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Dr. Lane’s Thoughts XIX

NEWARK

1) It is interesting for me to watch how conservatives (which is largely but not completely made up of Republicans) convince minorities that while their views may have started out as liberal or democratic when they were younger, that it is now time to ‘grow up’ to a more mature view which is encompassed by the conservatives and GOP.


The Republican message is clear to minorities: you were a member of a minority group when you arrived, now it is time for you to shun more immigrants who are not ‘like you’, you may have relied on social welfare when you arrived (e.g. food stamps, affordable housing, Planned Parenthood) now it is time for you to show solidarity to your ‘American’ neighbors (white) and work against these same programs, and so on.  They make the message clear – if you join with ‘us’ we will protect you from people who look and sound like you but aren’t you because now you are ‘one of us’.


It is easiest to turn people who come from European countries where brown-skinned people were rarely seen in a positive light.  Telling a person with white skin that the Democratic Party is largely made up of people with brown skin quickly makes a white immigrant into a Republican – they fail to understand that the programs they rely on when they arrived to the US came from the efforts of the Democratic Party.


This is why I find it so jarring when I see African-American faces at Trump rallies, or women, or Asian faces, or Latin-American faces.  These people are also routinely roughed-up at these rallies because they are suspected of being spies for liberal or Democratic groups, or at these rallies solely to cause disruption.  The leaders of these rallies know that directly or through coded words these same groups will be openly attacked or demeaning words will be directed at these same groups.


I am not saying that the Democratic Party is filled with only the best people but I can easily say this: The Republican Party has easily and comfortably worn the mantle of white supremacy, and has positions that are anti-woman, anti-Black, anti-immigrant, and has acted as a bastion of protecting the wealthy and mega-wealthy from all responsibility to their town, their state, and their country.


It is a cute myth that the major advances in the United States came largely from American-born white males but it is a myth.  A MAJORITY of the advances in the United States – the things invented and the ideas that changed the world that originated in the United States – came from people not born here.  Immigrants are what makes this country great and many of them came here poor and deserving of what this country offered.  Many of them came here as illegals.  Many of them came and overstayed their visas.  Many of them were not white and neither are their children.


When Trump stated in his speech to announce his Presidential run he said something that caught my attention.  He said about Mexico, “They’re rapists, they’re bringing drugs, they’re not sending their best people”.  He was talking specifically about Mexicans but he was implying all immigrants.


We are left with two strong ideas, (1) who was sent here by their home country?  Does Trump actually believe that countries send their citizens to the US and it isn’t the decision of the people who have come here? and (2) nobody leaves a country where their life is wonderful and they are fulfilled to go to another country that will offer them none of these same advantages.  People come to the United States primarily because in their home country they were not considered their home counties’ “best”they were despised, they were hunted, they were ostracized, they were ignored.  They left everything they have ever known to come to the US to start over again despite the hardship they expect to encounter because it is better than what they had.


The previous version of the Democratic party a long while ago were horrible racists and bigots but this is not the party today.  It doesn’t take much research to find that the Democrats kept the black man down, especially in the South and up to the 1970s was the instrument of oppression for black people in the South.  The Republican party truly was the party of Abraham Lincoln and his ideals from the early 1800s but that changed around the 1970s when instrumental people began to see the opportunity to take over the Republican Party and craft it into a party of the rich, privileged, and white.


The modern Republican policies have never been to help anyone get a start or thrive once they are here.  The Republican policies have largely contributed to helping people segregate themselves from ‘undesirables’ (read: brown and black people) or keep the money that have already gained from adding to the treasury through taxes that only benefit the very rich.  If you are reading this, they don’t mean you – they are talking about people far richer than you; people who did not earn their money but had it given to them through inheritance or nepotism.

2) I have written before about how the majority viewpoint of many people is that their opinion is as important or equal to your knowledge; even so much as their guess or their feelings is as important as your knowledge.  I see this all the time in my life with family and friends (I do not see it in my profession – the one thing that is ingrained in the medical profession is that guessing or scant knowledge can equal death so opinions are the sole dominion of true experts in a field.  Healthcare providers are held to a high standard and everything they do at all times is open to review).


The message to me about the people I encounter is that the end of their formative training (high school or college) is the end of their own perceived formal need for scholarly investigation and supporting information for their statements and a complete freedom to just extrapolate or conjecture what they say.  No more fact-checking or trying to get things right – “I’m a big kid now – no one can tell me what to do!!” their behavior suggests.

The issue that confuses me is how much easier it is today in 2020 for people to get the information they need to be informed.  There are many websites that will tell you the real answer to your question, whether it is the filing date, the deadline, the symptoms, the number or whatever it is you seek so that your ‘anal ventriloquism’ (my way of saying ‘talking out of your ass” or guessing without knowing) is no longer necessary.  There are many reputable websites and other sources of information which can support the true answer to issues of fact.


There was a time when people read newspapers which routinely went into some depth about the controversial topic that was being written about.  Next, we had news on TV which did not go into depth because to be entertaining about the topics the reporter or news anchor spoke about  – it needed to be encapsulated and condensed to be interesting and quick.  It told the boldest issues (headlines) but did not dwell on background of the subject.


Everyone knew that the TV news was brief and not complete but you only needed to pick up a newspaper to learn more about the controversial topic in greater detail.  It was built into the news cycle that a newspaper was more complete.  The better newspapers had the better reporters: The Sacramento Bee, The LA Times, The NY Times, The Washington Post and so on.  Many cities had 2 or 3 local newspapers.  Being a great reporter was a source of pride for a newspaper, hence the Pulitzer Prize which both commemorated and celebrated the best in newspapers.


Now we have lost a majority of our newspapers. Our news is whatever the person reads on TV which is, in turn, printed on a teleprompter to be read.  The news anchor knows nothing more than you do about the topic.  We have to trust our news source to be impartial and unbiased (cue the snickering and subdued laughter from anyone who reads this since the truth is that all news is written from a point of view of the writer and bias is inherent).


I have a love affair with a specific magazine – The Atlantic – which has been published since 1853 which has a certain style of writing I admire: it seems to clearly have editors who demand that all sides of an issue must be in every article.  You think that the author is biased and will never mention an opposing viewpoint?  No, it is there.  The author always addresses the other viewpoints and informs the reader why he may be against them or problems with the other viewpoint but it is there to be considered by the reader.  Also, the magazine uses flawless American English with a level of fluency that treats our American language as a delight of style and linguistic prowess.  Whether you read the articles to yourself or out loud to another person, the writers of the Atlantic make American English sing and capture the mind of the reader and therefore force them to understand the topic.


The best part of The Atlantic magazine is the ‘letters to the editor’ which either disagree or agree with the author of a previous article.  These letters also are written with profound intelligence and capture the type of reader, often learned with a deep understanding of the subject, who finds the same delight in the magazine that I do.


Knowing is better than guessing, admitting fault in understanding of a topic leaves you a place to explore so that you can become a better person and a better citizen.  We should all require ourselves to be better students of the world and leave conjecture and opinions to the ignorant.


It is easy for me to see my readers imaging that I am just not speaking to them about something that interests them – I am making a request that they do something that has fallen out of favor in the US: reading and studying, two things that have been supplanted by watching and listening.  Even our schools in the US have largely increased their emphasis on videos and the internet as teaching tools in a vain effort to either keep students interested and focused or just surrendering to the obvious forms of teaching as entertainment.


I leave you with a simple reason to take what I am writing here seriously: if you do not understand what is being told to you then you have given up the true purpose of democracy.  Thomas Jefferson made it clear in his writings that the cornerstone of participant democracy is an educated population.


No, I am not telling you that you should read, learn, and understand because you need to be a good citizen.  I am not telling you that this country depends on you working at being smart, rational, and using your intelligence to improve your life.  Those things are true and every idea held inside that thought would help you tremendously.


What I can tell you is that when you lack knowledge on a topic you become prone to believing in conspiracy theories about how the world works.  When you do not know how politics works, how a vaccine is made, what the basis of other religions are, how other countries work, what the basis of ‘social distancing’ is, how diseases spread, and so on it is a great deal easier to listen to someone ‘explain it to you’ instead of having to read the answer from trusted sources which will cause you to need to learn about 10 or 100 other topics.  Conspiracy theorists love a person who doesn’t question them!  An uneducated person is their fertile soil for growing mistrust.


Here is why you should give your life to lifetime education and keeping up on information and the issues that surround you: if you do not read and learn, if you do not develop a deeper understanding of the world then you can be sure that people who do study subjects and do read will control their destiny much more than you will.  Many of those same people will work hard to sway your opinion and get your votes and your money and will then control you.  You will have to trust them because you will not know enough to oppose them or question their motives or demand accountability from them.  You will live in a world of not just one Trump but a political leadership of nothing but ‘Trumps':  powerful people created from scripted TV shows reading from teleprompters with a history of criminal and near-criminal enterprises and motivations of greed and self-dealing.  They will do to you what Trump and his syncophants do now to the mostly white population that put him in office: steal from you and mock your ignorance.


3) James Woods, an actor of many great movies, stated this about Trump, “Let’s face it. Donald Trump is a rough individual,” Woods tweeted. “He is vain, insensitive and raw. But he loves America more than any President in my lifetime.”


Really James?  That is your criteria as to why Trump should be in office and allowed to remain POTUS? Just so you know, my dog (Leo #4) loves me completely but I still won’t let him drive my car.  It is the same reasoning as you have offered and the outcome is the same.


Also, every POTUS  has loved this country and Trump may love it as much.  Nevertheless, it is very clear that Trump only looks for ways to enrich himself and his family at the expense of the citizens of this country.  That is his sole reason for waking up in the morning and the only thing he consistently pays attention to.


Just because the USA has had men as unlearned as Trump as POTUS in the past (and many degenerates have held this esteemed position in politics with little regard for the country they serve) does not mean that we need one in the office in 2020.


4)  I want to tell you something about my practice as a chiropractor in an effort to explain why the goal of being a ‘sports chiropractor” (which was the goal of many of my classmates in chiropractic college) is one of the biggest jokes possible. I do not doubt the desire is pure and the motivation is an excellent one until you get to the important topic: who is going to pay you?  Very few teams on your way to the professional teams will pay you for your time and education up to the point of being given that coveted spot of being the official chiropractor of a recognized professional team.


Just as an aside: the team physical therapist gets paid at every level of sports, from little league to middle school, to college to AAA teams – they all can expect to get a paycheck for every athlete they see.  Those professionals are sought out and given a contract with a stipulated salary and per diem.  More than likely the chiropractor had to approach the team and beg/negotiate the chance to work on the players – for free.

The chiropractor will do this for about 15-20 years at every chance he gets – he will follow the team on away games, go to every home game on his own unpaid for time, during his vacations, and so on and try to prove his expertise in building up his credentials so that, maybe, a team with grown-up athletes will hire him.  If he is lucky he may be considered so good that he will go to the Olympic games where he will get to treat the USA team members (for free) for 15-20 hours a day during either the Summer or Winter Olympics (not both since the number of chiropractors who want these spots is greater than the USA teams who want the chiropractors).  If you read this correctly, this DC has worked at this second job for 15-20 years for little to no money.  The PTs, MDs, DOs, and other health professionals did the same number of years for pay from these teams and would never have worked there for free.


For reasons I do not understand, ‘sports chiropractors’ chase the chance to work on athletes.  My association even has a group who get together to study how to be better at treating this group! Chiropractors love to work for free for the very healthy and very undeserving.

5) Every insurer that you have heard of are just like people in the same family with the same last name.  It is just a way of grouping people – each health insurance company has a name.  Each company has many plans, each of them differ from each other.  In the same way that just because people have the same last name does not mean that if you know one member of the family that you know all of them and it is even more clear that if you know one family that you do not know all of their relatives.  Welcome to the world of insurance reimbursement!  Which is to say, I could try 3-4 times before I got the definitive answer, which was almost always “no” to payment.


How many times do you need to be asked for your notes before you realize that they will never “get them” (by fax, email, or mail) and they will never tell pay you?  If you are a man, you can understand that when you leave 3 messages for a girl and she never calls you back there is a message there that she will never come right out and say, which is “stop calling me”.  She will never tell you right out; you are just supposed to understand.


I understand: the insurer will never pay me for this patient’s visits.  They are not required by any set of rules or laws to pay me.  I just have to ‘get the message” and stop accepting their patients.  The patient will go on to to another chiropractor who hasn’t learned what I know until he stops seeing them and the patient wanders until there are no new chiropractors for him to see in his area – until all of them have wasted their time trying to get paid and tell the patient that they will not see them any more.


Do you want to know what happens when I tell the patient that I will not see them any longer because their insurer will not pay me?  The patients tell me something along the lines of, “yeah, I have heard that they don’t pay the doctors” and they move on to the next chiropractor stupid enough to agree to perform treatment.

At this point I want to tell you that I do not take insurance money any longer as a chiropractor.  I tried this losing game of taking insurance payments from Blue Cross/Blue Shield, AETNA, Medicare, Medicaid, and so on until it became apparent that they would rarely pay me and when they did, it was many months after the work, and only if I asked them 3-4 times to be paid for the same date of service.

Before the reader tells me that I could have hired a billing service (for 8% of the collections) I will remind you that 8% of an unsuccessful billing is still 8% of zero.  What billing service is interested in working with a practice that bills $8,000 a month of which $800 is collectible?  Yes, you are lucky to get even 10% of what you bill when you are a chiropractor – the insurance companies actively work against paying you for anything you do!


A billing company cannot force an insurer to pay you any more than the doctor can do it.  We all follow the same rules and use the same modifiers for the same services and suffer the same consequences when we don’t get paid.  Just to make this more confusing, each insurer interprets the rules of billing in its own unique way and no 2 insurers accept bills the same way.  No 2 plans within the insurer accept the rules the same way.

Let’s tell you about being paid as a chiropractor as if it was you being hired by a company.  They offer you a contract to work hourly for 5 days of the week, for a total of 40 hours.  This is just an normal job.

After the first week you look at your paycheck and you see that there are 8 hours missing from your pay.  When you inquire, you are told this, “oh yeah, you have to work all five days  of the week but we don’t pay you for Tuesdays.  You work Tuesday for free for us if you want to get paid for the other days”.  This is what happens when you treat a patient – you do 5 different things for the patient (called modalities) but they only pay you for one thing – the chiropractic adjustment.

When you protest to the insurance company they inform you that that is all they will pay for but they require that you do the other 4 things in order to get paid the $35-45 for the adjustment.  Basically, you are required to do your best work and use your training but you are only paid for one item.  Failure to do the other 4 (unpaid) things can be considered malpractice if it is questioned by a disciplinary board but the insurance company will not pay you – they know that you will do the other (unpaid) things because you have LEGAL REQUIREMENTS in your scope of practice.  The insurance companies have no legal or moral standards – they are just a business.

You ever go to a chiropractor and he rushes you through a session where he puts you on heat and muscle stimulation for 5 minutes and then presses on your back quickly and leaves?  Why should he do more than that when it is only the pushing on your back that he will get paid for?  He gets paid more for supervising the physical therapists in his office than for treating you (a PT gets $95 an hour to treat 4 patients simultaneously and the DC who supervises the PT will get about $300 for those 4 patients.  The DC will get about $70 if he sees 2 chiropractic patients in that same hour and he has to chart 20-30 minutes for each chiropractic patient to even get that $35 for each patient).

I gave my patients everything I could do – all the newest therapy ideas, all the best approaches and, in the end, I got very poor reimbursement.  I was declined reimbursement most of the time for unknown reasons with no repercussions.  When I inquired I was told to bill it again and I would be declined again.  No one at the insurance companies is required to tell you what was wrong or why you won’t get paid (“we can’gt tell you how to bill or how to practice” I would be told).   Because this can take months the patient you are seeing 3-5 times has already finished treatment and is gone by the time you realize you are not getting paid.  You can never bill the patient because you already agreed to accept their insurance and it is not the patient’s fault that the insurer will not pay you.

For 10 years I tried to be a great chiropractor and do 30 minutes of care per patient for that bad reimbursement.  I got very popular when patient found great care in my office when they were used to that 10 minutes of in-and-out that the previous chiropractors had done.  The minute that I stopped taking insurance money (November 15, 2019) and made my care $65 per session [it is now $70] all of my patients left to go back to the bad and quick chiropractic care because it was paid for by their insurance.  I expected that.


I can tell you that 10 minutes of care does not get the results of 30 minutes of devoted care but no one is going to do work that they do not get paid for.  Every chiropractor knows what works and they will not do it if they do not get paid.  I understand and so do they.

I still see patients but it is a rare occurrence. I am happy to do my CDL medical exams and get paid well.  I don’t need the stress of begging for money.

I have not accepted insurance money since November 15, 2019.  Monthly, I continue to get letters from the insurance companies informing me that they have audited my accounts and they have decided that what little money they paid me was too much and they want their money back!  Yes, it has been 6 months as of this writing that I took any money from them and the insurance companies are still trying to take back the little money they paid me.

It is OK, they tell me that they will take their money back from future payments.  I hope that they are not depending on that money. I will never work for them again.


When a doctor works for me I make sure that they are paid well.   I am not certain that this respect would be returned under other circumstances if they paid me but I have to follow my moral upbringing.  I cannot base my behavior on the expectations of reciprocity; my behavior and my actions are only my own and they must follow my own moral teachings and my own understanding of my [Jewish] faith.


In my years I have learned that everyone expects moral and decent, fair behavior toward them.  What they do when they are in charge should be equivalent but it is not always so.  It is a very odd world when you work for someone else – they suddenly because very problematic and see themselves as a ‘clever’ and ‘strong’ and a ‘business man” (it is almost always a man who behaves like this) and try to screw over anyone who works for them and anyone who does business with them.  This guarantees that no employee stays very long and no one works with them more than once.  The money that they ‘save’ by their behavior guarantees them very few friends.

6) When Trump leaves power you should expect many Republicans to pop up their heads and immediately exclaim how much they worked against him in every way they could but ‘behind the scenes’.  They will list their ‘brave’ efforts to ‘try and stop him’ and how they met often with their enlightened colleagues to plot Trump’s downfall.  Quietly, where no one could see them or know about their efforts.


Those brave freedom fighters!  Those bold disrupters!  The guerrilla fighters of the GOP!  Don’t believe them for a minute!  The time to speak is now in mid-2020!  The time to act is now, not when Trump and his presidency of liars, cheats, and white supremacists are in power!  Your silence is your agreement.


I only wish that when Trump is gone he not only takes his own people but also takes the weak members of the GOP who have supported him!  He can also take that human tortoise Mitch McConnell with him as well – a man happy to keep Trump in office because it was good for his brand of white Southern hypocrisy and supported his vision of a ‘pure’ white America.


Since you have reached this far, you should know that Mitch McConnell is married to Elaine Chao (US Secretary of Transportation) who is part of the largest shipping family in CHINA.  You can be assured that she is looking after her own interests and those of her family first and only then does she show concerns for the citizens of the USA.  


Every item you get that is shipped from China helps her and her family (father and sister own FOREMOST GROUP).  To be clear, Trump did not put her in office, it was George Bush when he was president.


We have a president who puts his own interests first so why not have a cabinet secretary who does the same?

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Dr. Lane’s Thoughts XVIII

NEWARK

1) Fair.  That’s not ‘fair’.  This word, “fair” is a word ensconced in the concept of justice and is only used in terms of the human perception of what is right or equal when in front of a form of justice-producing leadership, a god or someone who judges.


“Fair” is a word uttered by small children or undeveloped adolescents of any age (I have found that ‘adulthood’ is a legal number of 21 years old but not a number of years of emotional knowledge that can come on at any time, from 13-50 or more.  Some people never reach adulthood).  Fair is only a human concept in the way that we think of it.


Children are not designed to be fair.  From the beginning, they want and their parents provide.  It is up to the parents to teach what is fair and what is generous or kids will never learn.  Some parents fail to move the child from thinking of ‘fair’ as a selfish idea and toward ‘fair’ as an equitable idea available to all.


No one left alone in the middle of a jungle with no way of reaching other people is hamstrung in their ability to survive by the idea of ‘fairness’ – you just have to get on with the process of surviving.  Is a rabbit killed and eaten by a fox filled with the idea of fairness, or for that matter does the fox believe in fairness when he kills and eats the rabbit?  No person who eats food (meat or non-meat) considers whether it is fair that food is raised by people to be eaten.


You are born to whatever circumstances you are and then you grow up and survive.  You do your best and you find a way to make a life.  If you are constantly looking for fairness then you will be stuck as a child looking to other people for equaling what you perceive as imbalance.  Looking for fairness is a way of being stuck in one spot and blaming it on other people who you believe can make things right; ‘right’ for you but, just you.  The wonderful selfishness of looking for fairness is that you have already decided that someone else is the cause of what is fair/unfair and they are the solution.


Most important, you believe that you are innocent and good but, most of all, deserving of what you think of as ‘fair’ to be given to you.


On the matter of fairness and lack of survival advantage, many forms of “mental illness” and “emotional illness” that we have therapists and other forms of intervention to work with (I am intentionally excluding chemical imbalances which are treatable) just seem to disappear when basic survival is the only issue on the table, such as the scenario I noted before about being left alone in a jungle.  Considering the idea of fairness or your mental illnesses won’t help you survive.


For that matter, the food allergies that everyone seem to have these days seem to have gone up, by my estimation, about 10,000% since I was a child in the 1970s.  I can’t remember ever encountering a peanut or gluten sensitivity then but now every kid has at least one allergy and as many as they can create in their heads.  To paraphrase Chris Rock, when you are starving those kind of allergies and sensitivities seem to disappear.  To be clear, I am not saying that they don’t exist but I am saying that the number of people who have self-diagnosed themselves to these medical problems seems to be much higher than a human population could possibly contain.


Non-realistic allergies, minds set to look for fairness from others, delayed adolescence – all are the cornerstone of a weakened first-world mindset (I could write ‘American’ but I have an international readership).  If you need to tell the world that you ‘need help’ to survive then admit it.  Tell everyone the real story you want to tell about yourself: “I am weak on some level so do things special for me.  I need special food that doesn’t upset me, I need special actions from everyone else so that I do not fall apart and can function, I need special behaviors from everyone else that give me an advantage above others whether I deserve them or not’.  Just admit it – that is who you are.


That is who you are when you look for the world to change only for you.  Sing it loud and sing it proud!  Forever you are 12 and living with your parents who might care about what makes you happy.  Even if the rest of the world sees you as a grown man or woman of an age over 12 you have made it clear that you will never see yourself that way.  As your parents get older and less able to continue to do for you then continue to demand from them what you think is ‘fair’ in what you eat, want, and see as equitable since they are the ones that made you that way.


Isn’t that great – you can blame your parents for everything you think wasn’t done right for you: money to compensate for the bad wage on your job, money to pay for your ‘necessities’ that your bad work benefits won’t pay for, and a sounding board for how wrong the world is to you (your spouse, your friends, your own kids).


Do you see yourself in this essay?  Do you want to do something about this way of thinking in yourself?


Stop tolerating problems and become proactive.  The job is bad and people are ‘unfair’ to you – then leave and tell the bosses why you are leaving.  Maybe they will care or maybe they won’t but that is not for you to decide.


Are you certain that you have these allergies?  Get yourself tested and stop using it as an excuse for everything edible.


You still run to your old parents and demand to be compensated by them for what the world will not provide?  Try leaving them alone to keep what they have earned and find another way to get your material demands met by either simplifying your life or earning the money you need to pay for your ‘needs’.


2) Jeff Bezos is one of the wealthiest people that has ever lived.  No one can fault him on building his successful business – it is all his and he earned it. 


To contemplate how rich he is is almost impossible to wrap your head around.  I have been told that if you spent $180,000 a day since the year zero you could not spend his wealth in your lifetime.


His whole venture depends on his warehouses where he employees thousands of people to box the items purchased through his website.  These people work under very demanding conditions of strict time management to be useful to him.


They get paid very poorly for their work, which meets Mr. Bezos’s need for a capitalist model and allows him his untold wealth.


Since he cannot spend his money in his lifetime why is it such a bad idea if I would suggest a single idea: raise all of his employees wages by $1.00 an hour.  It would help them greatly and it wouldn’t affect his wealth in any way he could feel.


For comparison, he gave away half his money to his previous wife and it didn’t change his life in any way. ONE HALF OF HIS MONEY went away with no impact on him!  What would an additional $1,00 an hour cost him – an extra expense of $50,000 a day?  What would he gain?  Happier and more satisfied employees!


3)  Who represents you?  Who do you allow to be your voice on the issues that concern you?  Do you support the most strident voices, the most confrontational people who state that they are looking after your best interests?


Let’s just use me as an example – I am (1) white, (2) Jewish, (3) educated, (4) A citizen of New Jersey, (5) A US citizen, (6) a licensed chiropractor, (7) I have an office in Newark, NJ (8) I come from Buffalo, NY.  


Jews have Israel that has many people who feel that Jews must have sovereignty over that land, many Jews who feel that Jews are superior to other people but I know that all people have a range of quality and Jews do not have the ownership of great scholarship in any field.  White people have a mixed history of accomplishment and cruelty but then, again, so do all people in the world. I like being a chiropractor and the education I received was great at UBCC but there is nothing wrong about other occupations and I have a sense of pride being part of a team of equals in the care of patients.  I could go on and say the same about all of the other groups I am a part of. 


Do I like it when someone talks about the superiority of these groups I am part of when compared to people who are not part of these groups – sure I do!  I love it!  Those are my people!


It can be comforting to listen to strident voices who consider you superior to others but very scary when they can never find a commonality or similarity where differences that can be bridged and a community can be built.


How about when I hear these same people talk about the others (who are not part of my groups) are INFERIOR or THE ENEMY?  How about when I hear that these ‘others’ want me stopped or hurt or killed? Not equals in disagreement with equivalent needs and concerns with similar but opposite points of view but a force of ‘others’ to be wiped out for holding a difference from you or wanting me hurt.


No, I do not like that at all!  


Maybe you do like that; perhaps you enjoy being told that anybody who is not a part of your groups can and should be declared your enemy and you are comfortable to see other people seen as your antagonists.  An enemy means that you can see all life as a war and not a disagreement between equals.


Yes, it is difficult to tell the people who speak so well of you for being like them that they are not the voice you need in your life.  It such a compliment that they like you so much based on nothing but similarity but you must look to the bridge-builders, the calm representatives who want life to continue even with people who can never be the same as you.  People who can never be the same as you but must always be accorded the same rights as you for a voice and an opinion.


I will leave you with a message:  all the groups of ‘others’ who you think do not have your best interests in their hearts have members who see the world as you do.  They are also reasonable and they do not want to be told that they are better than you.  Those others want to build bridges with you and see you as part of their community.

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This Skin Condition Can Be a Sign of Diabetes

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This Skin Condition Can Be a Sign of Diabetes.

This Skin Condition Can Be a Sign of Diabetes.

Ronald Grisanti D.C., D.A.B.C.O.,D.A.C.B.N., M.S.

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Darkening of the skin at the nape of the neck could be an early indication of insulin resistance and diabetes.
The condition, called Acanthosis Nigricans (AN), is marked by the darkening and thickening of the skin on the sides or back of the neck, the armpits, under the breast, and groin.

Acanthosis Nigricans is a skin condition that signals high insulin levels in the body.

Acanthosis Nigricans is important because these markings can help identify persons who run the risk of developing diabetes in the future.

Once identified, the necessary measures to lower the insulin levels and reduce the risk of developing diabetes can be taken.

Similarly, the acanthosis nigricans markers will begin to fade.

Acanthosis nigricans is a skin manifestation of insulin resistance and an early indication of diabetes,” says Dr Anoop Misra, professor of medicine at the All India Institute of Medical Sciences (AIIMS), New Delhi.

Dr. Misra’s study followed adult patients with acanthosis nigricans who had no history of diabetes and discover that 58% of the patients reviewed had the metabolic syndrome. In fact 24% had full-blown diabetes.


All were clueless about their diabetic status.
Who is Dr. Anoop Misra?
Dr Misra is considered as a lead researcher internationally for insulin resistance, diabetes mellitus, hyperlipidemia and obesity in the Indian population. He has substantially contributed to the understanding of the mechanisms, prevention and management of obesity and diabetes mellitus in Indians by publishing more than 100 papers in the international journals, and debating on important issues in the International conferences.He has worked as the World Health Organization fellow at Royal Free Medical School, London and University of Texas Southwestern Medical Center at Dallas. He also worked as faculty in Internal Medicine and Endocrinology at the prestigious University of Texas Southwestern Medical Center at Dallas.
References:

Reinehr T. Clinical presentation of type 2 diabetes mellitus in children and adolescents. Int J Obes (Lond). 2005 Sep;29 Suppl 2:S105-10.

Charnvises K, Weerakiet S, Tingthanatikul Y, Wansumrith S, Chanprasertyothin S, Rojanasakul A. Acanthosis nigricans: clinical predictor of abnormal glucose tolerance in Asian women with polycystic ovary syndrome. Gynecol Endocrinol. 2005 Sep;21(3):161-4.

Mohrenschlager M, Ring J, Kohn FM.Diabetes mellitus: [Cutaneous and mucosal marker lesions] MMW Fortschr Med. 2005 Oct 6;147(40):34-6.

Bolding J, Wratchford T, Perkins K, Ogershok P.Prevalence of obesity, acanthosis nigricans and hyperinsulinemia in an adolescent clinic. W V Med J. 2005 May-Jun;101(3):112-5.

Grandhe NP, Bhansali A, Dogra S, Kumar B.Acanthosis nigricans: relation with type 2 diabetes mellitus, anthropometric variables, and body mass in Indians.

Postgrad Med J. 2005 Aug;81(958):541-4.

Flagothier C, Quatresooz P, Bourguignon R, Pierard-Franchimont C, Pierard GE. Abstract [Cutaneous stigmata of diabetes mellitus] Rev Med Liege. 2005 May-Jun;60(5-6):553-9.

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Social Distancing and High Blood Pressure

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Social Distancing and High Blood Pressure


Do you like that title?  Pretty provocative, right?


Why did I write a title like that?  It is because I have seen an uptick in a bad and dangerous behavior in my office since I reopened the place that reminds me of the fools who are protesting about how they believe that wearing masks and keeping 6 feet between themselves and others is in violation of their liberty.


What is that behavior that I am seeing?  My patients are not taking their high blood pressure medications!!  I hear so many excuses from them but I think that many of them simply do not feel like their high blood pressure (HBP) is real because it doesn’t feel like anything is wrong!


There is a reason that high blood pressure is called ‘the silent killer’ – you just feel normal!  If anything, the medications make you feel sick!


It is easy for me to assume that everyone knows what I know but that is not true – my life has been spent in medicine and I forget that not everyone thinks about health and medicine every minute of every day like I do! Let me lay out the facts for all of you about high blood pressure:


1) The pressure of your blood on your arteries and organs causes slow damage to the proper functioning of your body.  Often HBP shows no symptoms until the first big one: a heart attack!  By that time the damage is done and if you are lucky enough to survive the heart attack you will be in poor health for the rest of your life.


2) So why worry about the rest of your organs when it is your blood pressure that is your concern?  When I am writing about organs affected by HBP the principal ones I am talking about are your kidneys and your liver; two organs vital to your existence and very hard to either replicate or replace.


Bad kidneys?  DIABETES!  Your future is dialysis which is 3 hours of being connected to a machine that cleans your blood probably 3 days a week.  This vital organ comes to you as a pair (you have 2 of them) but you only need one to live well.  Dialysis is necessary because you destroyed both of them.


Your kidneys are so embedded in your body so that if you do get a transplant (the best ones come from a family member who is a match but many come from people who are recently deceased and allowed their organs to be harvested) they are sewn on top of your non-functional kidneys because taking out a kidney, especially from someone who doesn’t have functioning kidneys, is too difficult and dangerous.  


READ THAT PARAGRAPH AGAIN!  Someone you know or are related to either had to have a very long operation to remove their kidney so you can have it or someone had to die!  


If you put yourself in the position of needing a kidney because you did not treat your high blood pressure you are a selfish person – no excuses!  You had working kidneys and now you need a replacement because you would not take your medicine or change your lifestyle to bring down your blood pressure.


3)  Many things people can change will lower their blood pressure: lose weight and stop eating salt.  Those two things will often lower your blood pressure enough to avoid or discontinue blood pressure medication.  


Nothing exotic, nothing unique, no unnecessary intervention: just two things that anyone can do – lose 10 to 15 pounds and stop eating so much salt and foods that have a lot of salt


I lost 8 pounds in 6 weeks while staying at home due to COVID-19.  I ate all my (large) meals at home (I am married to a Latina – they cook lots of food) and did not eat much delivery or takeout food.  Any human being can lose 1 pound a week!


Salt?  Do you even know what food is supposed to taste like without salt?  I grew up with a mom with HBP so salt was not an ingredient in our home.  A single container of salt lasted so long that the label would change 3 times between containers in our house. When we did need to buy it I couldn’t recognize the brand she preferred because sometimes not only did the label change but the brand would be gone! 


My daughters consider salt to be one of the 4 food groups (my wife cooks without salt and the girls add it to everything).  They are lucky because estrogen is a natural heart protector.  This is the reason that menopause is a bigger problem than you know: all the conditions men have been worrying about since their 40s like HBP become a new burden to women in their 50s as estrogen declines and they often have not been warned!


4) I can hear all the shouts from here: but I am a healthy guy, I eat right, I exercise so why do I have HBP?  I have a way to show you why you have HBP – go get a a calendar or look at your genitals.


Don’t worry, I wrote this essay long before you are reading it so I have time.


Go on – look at the calendar, or your genitals.  You could look in a mirror if you feel like getting off your butt.


If you are male and over 40 (hence the need for a calendar) you probably have built up cholesterol on the arteries going in and out of your heart and that makes it harder for the blood to go in and out of this vital organ.  Moreso, you have cholesterol in the arteries of your heart.


Yes, your heart itself has very important arteries that keep it alive.  Learn about this one before a cardiac surgeon has to introduce it to you: LAD, the lateral anterior descending.  Arteries of the heart often do not have cute names and this one is named by where it is located from the front of your body.


Oh yeah, it has a cute name: the widow-maker.  When this one gets clogged with cholesterol men are in their 40s and 50s and the men die, leaving their wives as widows hence the name.  PREVENTABLE!!


You ever hear of a bypass, double bypass, triple bypass or quadruple bypass?  This refers to the number of arteries that a heart surgeon has to go around to keep the patient alive.  It always include the LAD.  Arteries filled with the accumulation of cholesterol that started in their teens and finally killed them 25-35 years later because the men failed to maintain their health.


5) Often people are not paired to their medications correctly so side-effects are immediately apparent when they start their HBP regimen.  The answer?  GET ANOTHER MEDICATION!!  There are about 30 blood pressure medications so find a good match with the help of your prescribing doctor.  Therefore there is no reason that another medication can’t be found that works better for you.


Maybe more than one medication is necessary.  I have patients on 3 medications but that works well for them.


My story:  I do well on BYSTOLIC or it’s generic equivalent.  I was switched to atelenol and it did not agree with me (digestive upset and general discomfort) so my doctor switched me back.  Bystolic is not on the formulary for my insurance plan so I have to buy it from Canada from my own pocket (but 25% of the cost compared to if I bought it in the USA – thanks insurance companies!!).


So why did I start this article by comparing people who don’t take their blood pressure medication to people who fight social distancing and wearing masks during the COVID-19 pandemic as issues of liberty and self-expression?


Both of these groups (as well as people who continue to smoke cigarettes in 2020) have one thing in common:  when they become so sick that they need medical intervention, hospitals, or new kidneys or a heart they want modern medicine to work hard to keep them alive from conditions that were mostly preventable.


Don’t fill up my mailbox with examples of babies born with defective kidneys or deformed hearts or stories of guys with miner’s lung or diseases that attacked their heart or kidneys, stories of children born with diabetes just to muddy the waters of my essay.  This essay is only about the clowns who refuse to follow common sense rules of prevention or good self-care.


Today I saw 13 patients between 8:30 and 2.  3 of them refused to take their blood pressure medication and had been living with HBP for at least a year before they came to me: a year of damaging their organs.  


Maybe these guys will start to get healthy again and their organs will repair themselves.  Maybe they will care about themselves.


Oh, let’s be real here!  These guys will start their medications or go back to the ones prescribed by their doctors long enough to get me off their backs about their blood pressure and immediately stop taking the medications with no lifestyle changes.  They will come back to me in a year or two years of further damage and we will play the game again.


One last word on this subject:  do you love your kids?  How about your grandkids?


High blood pressure will take you from them years before you need to die.


Die?  If you are lucky you will die!  Most likely your organs will fail and you will get diabetes.  Now your kids and grandkids get to see you in bad health and a burden to them!  You don’t die – you just spend the rest of your shortened life being a problem as they have to change their plans to assist you, watch you in the hospital as you go in and out with your kidney and heart problems, do lots of nothing with you in the house because you are too sick to go outside to do fun things!  


Your grandkids like being inside when it involves computers and gaming but spending time with you will mean helping you to use the bathroom or rubbing creams and lotions on your diabetic skin or putting compression socks on you.  Any idea how much a typical 6-14 year old enjoys doing those things?  The statistics aren’t in front of me but I speculate that the answer is close to zero.


What about going outside to run with the dog or toss around a Frisbee or ball, hike around a forest or go to the beach with their grandparents?  Much higher chance of enjoyment.


High blood pressure and using mask and social distancing: your choice. Make the right decision and stop being an ass.


This is your choice but one that falls on the shoulders of the people you love, respect, and care about.

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Exercise can do more than ease depression — it can prevent it (Dr. Oz)

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Exercise can do more than ease depression — it can prevent it

May 13, 2020

Actress, writer, director and producer Lena Dunham found that exercise was the key to getting on top of her emotional problems: “I know it’s mad annoying when people tell you to exercise, and it took me about 16 medicated years to listen. I’m glad I did.” We’re glad she found out how helpful exercise can be in reducing the symptoms of depression and anxiety. But researchers now say if she’d been active years ago she might actually have dodged the blues.

Research published in JAMA Psychiatry found that swapping out sedentary time for regular physical activity prevents depression. The researchers say that you can get the protection with 15 minutes a day of high-intensity exercise such as running, cycling at 12-14 mph, singles tennis, soccer or basketball; or with an hour of moderate-intensity exercise such as walking, playing doubles tennis or cycling at 10-12 mph; or a combination of both.

Exercise boosts endorphins and triggers release of a protein in the brain that prompts nerve cells to grow and make new connections, including in the hippocampus, the area of the brain that’s associated with memory and mood. Better brain function means better mood regulation.

The trick is to find exercise you enjoy so that you do it consistently. Try a bunch of things out if you’re not certain what you like. Some people thrive doing solo activities such as bike riding; others do well in a competitive setting like tennis or in a structured yoga or tae bo class. There’s something out there for you!

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Exercise can do more than ease depression — it can prevent it (Dr. Oz)

NEWARK

Exercise can do more than ease depression — it can prevent it

May 13, 2020

Actress, writer, director and producer Lena Dunham found that exercise was the key to getting on top of her emotional problems: “I know it’s mad annoying when people tell you to exercise, and it took me about 16 medicated years to listen. I’m glad I did.” We’re glad she found out how helpful exercise can be in reducing the symptoms of depression and anxiety. But researchers now say if she’d been active years ago she might actually have dodged the blues.

Research published in JAMA Psychiatry found that swapping out sedentary time for regular physical activity prevents depression. The researchers say that you can get the protection with 15 minutes a day of high-intensity exercise such as running, cycling at 12-14 mph, singles tennis, soccer or basketball; or with an hour of moderate-intensity exercise such as walking, playing doubles tennis or cycling at 10-12 mph; or a combination of both.

Exercise boosts endorphins and triggers release of a protein in the brain that prompts nerve cells to grow and make new connections, including in the hippocampus, the area of the brain that’s associated with memory and mood. Better brain function means better mood regulation.

The trick is to find exercise you enjoy so that you do it consistently. Try a bunch of things out if you’re not certain what you like. Some people thrive doing solo activities such as bike riding; others do well in a competitive setting like tennis or in a structured yoga or tae bo class. There’s something out there for you!

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Dr. Lane’s Thoughts XVII

1) Today is April 9, 2020.  I am limiting my time in the office severely both from common sense and from a very strong response from my wife that has made it clear that I am endangering her and the girls, as well as the dog.  I am not certain about the dog but she is right about the people (update:  I just learned that dogs are not susceptible or carriers of coronavirus)

It  was only a few years ago that the study and medicine of infectious disease was considered a dead-end for an American-trained doctor.   For American doctors there was simply not enough infectious disease to keep them challenged and when it did occur it was brief and geographically contained (e.g, hantavirus or Legionaire’s Disease). The only concerns that American doctors needed to concentrate on ,we were told, were chronic diseases such as diabetes or heart disease. The average American was more likely going to face the issues of old age and infirmity than an incurable infection from a virus or bacteria (especially if they did not travel much); longevity was the goal and the curse of medicine.

Infectious diseases were manageable and, if they were encountered, we knew two things: modern medicine could fight it and, most importantly, the populations affected were more than likely “over there”, meaning AFRICA and parts of ASIA – those people who ‘were not us’.

The US and Europe pride themselves for being the elite and self-named “first world” and certainly not the formerly named ‘third world’ (but now, generously named by us, ‘developing countries’).  We consider that we are self-sufficient and not dependent on any other nations other than each other to provide the majority of our needs.

The image of dying by the multitudes of a disease that inflicts itself on a population with increasing death rates conjures up small villages, huts, inferior technology and overwhelmed regional hospitals that would not pass for even a clinic in our country.

We take pride in how this sad image of damaged populations was last seen in the US over 100 years ago, a time before antibiotics and germ theory.  It was easy to feel superior and invincible.

It is 2020 and the virus (not bacteria, which is easier to fight) has crippled the nation.  I learned today that despite the idea that our country and its inhabitants have the city of Wuhan in China to blame, that it was most likely spread to NYC from people in Europe before being introduced by them to the US.  Diseases are like that, they do not respect boundaries of race or income and, most of all, they do not attach themselves to blame.

It was easy to see the problem on some level to “Chinese people” in small communities who do not have a way to prevent the spread of disease as being the cause of this calamity but quite another to see this as a problem which comes down to a single thought: an infectious disease anywhere is a disease everywhere.  Our best barrier to infectious disease HERE is a good public health response EVERYWHERE.

The previously unimportant field (with declining funding and decreasing interest to new medical graduates) of Tropical and Infectious Diseases (even the name conjures up images of palm fronds and brown peoples) is now the only field of medicine anyone can talk about.  
Like the ‘heroes’ that saved humanity in “War of the Worlds” and the topic of books and movies of recent memory, viruses are still the greatest threats mankind can face.  A virus is not even, technically, alive in that it cannot survive on its own without a host.  It has no means of living on its own.  A virus is nothing more than DNA or RNA in a traveling capsule that attaches itself to a cell and pushes its material into the genetic material of the host and, thereby, continues its own survival – a survival without purpose, truly the basis of all existence since the idea of ‘life’ has existed.


2)  My wife gave me a haircut a few days ago.  it is incredibly good.  It seems that she studied videos on how to get it right and I provided the cutter / trimmer which I have owned for about 20 years.  I have also used this home isolation to grow a beard,  How long that will last after I return to my public life is still undecided but it could become my new look. 


3) It occurs to me that many of you have no idea what I looked like until now.  You are welcome!  I admit that it is far more fun to look at my lovely Colombian wife but that may never happen (I can’t afford to have people fall in love with her).

My wife and I will probably get married a third time in Colombia in the next year.  This is how we can include her family who could not travel to our first 2 weddings (November 15, 2016 [civil, in front of a judge] and May 20, 2017 [Jewish with a rabbi]).  This wedding will be Catholic.

4) I know someone who is convinced that COVID-19 was created in a lab in China.  For many reasons this is both ridiculous and impossible. (1) Nature is much better at killing people with illnesses than humans can ever be (2) The amount of work it would take to do this and keep it a secret is beyond what any group of people is capable of (on the level of trying to fake the moon landing or hide Bigfoot) (3) Bacteria and viruses can only spread easily if a host organism (where it lives until it can be spread) is not going to die while it is inside of it – bats are perfect but human cells (which is where it would have to be raised in a lab to create it) are hard to raise and keep alive and grow (4) to be successful, a man-made virus would have to spread through a population of other people who have the greatest chance of infecting your enemies – killing a bunch of people in Wuhan China in order to infect people in other parts of the world doesn’t seem to be a good use of your virus if your goal was to kill non-Chinese people (5) Actual germ warfare (which is the name of the branch of the defense industry designed to stop enemy combatants using diease agents) has never been successful in the past and has limited itself to using known diseases to small groups of enemies, such as giving smallpox-infected blankets to Native Americans (6) You can’t really be certain that your enemies are going to be the only ones who die when you infect everyone equally (7) Killing non-combatants (the term used for populations who are not actively involved in the military or war process) is against every part of the code of war that was approved by the Geneva Convention.  Failing to follow the Geneva Convention is considered a war crime. (8) Killing people for reasons not related to the military or the act of war is calle MURDER and it never allowed by any country without cause (9) The way that a bacteria or virus survives in its host is to be benign or offer a survival advantage which allows it to spread without killing its host.  COVID-19 offers no advantage to the bats it probably started in (though this has never been shown definitively and is only suspected) (10) Every country in the world has been affected by COVID-19 so no one gained anything from stopping every economy worldwide.

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IMPORTANT COVID NEWS: Males are more susceptible to COVID-19

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IMPORTANT COVID NEWS: Males are more susceptible!


Male vulnerability
Men’s blood has higher levels than women’s of an enzyme used by the new coronavirus to infect cells, the results of a big European study showed on Monday 5/11/2020. 


Angiotensin-converting enzyme 2, a receptor on the surface of cells that binds to the new coronavirus and allows it to enter and infect cells, is found in the heart, kidneys, the tissues lining blood vessels, and especially in the testes.

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The world’s most nutritious foods

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The world’s most nutritious foods



This is an amazing list – not only does it explain which foods are good for you but it includes the cost of the foods.  What you should notice immediately is how inexpensive the best foods are for you!  Also notice that most of these foods are known to you!

After analysing more than 1,000 raw foods, researchers ranked the ingredients that provide the best balance of your daily nutritional requirements – and they found a few surprises.  Taken from this link   connected to the BBC
Our colleagues at BBC Good Food are focusing on practical solutions for ingredient swaps, nutritious  recipes and all aspects of cooking and eating during lockdown.
Imagine the ideal food. One that contains all the nutrients necessary to meet, but not exceed, our daily nutrient demands. If such a food existed, consuming it, without eating any other, would provide the optimal nutritional balance for our body.
Such a food does not exist. But we can do the next best thing.
The key is to eat a balance of highly nutritional foods, that when consumed together, do not contain too much of any one nutrient, to avoid exceeding daily recommended amounts. That’s especially important when we are thrown out of our usual routines, as so many have been with enforced isolation during the current pandemic.
Scientists studied more than 1,000 foods, assigning each a nutritional score. The higher the score, the more likely each food would meet, but not exceed your daily nutritional needs, when eaten in combination with others.
Calculated and ranked by scientists, these are the 100 most nutritious foods:

Please note: a few of the foods listed are endangered species, which we would not recommend. We would advise researching the provenance of all ingredients if buying them yourself.
100. SWEET POTATO (v)
86kcal, $0.21, per 100g
A bright orange tuber, sweet potatoes are only distantly related to potatoes. They are rich in beta-carotene.

NUTRITIONAL SCORE: 49
98. GINGER (v)
80kcal, $0.85, per 100g
Ginger contains high levels of antioxidants. In medicine, it is used as a digestive stimulant and to treat colds.
NUTRITIONAL SCORE: 49
97. PUMPKIN (v)
26kcal, $0.20, per 100g
Pumpkins are rich in yellow and orange pigments. Especially xanthophyll esters and beta-carotene.
NUTRITIONAL SCORE: 50
96. BURDOCK ROOT (v)
72kcal, $1.98, per 100g
Used in folk medicine and as a vegetable, studies suggest burdock can aid fat loss and limit inflammation.
NUTRITIONAL SCORE: 50
95. BRUSSELS SPROUTS (v)
43kcal, $0.35, per 100g
A type of cabbage. Brussels sprouts originated in Brussels in the 1500s. They are rich in calcium and vitamin C.
NUTRITIONAL SCORE: 50
94. BROCCOLI (v)
34kcal, $0.42, per 100g
Broccoli heads consist of immature flower buds and stems. US consumption has risen five-fold in 50 years.
NUTRITIONAL SCORE: 50
93. CAULIFLOWER (v)
31kcal, $0.44, per 100g
Unlike broccoli, cauliflower heads are degenerate shoot tips that are frequently white, lacking green chlorophyll.
NUTRITIONAL SCORE: 50
92. WATER CHESTNUTS (v)
97kcal, $1.50, per 100g
The water chestnut is not a nut at all, but an aquatic vegetable that grows in mud underwater within marshes.
NUTRITIONAL SCORE: 50
91. CANTALOUPE MELONS (v)
34kcal, $0.27, per 100g
One of the foods richest in glutathione, an antioxidant that protects cells from toxins including free radicals.
NUTRITIONAL SCORE: 50

Cantaloupe melon – rich in antioxidants
90. PRUNES (v)
240kcal, $0.44, per 100g
Dried plums are very rich in health-promoting nutrients such as antioxidants and anthocyanins.
NUTRITIONAL SCORE: 50
89. COMMON OCTOPUS
82kcal, $1.50, per 100g
Though nutritious, recent evidence suggests octopus can carry harmful shellfish toxins and allergens.
NUTRITIONAL SCORE: 50
88. CARROTS (v)
36kcal, $0.40, per 100g
Carrots first appeared in Afghanistan 1,100 years ago. Orange carrots were grown in Europe in the 1500s.
NUTRITIONAL SCORE: 51
87. WINTER SQUASH (v)
34kcal, $0.24, per 100g
Unlike summer squashes, winter squashes are eaten in the mature fruit stage. The hard rind is usually not eaten.
NUTRITIONAL SCORE: 51
86. JALAPENO PEPPERS (v)
29kcal, $0.66, per 100g
The same species as other peppers. Carotenoid levels are 35 times higher in red jalapenos that have ripened.
NUTRITIONAL SCORE: 51
85. RHUBARB (v)
21kcal, $1.47, per 100g
Rhubarb is rich in minerals, vitamins, fibre and natural phytochemicals that have a role in maintaining health.
NUTRITIONAL SCORE: 51
84. POMEGRANATES (v)
83kcal, $1.31, per 100g
Their red and purple colour is produced by anthocyanins that have antioxidant and anti-inflammatory properties.
NUTRITIONAL SCORE: 51
83. RED CURRANTS (v)
56kcal, $0.44, per 100g
Red currants are also rich in anthocyanins. White currants are the same species as red, whereas black currants differ.
NUTRITIONAL SCORE: 51
82. ORANGES (v)
46kcal, $0.37, per 100g
Most citrus fruits grown worldwide are oranges. In many varieties, acidity declines with fruit ripeness.
NUTRITIONAL SCORE: 51
81. CARP
127kcal, $1.40, per 100g
A high proportion of carp is protein, around 18%. Just under 6% is fat, and the fish contains zero sugar.
NUTRITIONAL SCORE: 51

80. HUBBARD SQUASH (v)
40kcal, $8.77, per 100g
A variety of the species Cucurbita maxim. Tear-drop shaped, they are often cooked in lieu of pumpkins.
NUTRITIONAL SCORE: 52
79. KUMQUATS (v)
71kcal, $0.69, per 100g
An unusual citrus fruit, kumquats lack a pith inside and their tender rind is not separate like an orange peel.
NUTRITIONAL SCORE: 52
78. POMPANO
164kcal, $1.44, per 100g
Often called jacks, Florida pompanos are frequently-caught western Atlantic fish usually weighing under 2kg.
NUTRITIONAL SCORE: 52
77. PINK SALMON
127kcal, $1.19, per 100g
These fish are rich in long-chain fatty acids, such as omega-3s, that improve blood cholesterol levels.
NUTRITIONAL SCORE: 52
76. SOUR CHERRIES (v)
50kcal, $0.58, per 100g
Sour cherries (Prunus cerasus) are a different species to sweet cherries (P. avium). Usually processed or frozen.
NUTRITIONAL SCORE: 53
75. RAINBOW TROUT
141kcal, $3.08, per 100g
Closely related to salmon, rainbow trout are medium-sized Pacific fish also rich in omega-3s.
NUTRITIONAL SCORE: 53
74. PERCH
91kcal, $1.54, per 100g
Pregnant and lactating women are advised not to eat perch. Though nutritious, it may contain traces of mercury.
NUTRITIONAL SCORE: 53
73. GREEN BEANS (v)
31kcal, $0.28, per 100g
Green beans, known as string, snap or French beans, are rich in saponins, thought to reduce cholesterol levels.
NUTRITIONAL SCORE: 54
72. RED LEAF LETTUCE (v)
16kcal, $1.55, per 100g
Evidence suggests lettuce was cultivated before 4500 BC. It contains almost no fat or sugar and is high in calcium.
NUTRITIONAL SCORE: 54
71. LEEKS (v)
61kcal, $1.83, per 100g
Leeks are closely related to onions, shallots, chives and garlic. Their wild ancestor grows around the Mediterranean basin.
NUTRITIONAL SCORE: 54

70. CAYENNE PEPPER (v)
318kcal, $22.19, per 100g
Powdered cayenne pepper is produced from a unique cultivar of the pepper species Capsicum annuum.
NUTRITIONAL SCORE: 54
69. GREEN KIWIFRUIT (v)
61kcal, $0.22, per 100g
Kiwifruit are native to China. Missionaries took them to New Zealand in the early 1900s, where they were domesticated.
NUTRITIONAL SCORE: 54
68. GOLDEN KIWIFRUIT (v)
63kcal, $0.22, per 100g
Kiwifruits are edible berries rich in potassium and magnesium. Some golden kiwifruits have a red centre.
NUTRITIONAL SCORE: 54
67. GRAPEFRUIT (v)
32kcal, $0.27, per 100g
Grapefruits (Citrus paradisi) originated in the West Indies as a hybrid of the larger pomelo fruit.
NUTRITIONAL SCORE: 54
66. MACKEREL
139kcal, $2.94, per 100g
An oily fish, one serving can provide over 10 times more beneficial fatty acids than a serving of a lean fish such as cod.
NUTRITIONAL SCORE: 54
65. SOCKEYE SALMON
131kcal, $3.51, per 100g
Another oily fish, rich in cholesterol-lowering fatty acids. Canned salmon with bones is a source of calcium.
NUTRITIONAL SCORE: 54
64. ARUGULA (v)
25kcal, $0.48, per 100g
A salad leaf, known as rocket. High levels of glucosinolates protect against cancer and cardiovascular disease.
NUTRITIONAL SCORE: 55
63. CHIVES (v)
25kcal, $0.22, per 100g
Though low in energy, chives are high in vitamins A and K. The green leaves contain a range of beneficial antioxidants.
NUTRITIONAL SCORE: 55
62. PAPRIKA (v)
282kcal, $1.54, per 100g
Also extracted from the pepper species Capsicum annuum. A spice rich in ascorbic acid, an antioxidant.
NUTRITIONAL SCORE: 55
61. RED TOMATOES (v)
18kcal, $0.15, per 100g
A low-energy, nutrient-dense food that are an excellent source of folate, potassium and vitamins A, C and E.
NUTRITIONAL SCORE: 56

60. GREEN TOMATOES (v)
23kcal, $0.33, per 100g
Fruit that has not yet ripened or turned red. Consumption of tomatoes is associated with a decreased cancer risk.
NUTRITIONAL SCORE: 56
59. GREEN LETTUCE (v)
15kcal, $1.55, per 100g
The cultivated lettuce (Lactuca sativa) is related to wild lettuce (L. serriola), a common weed in the US.
NUTRITIONAL SCORE: 56
58. TARO LEAVES (v)
42kcal, $2.19, per 100g
Young taro leaves are relatively high in protein, containing more than the commonly eaten taro root.
NUTRITIONAL SCORE: 56
57. LIMA BEANS (v)
106kcal, $0.50, per 100g
Also known as butter beans, lima beans are high in carbohydrate, protein and manganese, while low in fat.
NUTRITIONAL SCORE: 56
56. EEL
184kcal, $2.43, per 100g
A good source of riboflavin (vitamin B2), though the skin mucus of eels can contain harmful marine toxins.
NUTRITIONAL SCORE: 56
55. BLUEFIN TUNA
144kcal, $2.13, per 100g
A large fish, rich in omega-3s. Pregnant women are advised to limit their intake, due to mercury contamination.
NUTRITIONAL SCORE: 56
54. COHO SALMON
146kcal, $0.86, per 100g
A Pacific species also known as silver salmon. Relatively high levels of fat, as well as long-chain fatty acids.
NUTRITIONAL SCORE: 56
53. SUMMER SQUASH (v)
17kcal, $0.22, per 100g
Harvested when immature, while the rind is still tender and edible. Its name refers to its short storage life.
NUTRITIONAL SCORE: 57
52. NAVY BEANS (v)
337kcal, $0.49, per 100g
Also known as haricot or pea beans. The fibre in navy beans has been correlated with the reduction of colon cancer.
NUTRITIONAL SCORE: 57
51. PLANTAIN (v)
122kcal, $0.38, per 100g
Banana fruits with a variety of antioxidant, antimicrobial, hypoglycaemic and anti-diabetic properties.
NUTRITIONAL SCORE: 57

50. PODDED PEAS (v)
42kcal, $0.62, per 100g
Peas are an excellent source of protein, carbohydrates, dietary fibre, minerals and water-soluble vitamins.
NUTRITIONAL SCORE: 58
49. COWPEAS (v)
44kcal, $0.68, per 100g
Also called black-eyed peas. As with many legumes, high in carbohydrate, containing more protein than cereals.
NUTRITIONAL SCORE: 58
48. BUTTER LETTUCE (v)
13kcal, $0.39, per 100g
Also known as butterhead lettuce, and including Boston and bib varieties. Few calories. Popular in Europe.
NUTRITIONAL SCORE: 58
47. RED CHERRIES (v)
50kcal, $0.33, per 100g
A raw, unprocessed and unfrozen variety of sour cherries (Prunus cerasus). Native to Europe and Asia.
NUTRITIONAL SCORE: 58
46. WALNUTS (v)
619kcal, $3.08, per 100g
Walnuts contain sizeable proportions of a-linolenic acid, the healthy omega-3 fatty acid made by plants.
NUTRITIONAL SCORE: 58
45. FRESH SPINACH (v)
23kcal, $0.52, per 100g
Contains more minerals and vitamins (especially vitamin A, calcium, phosphorus and iron) than many salad crops. Spinach appears twice in the list (45 and 24) because the way it is prepared affects its nutritional value. Fresh spinach can lose nutritional value if stored at room temperature, and ranks lower than eating spinach that has been frozen, for instance.
NUTRITIONAL SCORE: 59
44. PARSLEY (v)
36kcal, $0.26, per 100g
A relative of celery, parsley was popular in Greek and Roman times. High levels of a range of beneficial minerals. 
NUTRITIONAL SCORE: 59
43. HERRING
158kcal, $0.65, per 100g
An Atlantic fish, among the top five most caught of all species. Rich in omega-3s, long-chain fatty acids.
NUTRITIONAL SCORE: 59
42. SEA BASS
97kcal, $1.98, per 100g
A generic name for a number of related medium-sized oily fish species. Popular in the Mediterranean area.
NUTRITIONAL SCORE: 59
41. CHINESE CABBAGE (v)
13kcal, $0.11, per 100g
Variants of the cabbage species Brassica rapa, often called pak-choi or Chinese mustard. Low calorie. 
NUTRITIONAL SCORE: 60

40. CRESS (v)
32kcal, $4.49, per 100g
The brassica Lepidium sativum, not to be confused with watercress Nasturtium officinale. High in iron.
NUTRITIONAL SCORE: 60
39. APRICOTS (v)
48kcal, $0.36, per 100g
A ’stone’ fruit relatively high in sugar, phytoestrogens and antioxidants, including the carotenoid beta-carotene.
NUTRITIONAL SCORE: 60
38. FISH ROE
134kcal, $0.17, per 100g
Fish eggs (roe) contain high levels of vitamin B-12 and omega-3 fatty acids. Caviar often refers to sturgeon roe.
NUTRITIONAL SCORE: 60
37. WHITEFISH
134kcal, $3.67, per 100g
Species of oily freshwater fish related to salmon. Common in the northern hemisphere. Rich in omega-3s.
NUTRITIONAL SCORE: 60
36. CORIANDER (v)
23kcal, $7.63, per 100g
A herb rich in carotenoids, used to treat ills including digestive complaints, coughs, chest pains and fever.
NUTRITIONAL SCORE: 61
35. ROMAINE LETTUCE (v)
17kcal, $1.55, per 100g
Also known as cos lettuce, another variety of Lactuca sativa. The fresher the leaves, the more nutritious they are.
NUTRITIONAL SCORE: 61
34. MUSTARD LEAVES (v)
27kcal, $0.29, per 100g
One of the oldest recorded spices. Contains sinigrin, a chemical thought to protect against inflammation.
NUTRITIONAL SCORE: 61
33. ATLANTIC COD
82kcal, $3.18, per 100g
A large white, low fat, protein-rich fish. Cod livers are a source of fish oil rich in fatty acids and vitamin D.
NUTRITIONAL SCORE: 61
32. WHITING
90kcal, $0.60, per 100g
Various species, but often referring to the North Atlantic fish Merlangius merlangus that is related to cod.
NUTRITIONAL SCORE: 61
31. KALE (v)
49kcal, $0.62, per 100g
A leafy salad plant, rich in the minerals phosphorous, iron and calcium, and vitamins such as A and C.
NUTRITIONAL SCORE: 62

30. BROCCOLI RAAB (v)
22kcal, $0.66, per 100g
Not to be confused with broccoli. It has thinner stems and smaller flowers, and is related to turnips.
NUTRITIONAL SCORE: 62
29. CHILI PEPPERS (v)
324kcal, $1.20, per 100g
The pungent fruits of the Capsicum plant. Rich in capsaicinoid, carotenoid and ascorbic acid antioxidants.
NUTRITIONAL SCORE: 62
28. CLAMS
86kcal, $1.78, per 100g
Lean, protein-rich shellfish. Often eaten lightly cooked, though care must be taken to avoid food poisoning.
NUTRITIONAL SCORE: 62
27. COLLARDS (v)
32kcal, $0.74, per 100g
Another salad leaf belonging to the Brassica genus of plants. A headless cabbage closely related to kale.
NUTRITIONAL SCORE: 63
26. BASIL (v)
23kcal, $2.31, per 100g
A spicy, sweet herb traditionally used to protect the heart. Thought to be an antifungal and antibacterial.
NUTRITIONAL SCORE: 63
25. CHILI POWDER (v)
282kcal, $5.63, per 100g
A source of phytochemicals such as vitamin C, E and A, as well as phenolic compounds and carotenoids.
NUTRITIONAL SCORE: 63
24. FROZEN SPINACH (v)
29kcal, $1.35, per 100g
A salad crop especially high in magnesium, folate, vitamin A and the carotenoids beta carotene and zeazanthin. Freezing spinach helps prevent the nutrients within from degrading, which is why frozen spinach ranks higher than fresh spinach (no 45).
NUTRITIONAL SCORE: 64
23. DANDELION GREENS (v)
45kcal, $0.27, per 100g
The word dandelion means lion’s tooth. The leaves are an excellent source of vitamin A, vitamin C and calcium.
NUTRITIONAL SCORE: 64
22. PINK GRAPEFRUIT (v)
42kcal, $0.27, per 100g
The red flesh of pink varieties is due to the accumulation of carotenoid and lycopene pigments.
NUTRITIONAL SCORE: 64
21. SCALLOPS
69kcal, $4.19, per 100g
A shellfish low in fat, high in protein, fatty acids, potassium and sodium.
NUTRITIONAL SCORE: 64

20. PACIFIC COD
72kcal, $3.18, per 100g
Closely related to Atlantic cod. Its livers are a significant source of fish oil rich in fatty acids and vitamin D.
NUTRITIONAL SCORE: 64
19. RED CABBAGE (v)
31kcal, $0.12, per 100g
Rich in vitamins. Its wild cabbage ancestor was a seaside plant of European or Mediterranean origin.
NUTRITIONAL SCORE: 65
18. GREEN ONION (v)
27kcal, $0.51, per 100g
Known as spring onions. High in copper, phosphorous and magnesium. One of the richest sources of vitamin K.
NUTRITIONAL SCORE: 65
17. ALASKA POLLOCK
92kcal, $3.67, per 100g
Also called walleye pollock, the species Gadus chalcogrammus is usually caught in the Bering Sea and Gulf of Alaska. A low fat content of less than 1%.
NUTRITIONAL SCORE: 65
16. PIKE
88kcal, $3.67, per 100g
A fast freshwater predatory fish. Nutritious but pregnant women must avoid, due to mercury contamination.
NUTRITIONAL SCORE: 65
15. GREEN PEAS (v)
77kcal, $1.39, per 100g
Individual green peas contain high levels of phosphorous, magnesium, iron, zinc, copper and dietary fibre.
NUTRITIONAL SCORE: 67
14. TANGERINES (v)
53kcal, $0.29, per 100g
An oblate orange citrus fruit. High in sugar and the carotenoid cryptoxanthin, a precursor to vitamin A.
NUTRITIONAL SCORE: 67
13. WATERCRESS (v)
11kcal, $3.47, per 100g
Unique among vegetables, it grows in flowing water as a wild plant. Traditionally eaten to treat mineral deficiency.
NUTRITIONAL SCORE: 68
12. CELERY FLAKES (v)
319kcal, $6.10, per 100g
Celery that is dried and flaked to use as a condiment. An important source of vitamins, minerals and amino acids.
NUTRITIONAL SCORE: 68
11. DRIED PARSLEY (v)
292kcal, $12.46, per 100g
Parsley that is dried and ground to use as a spice. High in boron, fluoride and calcium for healthy bones and teeth.
NUTRITIONAL SCORE: 69

10. SNAPPER
100kcal, $3.75, per 100g
A family of mainly marine fish, with red snapper the best known. Nutritious but can carry dangerous toxins.
NUTRITIONAL SCORE: 69
9. BEET GREENS (v)
22kcal, $0.48, per 100g
The leaves of beetroot vegetables. High in calcium, iron, vitamin K and B group vitamins (especially riboflavin).
NUTRITIONAL SCORE: 70
8. PORK FAT
632kcal, $0.95, per 100g
A good source of B vitamins and minerals. Pork fat is more unsaturated and healthier than lamb or beef fat.
NUTRITIONAL SCORE: 73
7. SWISS CHARD (v)
19kcal, $0.29, per 100g
A very rare dietary source of betalains, phytochemicals thought to have antioxidant and other health properties.
NUTRITIONAL SCORE: 78
6. PUMPKIN SEEDS (v)
559kcal, $1.60, per 100g
Including the seeds of other squashes. One of the richest plant-based sources of iron and manganese.
NUTRITIONAL SCORE: 84
5. CHIA SEEDS (v)
486kcal, $1.76, per 100g
Tiny black seeds that contain high amounts of dietary fibre, protein, a-linolenic acid, phenolic acid and vitamins.
NUTRITIONAL SCORE: 85
4. FLATFISH
70kcal, $1.15, per 100g
Sole and flounder species. Generally free from mercury and a good source of the essential nutrient vitamin B1.
NUTRITIONAL SCORE: 88
3. OCEAN PERCH
79kcal, $0.82, per 100g
The Atlantic species. A deep-water fish sometimes called rockfish. High in protein, low in saturated fats.
NUTRITIONAL SCORE: 89
2. CHERIMOYA (v)
75kcal, $1.84, per 100g
Cherimoya fruit is fleshy and sweet with a white pulp. Rich in sugar and vitamins A, C, B1, B2 and potassium.
NUTRITIONAL SCORE: 96
1. ALMONDS (v)
579kcal, $0.91, per 100g
Rich in mono-unsaturated fatty acids. Promote cardiovascular health and may help with diabetes.
NUTRITIONAL SCORE: 97

A short guide to the 100 most n100. S       

99. FIGS (v)
249kcal, $0.81, per 100g

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