rules to 5 to 1 would lead to double-digit spikes in premiums for older people and significant but smaller reductions for the young. A major reason for the dramatic swings is that age is one of the few elements that insurers are allowed to consider when setting rates. The 2010 health law barred insurers from considering most other factors, including the health and medical histories of people when setting rates and their genders.

The actuarial firm Milliman estimated that if insurers were allowed to charge older people five times more than young ones, adults in their 20s would see their annual premiums drop by $696 — 15 percent — to $4,008 next year.

But those savings would pale next to the added burdens on older people, Milliman said. Those in their 60s would see average annual premiums rise by 22 percent, growing by $3,192 to $17,916, according to Milliman’s projections, which were commissioned by AARP. That lobbying group for older Americans opposes loosening the age rules. A study last year by the Rand Corp. for the Commonwealth Fund, a New York foundation, projected up to 29 percent premium increases.

“We do need to make it more affordable for young people,” said Susan Murray, the Marshes’ health insurance broker in Dallas. But, she said, plans are already too expensive for many older people who earn too much to qualify for financial assistance from the government. “There are the lost people like Dale who just can’t afford it,” she said.

James Capretta, a former budget adviser to President George W. Bush now at the American Enterprise Institute, a Washington think tank, said older people can afford to pay higher premiums than young people, especially if Republicans add other provisions to cushion them from the highest costs.

“People 50 to 65 are probably in their higher earning years, they’ve had the capacity to work and save more,” Capretta said. “People at 25 are just starting out, and we’re adding this additional burden on them.”

Others worry the changes might backfire by discouraging healthy older people from signing up. “Those are the very people you want to keep,” said Sabrina Corlette, a researcher at Georgetown University’s Health Policy Institute. “They’re healthy, and because they’re older, they pay a higher premium.”

It’s not clear how many people would be swayed to buy — or drop — insurance if age changes were made. Milliman estimates that if the age ratio was increased to 5 to 1, enrollment for people ages 50 and older would drop by 18,000, while enrollment for those under 50 would increase by 386,000. That would mean a net increase in enrollment of 2 percent. Rand had more seismic estimates, predicting 3 million people under 35 would gain coverage but 700,000 people over 47 would drop coverage.

“Reduced coverage among older adults, who are at greater risk for health problems, under the 5:1 approach could likewise raise costs for hospitals, doctors, and other health care providers, who will see more uncompensated care,” the Rand economists wrote.

As Republicans mull various ideas to lower premiums, health economists say each has drawbacks. Some want to give the most expensive patients separate insurance underwritten by the government, which would add billions to the budget deficit.

Others want to trim all the types of services insurers must cover, but savings would be limited by the fact that the costliest kinds of care, including hospitals, doctors and prescription drugs, are the ones that most people can’t do without. Lawmakers are considering several methods to make sure healthy people buy insurance, including automatically enrolling them and letting insurers charge higher rates to those who let their coverage lapse.

Price suggested replacing income-based tax credits with age-based tax credits up to $3,000, but those wouldn’t even cover the premium increases anticipated by Rand and Milliman. It would be unlikely to be enough for someone like Robert Baker, a 59-year-old hairdresser in St. Louis, who says insurance costs are too high even though he qualifies for an income-related subsidy.

Baker said he did not buy insurance this year. The 2008 financial crisis wiped him out, he said, and he needs to sock away earnings for retirement. “If I spend most of that on insurance, I won’t have any money when I’m old,” he said.

KHN’s coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation.

Some Immigrants, Fearful Of Political Climate, Shy Away From Medi-Cal

Some foreign-born Californians are canceling their Medi-Cal coverage or declining to enroll in the first place, citing fears of a Trump administration crackdown on immigrants.

Among those dropping coverage are people in the country legally but concerned about jeopardizing family members who lack permanent legal status, according to government officials, immigration attorneys and health care advocates.

Others worry they will be penalized in the future for using public benefits such as Medi-Cal, the state’s version of the federal Medicaid program that provides health coverage to low-income residents.

“We’re hearing from a lot of counties that they’re getting calls from immigrant families who are receiving benefits, or whose children are citizens and may be receiving benefits, asking to be disenrolled,” said Cathy Senderling-McDonald, deputy executive director of the County Welfare Directors Association of California in Sacramento, which represents human services directors from the state’s 58 counties.

Senderling-McDonald stressed that the reports are anecdotal but are coming from across the state. “It’s not just one or two counties,” she said.

Many immigrants are dropping out even though they are legally entitled to and eligible for the benefits they’re receiving, she said.

In reality, experts say, terminating benefits might not help since the immigrants’ names are already in the system.

The Community Health Initiative of Orange County, a nonprofit group that helps local residents apply for health coverage, has worked in the past month with two immigrant families that have withdrawn applications for Medi-Cal coverage.

In one case, a Santa Ana mother had applied in January for full Medi-Cal benefits for her daughter, an unauthorized immigrant, said Aaron Reyes, the group’s director of programs and policy.

But the mother called back about a week later and told them to scrap the application, even though California provides full Medi-Cal coverage to all low-income children, regardless of immigration status.

“She said she heard that Trump was going to deport people, and that they’re going to use the names of people who are getting services,” he said. “We told her there was currently nothing like that going on, but she didn’t want to take any chances.”

In the other case, a Buena Park mom submitted an application last month for Medi-Cal and food stamps for her daughter, a green-card holder. A few weeks later, she called back to cancel the application.

“The parent said she was afraid of Donald Trump and didn’t want any problems,” Reyes said.

President Trump has made cracking down on unlawful immigration a focal point of his presidency. In addition to fraying relations with Mexico over his plans to build a wall along the southern border, he has vowed to get tough on unauthorized immigrants already here. Two weeks ago, immigration authorities rounded up hundreds of people in deportation raids across the country, including in California.

Trump’s administration also has drafted an executive order that would, if implemented, exclude potential immigrants likely to need certain types of aid and deport those already in the United States who have used social services, according to a Washington Post analysis of the order. It also would require social service agencies to report immigrants receiving benefits to federal authorities.

“The overall climate has been terrifying for immigrant families,” said Tanya Broder, senior attorney at the Los Angeles-based National Immigration Law Center. “We have literally heard from people who don’t know whether to continue cancer treatment. I encourage them to continue getting the care they need while they can get it.”

Broder wants immigrants to know that “at this point, the rules have not changed. The executive order has not been filed.”

Melissa Rodgers, director of programs for the San Francisco-based Immigrant Legal Resource Center, emphasized that immigrants who are currently receiving health care and nutrition benefits for which they’re eligible “are not breaking the law in any way.”

The most recent statistically credible statewide enrollment data from California’s Department of Health Care Services (DHCS) are about four months old, so they don’t yet show any possible Trump effect on enrollment.

Department spokesman Adam Weintraub said the federal government hasn’t imposed any significant changes on Medi-Cal since Trump’s inauguration.

But, he said, “DHCS cannot speculate as to any potential changes to the Medicaid program that may occur under a new administration.”

Weintraub added that the department “takes its responsibility to safeguard personal health information seriously” and shares only details about an applicant’s immigration status with the federal Centers for Medicare & Medicaid Services, and only “for the purposes of administering the Medicaid program.”

Two weeks ago, Ale Ricardez, program manager for San Diegans for Healthcare Coverage, spoke with a woman who had taken the first steps to rescind her family’s Medi-Cal application.

Everyone in the family is a citizen except the woman’s husband, who has work authorization and is in the process of getting his green card, Ricardez said.

“She was concerned that they would risk the immigration process for her husband if they continued with the application,” she said.

Ricardez told the woman that her family is legally entitled to the benefits as long as they qualify, but that didn’t change her mind, Ricardez said.

While some immigrants are canceling their coverage, others aren’t even signing up.

Alice Ting, an enrollment worker at Asian Pacific Health Care Venture, a group of clinics in Los Angeles and El Monte, received two calls in the past two weeks from nervous immigrants asking if they should cancel their Medi-Cal. Ultimately, they decided to remain enrolled after she explained they qualified, she said.

Another trend has grabbed her attention even more: She used to get daily phone calls from Chinese immigrants inquiring about how to apply for Medi-Cal. “I’ve noticed recently it’s decreased,” she said.

Jan Spencley, executive director of San Diegans for Healthcare Coverage, has witnessed a similar trend.

“We are seeing people who are not enrolling who are eligible, and people ending coverage who have it,” Spencley said. “People are not enrolling unless they have to.”

Advocates and immigration experts warn that dropping health coverage — or not signing up — might compromise public health, let alone an individual or family’s health.

“Letting fear lead to actual serious bodily harm, that’s really not the way to go,” Rodgers said. “If people need health care, they should get it.”

At the same time, Rodgers and others aren’t making promises about the future, because they don’t know what it holds.

“We don’t want to say, ‘This isn’t going to happen, don’t worry,’ and then have something bad happen,” Reyes said. “For us, it’s important to be as accurate as possible, which is really challenging right now.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Single-Payer Health Care Bill Introduced In California Senate

Legislation introduced in the California Senate last week would set the state on a path toward the possible creation of a single-payer health care system ― a proposal that has failed to gain traction here in the past.

The bill, which is a preliminary step, says that it is the “intent of the Legislature” to enact a law that would establish a comprehensive, single-payer health care program for the benefit of everyone in the state. The legislation, introduced by state Sen. Ricardo Lara (D-Bell Gardens), does not offer specifics of what the plan would look like, nor does it mention a timetable.

A single-payer system would replace private insurance with a government plan that pays for coverage for everyone. Proponents argue that single-payer systems make health care more affordable and efficient, but opponents say they raise taxpayer costs and give government too much power.

Medicare, the federally-funded health coverage for the elderly, is often held up as a model of what a single-payer system might look like.

Lara said in an interview late last week that the state needs to be prepared in case the Affordable Care Act is repealed, as President Donald Trump and Congressional Republicans have promised.

“The health of Californians is really at stake here and is at risk with what is being threatened in Congress,” Lara said, as the debate continued in Washington about the future of President Barack Obama’s signature health law. “We don’t have the luxury to wait and see what they are going to do and what the plan is,”

Lara noted that while the Affordable Care Act expanded health coverage for many Californians, it left others uninsured or underinsured. He said the single-payer bill builds upon his “health for all kids” legislation, which resulted in coverage beginning last May for 170,000 immigrant children here illegally.

“I’ve met many children who have asked me point blank, ‘What about my mom? What about my dad?’” Lara said.

He recently withdrew a request to the federal government, based on a bill he had introduced, that would have allowed adult immigrants here illegally to purchase unsubsidized health plans through Covered California, the state’s insurance exchange.

[caption id="attachment_188745" align="alignright" width="270"] Sen. Ricardo Lara, D-Bell Gardens (Courtesy Sen. Lara’s office)[/caption]

According to the text of the Lara’s bill, a single-payer system would help address rising out-of-pocket costs and shrinking networks of doctors.

No state has a single-payer health system. Perhaps the best-known effort to create one was in Vermont, but it failed in 2014 after the state couldn’t figure out how to finance it. Last year, Colorado residents rejected a ballot measure that would have used payroll taxes to fund a near universal coverage system.

In California, voters rejected a ballot initiative in 1994 that would have established a government-run universal health program. Gov. Arnold Schwarzenegger later vetoed two bills that would have accomplished the same goal.

It’s difficult to create consensus on single-payer plans because they dramatically shift how health care is delivered and paid for, said Larry Levitt, a senior vice president at the Kaiser Family Foundation (California Healthline is produced by Kaiser Health News, an editorially-independent program of the foundation.)

“Single-payer plans have lots of appeal in their simplicity and ability to control costs,” Levitt said. “But what I think has always held back a move to single-payer is the disruption they create in financing and delivery of care.”

The problem, Levitt said, is that even if they end up costing less overall, single-payer plans look to the public like a “very big tax increase.”

The California Nurses Association, the primary sponsor of the new bill, is planning a rally in Sacramento this week in support of a single-payer system. Bonnie Castillo, the group’s associate executive director, said the goal is to create a system that doesn’t exclude anyone and helps relieve patients’ financial burdens.

“Patients and their families are suffering as a result of having very high co-pay and premium costs,” she said. “They are having to make gut-wrenching decisions whether they go to the doctor or they stick it out and see if they get better on their own.”

Castillo said that with so much uncertainty at the national level, California has the ability to create a better system. “We think we can get this right,” she said.

Charles Bacchi, president and CEO of the California Association of Health Plans, said he hadn’t yet seen the bill, but the trade group has opposed single-payer proposals in the past.

“It’s hard to tell until you know the details,” Bacchi said. “But past studies have shown [single-payer systems] are incredibly expensive and would be disruptive.”

He said health plans, doctors, hospitals and others are “laser-focused on protecting and enhancing the gains we have made in coverage” under the Affordable Care Act and ensuring that California continues to receive critical funding. “We think that’s where the focus should be,” he said.

One possible concept of a single-payer system in California would be to bring together funding from several sources under one state umbrella: Medi-Cal, which covers the poor; Medicare, the federal program that covers older adults, and private insurance.

Lara said he has not yet figured out the financing, saying that it is still early in the legislative process. But he said that even as California continues to defend the Affordable Care Act, it is time to put forward an alternative.

“I think we’ve reached a tipping point now that we haven’t had before,” he said.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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