Growing Milkweed in Bethesda

When you plant a butterfly garden, you feel good.  You know you are helping pollinators of all kinds even as you focus on butterflies for their beauty and incredible natural history.  If you are careful in selecting nectar and host plants, a butterfly garden can be easy to maintain.  But, to have a Monarch Rescue Garden, you need to plant milkweeds. 

Once you figure out what milkweed to plant and where and how to plant them, you think the hard part is done, and watering may be your only concern.  It never occurred to me that a plant with the word "weed" in its name would need any special care.

THEN, the pests arrive.  Nobody told me about the milkweed's pests before I planted.  These pests are disgusting!  It's as if the milkweed has said to the world.  "Yes, I will feed the babies of the beautiful monarch, but I won't stop there.  I will feed some of the world's ugliest critters, too..  And some of those ugly critters will threaten the monarch's eggs.  I won't decide between them.  I'll let them figure it out for themselves."

So, last year I discovered the Milkweed Bug.  This is a bug that needs the milkweed to survive just as much as the Monarch does. It doesn't look so bad until you see its babies oozing out of the milkweed's seed pod. (see the picture).

They eat the seeds, and as they grow they suck the leaves.  In large numbers they can take nutrients away from monarch caterpillars, and they are just plain ugly in huge numbers. 

Then come the aphids.  These orange critters crowd the stems of milkweed plants.  They are bad for monarchs because they eat monarch eggs laid on the plant's leaves, and monarchs will avoid any milkweed that contains them.  They also look disgusting and slimy.  And the plant just wither under their influence..

Now, you are monarch rescue gardeners.  You must grow milkweeds.  If I were you, I would be thinking about how to engage my students or volunteers in a project to examine and "study" the pests of the milkweed, by searching your milkweed plants each day.  You could even reward the first student who finds an aphid or milkweed bug with a candy bar.  Maybe the teacher-leader has to think of her/himself as a bit of a Tom Sawyer.  Get those students to beg to clean the milkweed plants of pests.   (Now, how can I get my grandchildren to become milkweed cleaners? Snickers or M&Ms? )

Vitamin D deficiency in early pregnancy and preeclampsia later on.

This report on the relationship between Vitamin D status in early pregnancy and later development of preeclampsia, a dangerous condition in pregnancy certainly suggests that all women considering pregnancy should be tested for vitamin D levels, and despite the careful tone of the NIH editorial comment, should probably take some Vitamin D supplements while pregnancy is being considered.

Food-specific nutrition content from the Department of Agriculture

This little app from the U.S. Department of Agriculture is fun to use.  You can pick your nutrient, or nutrients, types of foods (or all), and get a ranked listing of the nutrient's content among foods.  Surprise!  Salmon has the most Vitamin D.  But, suppose I wanted to know about Vitamin B-12, an important nutrient for aging?  Right now, before going there, I have no idea what foods contain high levels of B-12 (that's cause I'm still young!).

Try it.  You'll like it.  You'll forget it.  But then you'll remember that you saw it here on my view from Bethesda and you will find it again under (you guessed it) the label Vitamin D.

Review of studies: Except for bone health, low Vitamin D doesn't cause disease

The National Library of Medicine's MEDLINE PLUS news line summarizes a large study reviewing the evidence on the link between Vitamin D status and disease.  The reviewers' conclusions:  the association between low vitamin D and all diseases EXCEPT BONE HEALTH means that low Vitamin D is a marker, not the cause of diseases.

Bone health is not nothing, as I found in my own experience.  The question I would ask is this:  If a disease (such as MS) lowers Vitamin D in some fashion (rather than the other way around), does the resulting low level of Vitamin D make for weak bones?  That is, shouldn't we be tested for our vitamin D status and treated for low D on the basis of bone health alone?  

One thing is clear:  all the Vitamin D hype in the past 10 years has brought forth a good deal of research on its value.  Because D supplements are not profitable to drug companies, such research must be sponsored by government or non-profit entities.  There is nothing like controversy to stimulate such research.

All the sins of Larry Summers that justified his comeuppance

Since yesterday, when Larry Summers announced that he is taking his name out of consideration for the Chairman of the Federal Reserve, I have received two emails from old friends.  Hey, Judy, what do you think of that?  (As if they didn't know!)
Let us not cry for Larry and his lost dream.  He will have to satisfy himself in his comfy office at Harvard, and at whatever hedge fund he's hanging out at these days.  The man will not starve, though a little bit of fasting might not hurt him.
Still, it is time for me to lay out ALL of his sins, and to wonder why President Obama would ever have thought he would be acceptable to his (Obama's) base.  Most of these you will know about.  One, however, was embedded deep in one of Summers' op-ed pieces in the Washington Post over the past year.  It's the most cardinal sin of all.

Recap:  The frequently mentioned sins:  

1.  Responsible for the Financial Crisis:  He and his mentor (Bob Rubin) disparaged Brooksley Born, of CPSC, back in the 1990's, when she tried to get the Clinton Administration to do something about  the danger of unregulated derivative markets.  Those two, along with Alan Greenspan, snickered at little Brooksley who, as female, could not possibly understand the workings of big finance.  Eventually, to ensure their point of view, the four horsemen (Rubin, Greenspan, Summers and Gramm)  shepherded the Commodities Futures Modernization Act of 2000 through Congress near Christmas 2000.  Did Clinton even know what he had signed?  Well, not his greatest hour, but he listened to his advisors.  His advisor, our boy Summers, was not only wrong on the issue, he was arrogant about opposing views.   Unlike Alan Greenspan, he has never apologized for his role in the fiasco.

2.  Harvard Remarks on Women:  After alienating the faculty (let's forgive that), he made some remarks about women and math, which were probably inadvertent but which reflected an unscientific mindset and a clear bias against women.  He was pointing out the achievement gap in higher math between men and women. That's simple fact.  He argued for more research on the causes of same.  That's good.  But, then, he couldn't stop.  He said his "hunch" was that the cause of the gender gap is genetic and not environmental.  Ah, Larry. There it is.  No evidence, but your null hypothesis (needing to be disproven) was genetic male superiority!  Done as President of Harvard.  Yea!

3.  Performance in the White House during the Obama years.  Divisive, dithering, turf-conscious.  Ron Susskind's book, "Confidence Men" laid it all out.  I needn't say more.  Here is the New York Times article that describes Summers and what everyone (except the President, apparently) thought about him.  I will say no more as this item makes me wonder about my own crush on President Obama.  I don't want to go there.

The Mortal Sin:  (not mentioned in any of the news articles)

1.   The man supports the building of the Keystone Pipeline.  Why, he's such a genius that he knows about energy policy and global warming even better than the vast majority of climate scientists,   When I read his Washington Post Column (on economic growth) in which he put forth his argument, I felt obliged to write an angry letter to the Post editor asking why they print this man's drivel after his performance in numbers 1, 2, and 3 above. (I thought I was being clever, but my screed was not published.)  I have just spent a half hour looking for that opinion piece in the Post and could not find it.  But here it is, reprinted in a Reuters-India paper.

RIP, Public Servant Summers!  Enjoy retirement advising the hedge fund managers.

Charts on Long-Term Trends in Foreign-Born US Population

CBO has some great charts from the US Census that show how the immigrant population has changed over the last 100 years and, even better, how the educational attainment of said foreign-born individuals compares to native-born US citizens.  The big surprise to me is how well people from South America and the Caribbean do education-wise compared with those born here.  Why is that?  Haven't a clue.   But, perhaps it has something to do with another CBO chart that shows the comparatively high number of people from Mexico and Central America who are in the USA in an "unauthorized" status.

Vitamin D3 supplements alter gene expression in white blood cells - in a good way?

Here is a report of a paper in the public domain, on NIH website, which showed what Vitamin D3 supplementation did to the genes that govern immune response (and other responses).  This gives underlying scientific rationale for the importance of Vitamin D in auto-immune diseases.  PLOS Paper on Vitamin D.

Great Charts on the Sequester Cuts

Here is a great set of graphics on how much will come out of which programs and states, put out by ProPublica

What your health bills will be under Medicare

Here is a page from the Medicare.gov Website that tells you what the various programs pay for, and how much they cost in premiums.  I liked it because it is succinct and easy to understand.

Rules for Converting Vitamin D25 measurements

For those of us in USA, we use ng/ml, whereas the rest of the world uses nmol/l to measure Vitamin d25 blood levels. This makes it difficult to understand what researchers are using as cut-off points for "low" or "high" threshold values.
Here is the conversion formula:

• to convert nmol/L to ng/mL, multiply nmol/L by 0.4;

•  to convert ng/mL to nmol/L, multiply ng/mL by 2.5.]

Vitamin D and Multiple Sclerosis: more hints of effect

Admittedly, the high-quality evidence linking Vitamin D3 supplemention to moderation in  the course of multiple slcerosis is limited and somewhat conflicting.  Here's a new, very small, randomized clinical trial from Finland, which seems to suggest that D3 supplementation at high doses DOES make a difference.  At least it keeps hope alive until bigger, more definitive studies are reported in the future.  If it were I, I wouldn't wait to find out.

And, this just in, from National Library of Medicine's Medline page, a report of a study that followed a large number of individuals over time, recording their Vitamin D levels.  Those authors found a strong negative association between blood levels of Vitamin D (25OHD) and severity of symptoms.

Vitamin D Thwarts winter colds and flu in children

A study about to come out in Pediatrics (and noted by NIH's Medline web site) shows that giving daily Vitamin D supplements to children with LOW levels of Vitamin D reduces their susceptibility to winter colds and flu.  Conducted by Mass General Hospital researchers, but in Mongolia where there is an ample supply of  non-sunlight in winter.  Also, lots of kids deficient in Vitamin D in the winter.  Perhaps Mongolian milk isn't fortified with Vitamin D. (This last sentence reveals my utter lack of knowledge of modern life in Mongolia.) So, American kids might do better in winter on Vitamin D levels even without supplements.
But, what if your kid doesn't like milk and doesn't drink enough --4 glasses a day at the very least --to keep levels up?  Has your  pediatrician  tested his/her Vitamin D  levels? If not, you might gently suggest at the next visit (especially one in the winter time) that you'd like the doctor to test Vitamin D, or at least ask him or her whether it has been tested in the past (in the winter time).

Quick access to ratings of nursing home quality

Over the years I've had plenty opportunities to observe nursing homes in action, not only for my parents' generation, but also for my own post-surgical rehab.  And, recently I've spent a good amount of time visiting an older friend who spent a lot of time in several nursing facilities in the Maryland suburbs.  This nursing home rating tool, made available through ProPublica, is an excellent summary source of information, and the information you can get by clicking on an individual home's profile dovetails with my own impressions of the various places I've recently seen.
So, I'm entering this post into my "citizen portals" label, recognizing that I (and you) may have plenty of reason to research information on potential nursing homes.  If a friend asks for advice, all you have to do is remember my blog's name:  www.theviewfrombethesda.blogspot.com  and they will be able to get to this applicaiton.

High doses of Vitamin D prevent fractures in oldsters

I know, I know, it's getting boring.  Here's a study, summarized by Medline Plus (Natl Library of Medicine), showing that in older people, doses above 800 IU are necessary to get a reduction in hip fractures.  So, all that conservatism in the IOM study is missing out on the fact that oldsters such as us may need a whole lot more vitamin D than they suggest.

SCOTUS OPINION on Obamacare- Read it here!

Here is the C-span link to the Supreme Court opinion on the ACA.
Who would have thought that logic (i.e., a mandate that is enforced as a tax is a tax! and Medicaid is a voluntary program, that States can opt out of in pieces) would prevail?

Is this another switch in time that saved nine?  Or the opposite?  Only time will tell.  My relief tells me exactly where my own opinions lie.

What's the best outcome of SCOTUS on Obamacare?

Here we are, on the possible eve of the supreme court's decision on the constitutionality of the Affordable Care Act (ACA).  I've been grappling with what I want to see as the outcome, from the standpoint of what's good for the health care system, what's good for Obama's reelection, for the Democrats in Congress, and finally, for the crowd of  people who deeply believe that a single-payer health care system (a la Medicare) is best for the entire country.  To clarify, when I think about what's good for the health care system, I have in mind the ultimate effects on cost, quality and equality of access...those three competing objectives of public policies governing the delivery of health care.
What's good for Obama's re-election?  I believe the best thing for Obama politically speaking  is to have the whole bill nullified (except for the Medicare provisions, which nobody is talking about anyway).  That would wipe out the state-level exchanges, the insurance mandate (of course), and all the Medicaid provisions that expand access to Medicaid to all individuals and families with incomes less than 133% of the Federal poverty line (about $14K for individuals;  and $31K for a family of four).  I can't imagine how striking down the insurance mandate could leave in tact the ban on insurers discriminating on the basis of pre-existing conditions, or even the requirement to cover the under-26 crowd (even though some major insurers say they will keep that one.)
I think it would be good for voters to go back to square zero on health care.  It would take the fire out of the conservatives' righteously(?) indignant bellies over the mandate, while leaving the rest of the country to mull the alternatives.
What's good for the Democrats in Congress?  Re-election wise, see above.  Ideologically wise?  What ideology?  Dollars (theirs)  is what matters to them.
What's good for the Single-payer ideologues?  This is a no-brainer.  The mandate goes, the Medicaid provisions stay.  Most Americans do not realize that the Medicaid provisions, in addition to expanding eligibility, require Medicaid to pay for physician services at Medicare rates..  We hear a lot about how Medicare fees are low compared with private rates, but Medicaid fees are 30% lower than that!  And, to top it all off, the Federal government will pick up the entire tab for the health care costs of the new eligibles.  (Yes, yes, that's for 2 years, after which the Federal % drops to 90% and the Medicaid fee schedule rule drops, but who believes that the doctors won't have the clout to extend the fee schedule, just as they have managed to keep fees from plunging under Medicare's law by one-year extensions?)
Bottom line:  an extension of the Medicare-like single-payer system to a greater part of the population, and a gradual acclimation of the public to the idea that universal coverage can only come from a single-payer system.
What's good for the Health Care System?   At this point, I am rooting for a complete nullification, though  I am aware it's a long-shot.  That's because I don't believe in a single-payer system. So, what I mean is that if the mandate is going to be shot down, then I hope they shoot down Medicaid, too. That way, in having to start from scratch, perhaps Congress will put all the people into exchanges, which will treat the lower-income folks with the same respect they treat others. And, instead of  "exchanges," it should be "exchange."   I believe in a regulated market place (much like the Federal Employees Health care system) that offers competing plans meeting minimum coverage requirements.  The exchanges sounded like a good idea, but they are implemented at the state level, which doesn't allow much ability to pool risks, especially in smaller states.  (The state-level exchanges came from the Senate and its nefarious (Demorcatic) leadership, while the (Democratic) House bill had a national exchange system that would have guaranteed a large pool of enrollees.)
At this point, it would be worthwhile to go back to ground zero and let the nefarious Republican leadership deal with the consequences of its political intransigence and the public with another failure of our country to make access to health insurance (and therefore decent access to health care) a right.
What do you think?

Vitamin D supplementation reduces mortality in the elderly

A meta-analysis from 8 large randomized clinical trials, involving more than 70,000 elderly people, found that  Vitamin D supplementation decreased mortality over 3 years by 7 percent.  That's huge.

Vitamin D and Stroke Risk

Now from the journal Stroke, a study from the famous Kuakini Honolulu Heart Program that followed over many years several thousand Japanese-American men living on Oahu, beginning in 1965.  A recent study of stroke outcomes has found that men with DIETS rich in Vitamin D had a 27% reduction in stroke risk, after adjusting for all the other usual suspects (smoking, cholesterol, etc etc).  
Not a clinical trial, but the measurements of diet were well done. Unless Japanese men are so different from the rest of us that we can't generalize, the study is highly suggestive of causation. 
I haven't read the full article, cause I don't have access to Stroke and don't want to pay for an article that should be in the public domain (since the public undoubtedly funded the original study).  But 27% risk reduction in a common source of death and disability isn't something to be ignored.  
To paraphrase my old Turkish friend Isik, "What if it works?"

LWV should look into transparency of Fracking information

Here's something for a League of Women Voter's initiative to tackle! From ProPublica:   Fracking industry is pushing for legislation that would muddy the information about the chemical composition of fracking materials.  Where is transparancy?  (Not in the water?  Not in the government?)

More on Vitamin D and Alzheimers

This study was just reported and commented on by the Vitamin D Council's Newsletter.  It's French.  They aren't so different. Bottom line -- those with high intake of Vitamin D - sunshine - omega3 fatty acids, or some combination of the above, had lower risks of Alzheimers 7 years later.  To paraphrase President Obama (who was speaking about energy policy), What's not to like ALL OF THE ABOVE?