Billie S. Dickenson, Author at Spencer Fitness Central

What Motivates People to Seek Help From a Snoring Specialist?

Billie S. Dickenson December 28, 2022

There are people who snore and have no apparent issues as a result. Others feel that snoring is interfering with their quality of life in some way, and may be affecting their health. The truth is that snoring is not something to be taken lightly. Here are some of the more common reasons why people decide to seek out a snoring specialist and find out what's causing the snoring in the first place.

Concerns By Family Members

It's not unusual for people to seek medical care after family members raise concerns about their snoring. This is especially true when the snoring has a spouse or partner thinking about sleeping in another room. When other family members can be in other parts of the house and clearly hear the snoring, that's a sure sign something is up.

In this instance, the patient may seem to be fine, but has some concern for the welfare of others. If some treatment will end the snoring, everyone will be a little happier.

Waking Up in the Middle of the Night

Others may not feel the need to see a specialist until the snoring begins to cause issues with the ability to sleep. For example, the patient notices that he or she wakes up multiple times at night. There seems to be no apparent reason for waking up. Once awake, getting back to sleep is not always easy.

Concerns about this are reason enough to seek help from a medical professional. It's quite possible that whatever causes the snoring is also the reason behind waking up during the night. Even the snoring itself may be the cause. Once the origin is identified, it will be easier to administer a treatment and once again enjoy a good night's sleep.

Feeling Tired First Thing in the Morning

There's no doubt that snoring may lead to enjoying less restful sleep. Even if the patient does not remember waking up frequently, the quality of sleep may be less than what the patient needs. The outcome is feeling tired in the morning, almost as if there was no sleeping at all.

With the aid of a snoring specialist, it's possible to determine if snoring is involved. That will make it easier to determine what's causing the snoring, settle on a course of treatment, and hopefully be able to sleep soundly again.

Feeling Self-Conscious About Camping and Other Pursuits

Knowing that you snore may cause you to avoid certain activities that would otherwise be enjoyable. For example, you would love to go fishing and camping with friends for a weekend, but worries about snoring and keeping others awake may cause you to decline invitations. In like manner, you may be concerned about taking business trips that would require sharing a hotel room with a coworker.

Rather than continue to skip things that you would like to do, seeing a specialist is the best solution. Once the snoring is no longer a problem, it will be easier to relax and enjoy any activity that you like.

If you've noticed that snoring is happening, now is the time to find out why. Once the reason is uncovered, it will be a lot easier to decide what needs to happen next.

Health Insurance

US health insurers raise rates to match increase in usage

Billie S. Dickenson July 31, 2022

SACRAMENTO, California (AP) — After putting off routine health care for much of the pandemic, Americans are now returning to doctors’ offices in big numbers — a trend that’s starting to show up in higher insurance rates across the country.

Health insurers in individual marketplaces across 13 states and Washington D.C. will raise rates an average of 10% next year, according to a review of rate filings by the Kaiser Family Foundation.

That’s a big increase after premiums remained virtually flat for several years during the pandemic as insurers seek to recoup costs for more people using their policies, combined with record-high inflation that is driving up prices for virtually everything, including health care.

The rates review included Georgia, Indiana, Iowa, Kentucky, Maryland, Michigan, Minnesota, New York, Oregon, Rhode Island, Texas, Vermont and Washington.

“We’re at a point in the pandemic where people are using health care that they may have put off before,” said Larry Levitt, executive vice president for health policy with the Kaiser Family Foundation. “We have a double whammy right now of people using more care and inflation throughout the economy.”

In California, state officials announced Tuesday that rates would increase an average of 6% next year for the 1.7 million people who purchase coverage through Covered California, the state-operated health insurance marketplace. That’s a big jump after years of record low increases, when rate increases averaged about 1% in the past three years.

Increased use of health plans was the biggest reason for the increase, accounting for four percentage points, according to Jessica Altman, executive director of Covered California.

“That is really the consistent message that other states are seeing as well, and even more so than California,” she said.

About 14.5 million people purchased individual health coverage through state marketplaces this year, according to the Kaiser Family Foundation.

That’s a small portion of the total number of insured Americans, as about 155 million people get their insurance through their employer-sponsored coverage. But Kaiser said the filings for the individual plans are more detailed and publicly available.

The annual open enrollment period for when customers can shop for and buy 2023 coverage starts this fall. That’s the main window each year when people on the individual market can buy coverage or change plans.

How much people will pay for coverage depends on a variety of factors, including where they live and what type of plans they choose.

The rate increases come as Congress debates whether to extend financial help for consumers through the American Rescue Plan — the $1.9 trillion economic aid package Congress passed last year to combat the economic impacts of the pandemic.

The American Rescue Plan included significant funding to keep health insurance premiums low for people who purchase coverage through state marketplaces.

California receives about $1.7 billion annually from that funding to make sure no one paid more than 8.5% of their household income on monthly premiums.

If that assistance expires at the end of this year, about 3 million Americans — including 220,000 Californians — would likely drop coverage because they will no longer be able to afford it, according to an analysis by Covered California.

Without guidance on whether Congress will extend the assistance next year, some insurers have reacted by proactively raising rates in anticipation of people dropping coverage. The uncertainty accounted for half a percentage point of California’s 6% increase, Altman said.

California officials have lobbied hard for Congress to extend the financial assistance through the American Rescue Plan. In general, the price of health insurance premiums depends on who is buying coverage. If its mostly sick people, the premiums are more expensive. If more healthy people buy them, the premiums cost less.

Altman said California has managed to keep its rate increases below the national average in part because more healthy people are buying coverage through Covered California than most other states.

She said that’s in part because of a California law that taxes people who refuse to purchase health coverage. But she said it’s also because of subsidies that keep premiums low so more people can afford them.

Altman said not extending the federal financial assistance would price some people out of coverage and “is the core outcome to be concerned about here.”

“That would be a big step backwards,” she said.

___

Associated Press health writer Tom Murphy in Indianapolis contributed to this report.

Health Insurance

A Retirement Journey: Health Insurance Issues

Billie S. Dickenson July 30, 2022

Over the past two weeks, we’ve focused on the story of Bob, a recent retiree. We’ve gone over his pre-retirement experience and his journey through the processing of his retirement application. This week, we’ll look at his health insurance choices.

Bob has an ongoing dilemma when it comes to health insurance. He arguably doesn’t really need Federal Employees Health Benefits coverage or Medicare, because he is a veteran with a service-connected disability. That means all of his medical needs (service-connected and otherwise) are provided by the Veterans Health Administration, at no charge. VHA does bill private insurers (including those in FEHB) for the non-service connected care it provides.

Nevertheless, Bob enrolled in FEHB during his civilian service at the Federal Aviation Administration for a couple of reasons: in case he should need it for a future spouse, should he remarry, and in order to meet the requirement of being enrolled for the five years prior to retiring. Now that he’s retired, if he cancels his FEHB coverage, it’s a one-way ticket out. Bob isn’t eligible to suspend his FEHB, since having VA health benefits is not one of the reasons an enrollee can take this action. And he isn’t eligible for TRICARE because he isn’t retired from military service.

Since Bob is over 65, he is enrolled in Medicare Part A. But he chose not to enroll in Part B (coverage for doctors and outpatient services). This won’t put him at great risk, because FEHB doesn’t require Medicare enrollment to maintain coverage. Bob has considered dropping FEHB, but he believes it’s possible Congress may not provide enough funding in future years for the VA to care for all veterans. Veterans who are in one of the lower priority groups could conceivably lose health care benefits in the future.

Bob could enroll in Part B later in a future general enrollment period. These are held each year from Jan. 1 to March 31, with coverage effective July 1. But he might be subject to a late enrollment penalty for every 12-month period in which he could have been enrolled but chose not to. Currently, Bob has the opportunity to participate in a Part B special enrollment period,during which he can enroll without penalty. It will end eight months after his retirement last December.

Here’s Bob on his insurance decisions:

I enrolled in FEHB with the GEHA Standard Option FEHB plan when I onboarded in 2012, but switched to the GEHA High Deductible Health Plan about four years ago. My current premium is $136.95 per month. The HDHP includes a Health Reimbursement Arrangement, since I am not eligible to have a Health Savings Account. Having other health insurance, such as Medicare, disqualifies members from using the HSA, so GEHA establishes an HRA that does not earn interest and is not portable if I switch to another plan. But it does provide $900 annually to spend on co-pays for qualified medical expenses, as defined by the IRS.

The way I see it, having this extra $900 a year benefit effectively reduces my monthly premium. The way it works is when the VA sends the bill for my care to GEHA, GEHA pays the amount that would be covered by the plan. The remainder is covered by the VA, leaving me with $0 out of pocket expense for my care. I don’t have to worry about meeting the deductible or paying copayments since the VA covers my medical expenses.

Upon reaching my 65th birthday, I enrolled in Medicare Part A, since there is no premium for this coverage that helps cover the cost of in-patient hospitalization. Post-retirement, I am continuing my FEHB plan with GEHA but not Medicare Part B. Still, I question whether I really need it, when all of my medical care is free at the VHA. Veterans make up 30 percent of the federal workforce. And some of those veterans, like me, have service-connected disabilities and access to free medical care through the VHA. I also know retired veterans who thought that TRICARE for Life was free, until I told them that they had to enroll in Medicare Part B as well. With very few exceptions, all of my VHA visits are non-service-connected.

Bob’s Bottom Line

Bob’s top piece of retirement planning advice is not to be afraid to ask questions. He told me the people he spoke with at various federal agencies actually seemed to enjoy helping with whatever questions he had. Keep in mind that Bob communicates very clearly and takes his time. Customer service is a two-way street.

Of course, when it comes to retirement preparation, everyone needs to run the numbers. Make some rough financial projections, so you have a general idea of your income and expenses in retirement.

Bob has about half of his retirement income coming from his Social Security benefit, a little less than 20% from his federal retirement benefit, about 30% from a private sector pension that does not receive a cost of living adjustment, and roughly 3% coming from the VA. He doesn’t need to withdraw from his investments yet.

Overall, Bob is in very solid financial shape, due to his foresight, patience and planning.

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Health Insurance

Health insurance giant Empire pulls out of NYC’s controversial Medicare plan for retired city workers

Billie S. Dickenson July 29, 2022

A major insurance company has pulled out of a deal to administer New York City’s new Medicare Advantage Plan — the latest setback in the city’s effort to shift roughly 250,000 retired municipal workers onto the controversial health coverage.

Empire BlueCross BlueShield, one of the country’s largest health insurance providers, notified Mayor Adams’ office that it’s not going to help roll out the Advantage plan after the city failed to provide a start date and benefit specifics as requested by July 15, the company said in a statement Tuesday.

“This timeline was important because delaying any further would not give retirees enough time to fully understand their options, benefits, and coverage in advance of open enrollment,” the statement read. “Given the level of uncertainty at this time, we informed the city that (Empire) is not able to participate.”

In light of Empire’s withdrawal, City Hall spokesman Jonah Allon said Adams’ administration is on the hunt for a new provider.

“We remain committed to moving forward with the program and are exploring alternative options,” Allon said.

New York City Mayor Eric Adams (Shawn Inglima/for New York Daily News)

Empire’s exit is the latest hiccup in the Adams administration’s push to implement the Advantage plan, which is supposed to save the city hundreds of millions of taxpayer dollars annually thanks to the partnership with a private insurance provider.

First proposed by former Mayor Bill de Blasio, the plan was supposed to go into effect earlier this year with Adams’ blessing.

But Manhattan Supreme Court Justice Lyle Frank blocked the plan, ruling in March that it was illegal because it contained a provision that would slap a $191 monthly penalty on retirees who opted to keep their current traditional Medicare instead of getting automatically enrolled in the Advantage plan for free.

The Adams administration is appealing Frank’s ruling. City Hall confirmed Tuesday that the appeal is ongoing.

Frank’s decision was the result of a lawsuit filed by the NYC Organization of Public Service Retirees, which has argued the Advantage plan would water down health coverage for the city’s tens of thousands of retirees, including by instituting complicated pre-authorization requirements for certain medical procedures and treatments.

FILE - In this May 14, 2019, file photo signage on the outside of the corporate headquarters building of health insurance company Anthem is shown in Indianapolis. (Michael Conroy/AP)

Marianne Pizzitola, the organization’s president, said she has for months asked City Hall for an opportunity to discuss the matter with Adams — and that she finally got a meeting scheduled with the mayor for this past Monday.

However, late Sunday, Pizzitola said she got word from City Hall that Adams could no longer meet after finding out the city remains in litigation with her group.

Pizzitola, a retired FDNY EMT, said she wishes Adams would take time to hear from her and the thousands of other former city workers who have pleaded with him to scrap the Advantage plan and let them stay on traditional Medicare.

“I really wish that he would just listen,” she said.

Health Insurance

How to avoid a tax surprise from marketplace health coverage

Billie S. Dickenson July 27, 2022

Kateryna Onyshchuk | iStock | Getty Images

If your income is trending much higher this year than you anticipated, it's likely a welcome shift.

However, for anyone who gets their private health insurance through the public marketplace, that extra cash could mean an unexpected tax bill when they prepare their 2022 return next spring. A midyear income check could help avoid that.

Basically, if you receive premium subsidies (technically, advance tax credits) through the marketplace, having annual income that's higher than what you estimated when you enrolled could mean you're not entitled to as much aid as you're receiving. And any overage would need to be paid back at tax time.

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Report changes that may affect insurance subsidies

"You really should go into [your account] and take the steps to change your estimate so they can revise the subsidies as soon as possible," said Kristin Esposito, director for tax policy and advocacy with the American Institute of CPAs.

Esposito said a drop in income should also be reported — which could result in you getting bigger monthly subsidies. Make sure your account reflects other life changes, too, including marriage or a new member of your household, which also can impact the size of the aid.

"There are a lot of circumstances that can change and affect your insurance coverage," said Cynthia Cox, a vice president at the Kaiser Family Foundation and director of its Affordable Care Act program.

Changing your information generally involves calling the exchange or going to your online account and updating your application (or calling the exchange). If you used an insurance agent or broker to sign up, or were assisted by a community organization, you should be able to get help from them, as well.

Income cap changes may reduce tax surprises

Roughly 89% (12.9 million) of the 14.5 million people enrolled in private health insurance through the public marketplace — which was authorized by the Affordable Care Act of 2010 — are receiving subsidies. Generally speaking, people who get coverage this way — either through healthcare.gov or their state's exchange — are those who can't get workplace insurance or who don't qualify for Medicaid or Medicare.

Subsidies through the exchange were expanded for 2021 and 2022 due to the American Rescue Plan Act of 2021. (Senate Democrats are trying to get the current expansion extended for two more years, although it's still uncertain whether it will happen.)

It's still important to report an income change to avoid any kind of surprise, but hopefully the worst kinds of surprises won't happen as much this year.

Cynthia Cox

Kaiser Family Foundation and director of its Affordable Care Act program

Prior to the temporary expansion, the aid was generally available to households with income from 100% to 400% of the federal poverty level.

The cap on income was eliminated for 2021 and 2022, and the amount that anyone pays in premiums is currently limited to 8.5% of their income as calculated by the exchange.

The temporary removal of the income cap means there may not be as many cases of people having to repay all of their subsidies: Before, if someone estimated their income was at 399% of poverty but it ended up at 401%, they'd have to account for those subsidies on their tax return.

"It's still important to report an income change to avoid any kind of surprise, but hopefully the worst kinds of surprises won't happen as much this year," Cox said.

Review key tax forms next spring

When you start getting tax forms early in 2023 (for example, your W-2, or 1099 forms due to interest or dividend income), one of them generally will be a Form 1095-A from the insurance marketplace, which details how much you received each month in tax credits.

That document is then used to complete Form 8962, which shows whether you received the correct amount in subsidies — and if not, what the excess or shortfall is, Esposito said.

Any amount you weren't eligible for would reduce your refund or increase the amount of tax you owe. Likewise, if you are entitled to more than you received, the difference will either increase your refund or lower the amount of tax you owe.

Health Insurance

Retiree health insurance to end for new administrators in Buffalo schools | Education

Billie S. Dickenson July 26, 2022

Lifetime health insurance is about to become a thing of the past for administrators in the Buffalo Public Schools.

Administrators hired after July 2023 will not be eligible for health insurance paid for by the district after they retire, under the terms of a new contract approved this week by the School Board.

“It is significant. It’s something the district had pursued for at least the last two collective bargaining agreements,” said Robert Boreanaz, the attorney for the Buffalo Council of Supervisors and Administrators.

Over the years, Boreanaz said, Buffalo had become one of the few districts in New York State still providing retirees with health insurance.

Administrators hired prior to July 2023 will remain eligible for retiree health insurance.

Those hired after July 2023 will have the option of selling back to the district up to 120 unused sick days to be used toward the cost of their health insurance premiums after they retire.

Teachers in Buffalo still receive retiree health insurance. The Buffalo Teachers Federation is currently in negotiations with the district for a new contract. Union President Phil Rumore said the district is hoping to negotiate an end to retiree health insurance for teachers.

“Every union has the right to do what they think is best for their members,” Rumore said. “But I believe it’s against everything that unions stand for, to sacrifice newer members for existing members.”

The administrators union represents about 200 principals, assistant principals and Central Office administrators.

"This contract benefits both parties by eliminating the discrepancy in pay between elementary and high school principals, makes changes to health care benefits, in addition to raises and a signing bonus," said School Board President Lou Petrucci.

Until now, elementary principals had been paid less than high school principals.

“Many years ago, the elementary schools were much smaller than the high schools, and had less students. That’s not the case anymore,” Boreanaz said.

The contract brings nominal increases in the amount that administrators have to contribute toward their health insurance premiums. Veteran administrators will now pay 10% of their premium, and new administrators will pay 16%.

The contract also brings pay increases.

This summer, administrators will receive a 10% raise, plus step increases. Then, for each of the following three years, they will receive a 3% raise, plus step increases.

Boreanaz pointed out that the administrators union’s previous contract, which was reached in 2017, expired nearly two years ago.

Administrators also will each receive a one-time bonus equal to 7% of their annual salary as a result of ratifying the new contract.

The administrators union met with district officials 13 times over 16 months to hash out the terms of the new contract, he said. The majority of the progress toward reaching the contract was achieved under the past few months under Superintendent Tonja Williams, Boreanaz said.

“Unequivocally, the principals and administrators of the Buffalo School District are really looking forward to a new chapter and working with and supporting the new superintendent,” he said.

Now that the administrators contract has been settled, Petrucci said, the board can focus on settling the teachers contract.

"Contracts are about more than just dollars; new contracts help the district to address changes in working conditions and benefits," he said.

Nutrition

In Order to Live Longer, Weigh Exercise and Nutrition Equally

Billie S. Dickenson July 26, 2022

According to a new study published in the British Journal of Sports Medicine, putting all of one’s eggs in either the exercise basket or the nutrition basket cannot protect you from chronic diseases. An effective longevity routine needs to include a balance of both.

An international team of researchers sourced data from 350,000 individuals from the U.K. Biobank, a massive database of health information on British citizens, which medical professionals rely on for these sorts of sweeping analyses. They began the study a decade ago, when the median age was 57, and the participants were all free from “cardiovascular disease, cancer or chronic pain.”

The researchers set rubrics for diet quality and level of activity. For instance, as The New York Times pointed out, the best diets included “over four cups of fruit and vegetables per day, two or more servings of fish per week, less than two servings of processed meats per week and no more than five servings of red meat per week.” Meanwhile, the best exercisers regularly walked, biked and engaged in “vigorous exercise” for more than 10 minutes at a time. Breaking a sweat for just 10 to 75 minutes a week was associated with “lower risk of cardiovascular disease mortality.” That’s one short session a day.

Far and away, the lowest mortality risk came at the center of the Venn diagram: those who sourced high-quality diets alongside consistent movement were likelier to live longer, healthier lives. Their data was especially robust in the realm of cardiovascular health, which is no small achievement. Across the globe, cardiovascular disease (CVD) is easily the leading cause of death.

This might all sound really obvious. We all know that working out and eating right is a great idea. Why do we need expensive, international studies to remind us of something we learned in elementary school health class?

In practice, though, it’s difficult to observe both equally. There are a fair share of people who eat nutritiously, yet don’t observe a consistent fitness regimen (which hamstrings one’s heart health, limits endurance and has an array of unwanted side effects, like poor bone density). On the flip side, there are many amateur and professional athletes who view their concentration as license to eat whatever they want.

Marathon trainees go crazy on Seamless after a long run, weightlifters commit to “dirty bulking” as they try to up their bench press. This reductionist thinking assumes that health is simply a game of calories in and calories out — and goes further to imagine that if you’ve worked really hard on the roads or in the gym, you’ve “earned” a piece of cake.

From a mental health standpoint, yes, it’s important to treat yourself. But from a longevity perspective, it’s important to remember that the body treats unhealthy food choices all the same. Unfortunately, it isn’t possible to outrun or out-lift a steady slate of meals high in sugar, salt and fat. It can come as a shock — to the patient and all their friends — when a high-performing athlete develops a chronic disease. But if that athlete wasn’t favoring a non-processed, whole-food, largely plant-based diet, CVDs are very much in play.

The good news? You don’t have to listen to fitness influencers on Instagram. Your workouts don’t have to be so difficult, and your body doesn’t have to look a certain way. Instead of training like a triathlete, favor simple adjustments to your daily routine that the body absolutely counts as exercise. Walk everywhere; take the stairs where possible; make sure you really sweat a few days a week. If you pair a lifetime of movement with a clean diet, your lifetime’s going to stick around a while.

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Health Insurance

N.J. public workers face big increase in health insurance rates in coming year

Billie S. Dickenson July 25, 2022

Hundreds of thousands of public workers, early retireesm and school employees in New Jersey are facing potential rate increases of as much as 24% for health benefits under proposals being considered by the State Health Benefits Commission.

Rate increases being considered include a 24% increase for medical and a 3.7% increase for pharmacy benefits for active public workers, as well as a 15.6% increase in medical and a 26.1% increase in pharmacy benefits for public workers who retired before the age of 65, according to an email sent to county administrators from New Jersey Association of Counties Executive Director John Donnadio.

Donnadio said in the email that the figures, which haven’t been made public, were shared by an insurance and benefits broker.

StateTreasury spokeswoman Jennifer Sciortino acknowledged rate increases were being considered and added that rates for active members and early retirees would likely increase between 12-20% across the various plans for the upcoming year.

A vote to approve the rate increases was scheduled for Monday, but the state health benefits board and the Division of Pension and Benefits postponed the vote after acknowledging during a public meeting on July 13 that more time would be needed to address questions and concerns, Sciortino said.

“As has been the official process for many years now, the presentation materials provided to the State Health Benefits Program and School Employees Health Benefits Program Commissions last week are confidential until the rates are finalized,” Sciortino said.

The New Jersey League of Municipalities on Wednesday sent an email urging members to contact their representatives and the governor’s office, prompting a public outcry from state and local governments, as well as Democratic and Republican state lawmakers.

“This is a staggering increase that will saddle taxpayers, public sector workers and educators with higher costs at a time when we are all contending with inflationary pressures and a possible recession,” state Senate President Nicholas Scutari, D-Union; Senate Majority Leader Teresa Ruiz, D-Essex and Senate Budget Chairman Paul Sarlo, D-Bergen, said in a joint statement.

The Democratic state senators urged the board to reject the proposal and called on New Jersey Treasurer Elizabeth Muoio to use her authority to block the planned approval “and make sure a full accounting of the finances of the two health benefits’ plans is made public and fully discussed.”

Republican leadership in the state Legislature on Thursday called for the creation of a special legislative committee to investigate Democratic Gov. Phil Murphy’s administration for a “failure to control health care costs for public employees, retirees and taxpayers.”

“The 24% premium increase proposed for most active employees will take thousands more out of their paychecks annually and lead to huge costs for local governments that will translate into higher property tax bills for struggling families,” state Senate Republican Leader Steven Oroho, R-Sussex, said in a statement. “We must investigate the failures that led to these catastrophic premium increases to develop an effective plan going forward.”

The proposed rate increases shine a new spotlight on allegations that the Murphy administration squashed an attempt to recover $34 million the state paid to Horizon for a cost savings program that outside consultants found “yielded no apparent savings,” according to a report from Bloomberg.

Horizon administers health care plans for state and local government employees and retirees in New Jersey.

“It’s absolutely scandalous that high-level administration officials would intercede to prevent Horizon from being held accountable as premiums are set to skyrocket,” Senate Republican Budget Officer Declan O’Scanlon, R-Monmouth, said in a statement. “Employees, retirees, and taxpayers deserve to know why.”

Sciortino said several “extraordinary factors” are affecting rates for the coming year, including higher utilization of medical services during the COVID-19 pandemic and a return to normal services and procedures that had been previously postponed.

Those factors are being compounded by rising prices amid historic inflationary pressures that have increased health care costs nationwide.

“While there is significant volatility in health care trends, the rate increases for the State plans are in line with rate increases that our consultants’ other clients are experiencing and are also being reported nationwide,” Sciortino said. “We believe that these circumstances are an anomaly, rather than the norm, and we believe that it is more likely than not that utilization and costs will normalize.”

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Derek Hall may be reached at [email protected]. Follow him on Twitter @dereknhall.

Nutrition

US$ 500 Million Project Will Help to Strengthen Egypt’s Food and Nutrition Security

Billie S. Dickenson July 25, 2022

Washington, June 29, 2022 – The World Bank’s Board of Executive Directors yesterday approved a US$500 million loan to bolster Egypt’s efforts to ensure that poor and vulnerable households have uninterrupted access to bread, to strengthen Egypt’s resilience to food crises and to support reforms in food security policies, including to improve nutritional outcomes.

The Emergency Food Security and Resilience Support Project will help cushion the impact of the war in Ukraine on food and nutrition security in Egypt. The Russian Federation and Ukraine are the world’s largest wheat exporters, and the war has driven up prices and created nutritional shortfalls, particularly for people who rely on bread for their daily nutritional needs. Bread is a staple in Egypt and this new project links wheat imports to direct assistance to the poor and vulnerable population through Egypt’s Bread Subsidy Program.

“This project supports the government’s strong commitment to ensuring that the needs of citizens continue to be met even amid a very challenging global context caused by concomitant crises such as COVID-19 and the war in Ukraine,” said Dr. Rania Al-Mashat, Egypt’s Minister of International Cooperation. “In addition to ensuring sustained food security, this project supports national climate efforts by increasing agricultural resilience.”

The project will finance the public procurement of imported wheat, equivalent to one month of supply for the Bread Subsidy Program which supports around 70 million low-income Egyptians, including approximately 31 million people under the national poverty line. The project will also support national efforts to reduce waste and loss in the wheat supply chain through the upgrade and expansion of climate-resilient wheat silos, sustainably improve domestic cereal production, and strengthen Egypt’s preparedness and resilience to future shocks.

The new financing supports Egypt by mobilizing immediate short-term relief to address supply and price shocks while simultaneously bolstering Egypt’s longer term food security strategy and improved nutrition for the poor and vulnerable. A significant number of households in Egypt reduced their food consumption during the COVID-19 pandemic, which could have a lasting impact on nutrition and the cognitive development of young children. An improved nutrition strategy, including through balanced diets, is a key element of this project.

“This emergency operation comes at a very critical juncture when the food security of many countries is threatened by the war in Ukraine,” said Marina Wes, World Bank Country Director for Egypt Yemen and Djibouti. “It is part of broader World Bank efforts to support Egypt’s green, inclusive and resilient recovery. As always we are keen to continuously support Egypt in overcoming obstacles to its ambitious sustainable development plans and to further enable the country to pave the way for a prosperous and productive future for all its citizens.”

The project incorporates climate change efforts through a variety of interventions, including via investments to modernize wheat silos to significantly reduce wheat waste and loss, as well as introducing farmer extension and training programs that promote climate-smart agricultural practices.

On May 18, the World Bank announced actions it plans to take as part of a comprehensive, global response to the ongoing food security crisis, with up to $30 billion in existing and new projects in areas such as agriculture, nutrition, social protection, water and irrigation. This financing will include efforts to encourage food and fertilizer production, enhance food systems, facilitate more trade, and support vulnerable households and producers.

Nutrition

Health & Nutrition 101: Weight Loss or Health Gain?

Billie S. Dickenson July 24, 2022

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By Gina Cousineau

As a nutrition expert and trained chef, you might think I am outside of my scope of practice when I tell you my goal is to save my clients’ lives, not only one plate at a time, but also through teaching them how to advocate for their health.

Unfortunately, as I have written about previously, our health care system doesn’t have the checks and balances necessary to prevent your needs from falling through the cracks. This, paired with an individual’s desire to wish away their ailments, really sets us up for increased disability and shortened lifespans.

Trained in integrative and functional nutrition, I consider myself an interventional health care practitioner, who works in conjunction with your medical providers to help you champion for your own well-being.

All prospective clients tell me they know what to do; they just don’t do it. And while I understand change is painfully difficult, if you were offered baby steps to move toward improving your health and longevity, would you consider it?

I believe your answer would be a resounding “yes.”

I always start with the question to prospective clients of “what is your goal?” If weight loss is your end-all, then feed the multibillion-dollar diet industry and choose one. Fact is, and you already know this from personal experience, you will lose the weight (or at least some of it), but you will not be able to keep it off.

So, instead, let’s consider changing that goal to “health gain” and allow the scale to move in your desired direction as a perk, not a priority. This small shift in your mindset can really help you focus on making more healthful and wholesome changes in the kitchen, as well as with your activities of daily living.

No restrictive and punitive diets, and no killing yourself in the gym; just imagine.

Daily, I shake my head as individuals tell me they believe they can “out-train that bad diet.” They can’t. Your fancy coffee drink takes 10 minutes to consume, and few of you can train hard enough in an hour to balance just those calories.

While the nutrition space of late is pushing mindful and intuitive eating, I personally believe that there is nothing instinctual about your eating as an adult.

Starting next month, I will launch a series of live webinars, recorded for your convenience, focusing on advocating for your health and reducing your risk of lifestyle diseases such as heart disease, stroke, diabetes, hypertension, colorectal cancers, and more.

While nutrition and fitness will be part of the conversation, preventative care will lead the way.

Because I only have one opportunity a month to influence your well-being, I have decided to offer my loyal readers, along with these webinars, the opportunity to participate in a complimentary 50-minute private session, in-person in my home office in San Clemente or via Zoom.

While I hope to get in as many of you as possible over the next few months, your fully completed application will dictate which of you will be chosen.

Within this application, you are able to share your family health history, as well as your own story, and these details provided prior to our meeting, will allow for a fruitful and comprehensive opportunity for you to help yourself advocate for a long, healthy, independent, joyful life.

Simply go to mamagslifestyle.com and register in the pop-up in the center of the page. Indicate which paper you found us in, as only readers will have this opportunity to meet with Mama G.

Gina Cousineau is a local nutrition expert who specializes in weight loss and helping her clients improve their health. As a trained chef with her BS in Dietetics and MS in Integrative and Functional Nutrition, her goal is to help her clients enjoy every morsel they consume, learning how to move with ease in the kitchen while using their “food as medicine.” Subscribe to her weekly newsletter for complimentary cooking classes, recipes, webinars and more at mamagslifestyle.com, or reach her at [email protected] and 949.842.9975.

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