Author Topic: What comes after the ACA?  (Read 1435285 times)

Exflyboy

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Re: What comes after the ACA?
« Reply #5700 on: August 23, 2019, 11:53:43 AM »
yeah that 80% part B coverage is a 20% unlimited liability.. How is Chemo paid?

That looks like Part B to me and with some chemo's costing north of $1M/year.. Yeah you need a Medigap policy or similar.

seattlecyclone

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Re: What comes after the ACA?
« Reply #5701 on: August 23, 2019, 12:12:17 PM »
yeah that 80% part B coverage is a 20% unlimited liability.. How is Chemo paid?

That looks like Part B to me and with some chemo's costing north of $1M/year.. Yeah you need a Medigap policy or similar.

This is one reason why I'm rather wary of the calls for "Medicare for All." The parts of Medicare that you actually buy directly from the government (A and B) have no out-of-pocket maximum, and if you make less than 400% of the poverty level your premiums for a bronze-level ACA plan (with an out-of-pocket maximum!) could well be lower than just the Medicare Part B premiums.

If you're on Medicare and want to limit your financial downsides, you need to buy a supplemental plan from...you guessed it...a private insurance company! These plans don't seem to have any income-based subsidies available, so the difference in premiums only gets bigger.

As much as there is to dislike about the system of private insurance carriers acting under the ACA, simply lowering the Medicare eligibility age without changing the program in other ways seems like it could be one step forward, two steps back for many of us.

ecchastang

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Re: What comes after the ACA?
« Reply #5702 on: August 23, 2019, 01:26:58 PM »
I am glad this year not to have to pay the penalty for not having insurance.  My first year with ACA was 212 per month, next was 320, and I dropped it when it went to over 400 monthly.  Now it is over 500, but next year I will have a low enough income after maxing out solo401k and IRA to get a decent subsidy. 

Exflyboy

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Re: What comes after the ACA?
« Reply #5703 on: August 23, 2019, 02:24:26 PM »
I am glad this year not to have to pay the penalty for not having insurance.  My first year with ACA was 212 per month, next was 320, and I dropped it when it went to over 400 monthly.  Now it is over 500, but next year I will have a low enough income after maxing out solo401k and IRA to get a decent subsidy.

Note if you are interested in a Bronze plan you can also contribute to an HSA to further reduce income, working or not.

ecchastang

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Re: What comes after the ACA?
« Reply #5704 on: August 23, 2019, 02:28:20 PM »
I am glad this year not to have to pay the penalty for not having insurance.  My first year with ACA was 212 per month, next was 320, and I dropped it when it went to over 400 monthly.  Now it is over 500, but next year I will have a low enough income after maxing out solo401k and IRA to get a decent subsidy.

Note if you are interested in a Bronze plan you can also contribute to an HSA to further reduce income, working or not.
Previously had Bronze, but subsidy requires silver.

SugarMountain

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Re: What comes after the ACA?
« Reply #5705 on: August 23, 2019, 02:35:15 PM »
I am glad this year not to have to pay the penalty for not having insurance.  My first year with ACA was 212 per month, next was 320, and I dropped it when it went to over 400 monthly.  Now it is over 500, but next year I will have a low enough income after maxing out solo401k and IRA to get a decent subsidy.

Note if you are interested in a Bronze plan you can also contribute to an HSA to further reduce income, working or not.
Previously had Bronze, but subsidy requires silver.

Does it? I thought you could buy any valid ACA plan but the subsidy amount was based on the 2nd cheapest Silver.

seattlecyclone

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Re: What comes after the ACA?
« Reply #5706 on: August 23, 2019, 02:37:55 PM »
I am glad this year not to have to pay the penalty for not having insurance.  My first year with ACA was 212 per month, next was 320, and I dropped it when it went to over 400 monthly.  Now it is over 500, but next year I will have a low enough income after maxing out solo401k and IRA to get a decent subsidy.

Note if you are interested in a Bronze plan you can also contribute to an HSA to further reduce income, working or not.
Previously had Bronze, but subsidy requires silver.

The cost sharing subsidies (most valuable for folks under 200% of the poverty line) are only available with silver plans. The premium reduction subsidies (for folks under 400% of the poverty line) are available for all plans sold on the exchange, and the dollar amount of the subsidy will be the same regardless of which plan you choose.

Exflyboy

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Re: What comes after the ACA?
« Reply #5707 on: August 23, 2019, 02:53:35 PM »
Right we currently get a subsidy of about $1300/m and pay just over $8/m for our Bronze plan with a $13,200 deductible. Covered at 100% (in theory!) above that.

As we have been on this plan for 3 years and had no claims, the extra savings compared to the Silver plans have more than paid for themselves.

pecunia

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Re: What comes after the ACA?
« Reply #5708 on: August 23, 2019, 06:10:01 PM »
Right we currently get a subsidy of about $1300/m and pay just over $8/m for our Bronze plan with a $13,200 deductible. Covered at 100% (in theory!) above that.

As we have been on this plan for 3 years and had no claims, the extra savings compared to the Silver plans have more than paid for themselves.

That's basically free and you are a rich man.  How do you shield the income?

seattlecyclone

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Re: What comes after the ACA?
« Reply #5709 on: August 23, 2019, 07:43:36 PM »
Right we currently get a subsidy of about $1300/m and pay just over $8/m for our Bronze plan with a $13,200 deductible. Covered at 100% (in theory!) above that.

As we have been on this plan for 3 years and had no claims, the extra savings compared to the Silver plans have more than paid for themselves.

That's basically free and you are a rich man.  How do you shield the income?

You don't necessarily need to shield that much income!

I just signed into our exchange here in Seattle to price out a plan for a couple of 57-year-olds with a $50k income. A bronze HSA plan can be had for $173/month after the $1,042/month subsidy is applied.

The crazy thing is that a 37-year-old couple with the same income would pay more ($286/month after a $331/month subsidy) for the same bronze plan! The reason why? The ACA sets the subsidies so that the net cost of the second-cheapest silver plan in your area is a set percentage of your income. That percentage is the same regardless of your age, so the 37-year-old and 57-year old will end up paying the same price if they pick that particular silver plan. However the insurance companies charge proportionally more for older people.

As you get older, the difference in premiums between different plans will widen, since the sticker price scales up by a similar factor regardless of which plan you choose. If you choose something more expensive than the second-cheapest silver plan, you can therefore expect to pay more for your premiums as you age, assuming constant income. The flip side is that if you choose something less expensive than the second-cheapest silver plan, you can expect your premiums to go down with time.

Given differences in the market between different areas of the country, I could totally believe that the difference in price between a bronze and silver plan is a bit bigger in Corvallis than Seattle, enabling a nearly-free net premium even with a pretty comfortable income level.

ecchastang

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Re: What comes after the ACA?
« Reply #5710 on: August 23, 2019, 07:55:49 PM »
Right we currently get a subsidy of about $1300/m and pay just over $8/m for our Bronze plan with a $13,200 deductible. Covered at 100% (in theory!) above that.

As we have been on this plan for 3 years and had no claims, the extra savings compared to the Silver plans have more than paid for themselves.
[/quote
Had no idea the subsidy would work for a bronze plan.  Income was too high the last couple years to qualify anyway.  Back to having health insurance in 2020.

Exflyboy

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Re: What comes after the ACA?
« Reply #5711 on: August 23, 2019, 08:04:25 PM »
Right we currently get a subsidy of about $1300/m and pay just over $8/m for our Bronze plan with a $13,200 deductible. Covered at 100% (in theory!) above that.

As we have been on this plan for 3 years and had no claims, the extra savings compared to the Silver plans have more than paid for themselves.

That's basically free and you are a rich man.  How do you shield the income?

Actually thats pretty easy, just live on after tax sale of investments.

Then the only real income is the capital gain. Then you can offset some of that by maxing out the contribution to an HSA.


Even better is we don't get hit with Federal income tax either.

A few details.. we need about $50k in spending money and because its all after tax we end up with a MAGI of $31k or so.
« Last Edit: August 23, 2019, 08:19:18 PM by Exflyboy »

SugarMountain

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Re: What comes after the ACA?
« Reply #5712 on: August 23, 2019, 11:04:16 PM »
Right we currently get a subsidy of about $1300/m and pay just over $8/m for our Bronze plan with a $13,200 deductible. Covered at 100% (in theory!) above that.

As we have been on this plan for 3 years and had no claims, the extra savings compared to the Silver plans have more than paid for themselves.

That's basically free and you are a rich man.  How do you shield the income?

Actually thats pretty easy, just live on after tax sale of investments.

Then the only real income is the capital gain. Then you can offset some of that by maxing out the contribution to an HSA.


Even better is we don't get hit with Federal income tax either.

A few details.. we need about $50k in spending money and because its all after tax we end up with a MAGI of $31k or so.

That's basically my plan as well, at least for several years I should be able to manage our income to be very low, harvesting losses and recently invested money that has very little in capital gains. I'm actually worried about showing enough income to stay off of Medicaid

I wasn't aware that you could invest in an HSA as part of the ACA on the exchange. Good to know.

Exflyboy

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Re: What comes after the ACA?
« Reply #5713 on: August 23, 2019, 11:58:02 PM »
Right we currently get a subsidy of about $1300/m and pay just over $8/m for our Bronze plan with a $13,200 deductible. Covered at 100% (in theory!) above that.

As we have been on this plan for 3 years and had no claims, the extra savings compared to the Silver plans have more than paid for themselves.

That's basically free and you are a rich man.  How do you shield the income?

Actually thats pretty easy, just live on after tax sale of investments.

Then the only real income is the capital gain. Then you can offset some of that by maxing out the contribution to an HSA.


Even better is we don't get hit with Federal income tax either.

A few details.. we need about $50k in spending money and because its all after tax we end up with a MAGI of $31k or so.

That's basically my plan as well, at least for several years I should be able to manage our income to be very low, harvesting losses and recently invested money that has very little in capital gains. I'm actually worried about showing enough income to stay off of Medicaid

I wasn't aware that you could invest in an HSA as part of the ACA on the exchange. Good to know.

Actually its the other way round.. If you want to minimise MAGI you want to sell investments with the highest capital gains.

I.e you want to generate the required spending money but minimise your income.

If your income is too low.. then sell investments with minimal gains (but held for longer than 1 year to avoid short term capital gains).. I.e to generate required spending money but getting your MAGI higher.

Yes the HSA only works with a high deductible (Bronze) plan.

We also get about $15k in rent (after depreciation expenses) and so far we have generated our $50k but with a MAGI of about $31k.

We put our rents up this year though so this maybe the last year we score a premium of $8/month.. Gosh darn.. we earn too much money.

God help us when we start pulling on the pensions..:)

Classical_Liberal

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Re: What comes after the ACA?
« Reply #5714 on: August 24, 2019, 12:16:49 AM »
Capital gains are included in MAGI.

Exflyboy

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Re: What comes after the ACA?
« Reply #5715 on: August 24, 2019, 12:17:18 AM »
Ooh.. Here's another thing. You could draw on the contributions to any ROTH IRAs to generate spending money with zero raise in your MAGI.

Exflyboy

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Re: What comes after the ACA?
« Reply #5716 on: August 24, 2019, 12:21:46 AM »
Capital gains are included in MAGI.

Yes but how much spending money you generate per unit of capital gains is the question.

Say you have invested $10k but the investment grows to $20k.. Then you sell. In this case you get $20k you can spend but only have a MAGI increase due to the sale of only $10k.

seattlecyclone

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Re: What comes after the ACA?
« Reply #5717 on: August 24, 2019, 01:05:11 AM »
Yes the HSA only works with a high deductible (Bronze) plan.

A high deductible plan is required for the HSA, yes, but it's not universally true that only bronze plans qualify. While the only HSA-compatible plans on the Seattle exchange right now happen to be at the bronze level, I've seen silver HSA-compatible plans there in prior years, and I've read there's a company planning to offer one again next year.

ecchastang

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Re: What comes after the ACA?
« Reply #5718 on: August 24, 2019, 07:40:04 AM »
Yes the HSA only works with a high deductible (Bronze) plan.

A high deductible plan is required for the HSA, yes, but it's not universally true that only bronze plans qualify. While the only HSA-compatible plans on the Seattle exchange right now happen to be at the bronze level, I've seen silver HSA-compatible plans there in prior years, and I've read there's a company planning to offer one again next year.
Just looked at the exchange and in my area there is one Silver HSA. 

ecchastang

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Re: What comes after the ACA?
« Reply #5719 on: August 24, 2019, 07:54:57 AM »
Here is a question for those in the know. 

Suppose you plug in your numbers and you can get a $421 credit, and you see on the exchange that there is a Bronze HSA plan for $387.  What happens to that $34 difference? 

Can you still get the full tax credit even though the plan you purchase costs less than that?

seattlecyclone

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Re: What comes after the ACA?
« Reply #5720 on: August 24, 2019, 10:07:47 AM »
Here is a question for those in the know. 

Suppose you plug in your numbers and you can get a $421 credit, and you see on the exchange that there is a Bronze HSA plan for $387.  What happens to that $34 difference? 

Can you still get the full tax credit even though the plan you purchase costs less than that?

Nope. You'd forfeit the $34 in that case. See Line 11 of Form 8962. In part (a) you put down your actual premiums for the plan you chose, in part (d) you calculate your maximum credit based on the price of the second-cheapest silver plan, and in part (e) you get your actual credit by choosing the smaller of parts (a) and (d). The government might pay for your health insurance, but they won't pay you to take it.

ecchastang

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Re: What comes after the ACA?
« Reply #5721 on: August 24, 2019, 11:25:20 AM »
Here is a question for those in the know. 

Suppose you plug in your numbers and you can get a $421 credit, and you see on the exchange that there is a Bronze HSA plan for $387.  What happens to that $34 difference? 

Can you still get the full tax credit even though the plan you purchase costs less than that?

Nope. You'd forfeit the $34 in that case. See Line 11 of Form 8962. In part (a) you put down your actual premiums for the plan you chose, in part (d) you calculate your maximum credit based on the price of the second-cheapest silver plan, and in part (e) you get your actual credit by choosing the smaller of parts (a) and (d). The government might pay for your health insurance, but they won't pay you to take it.
Thanks

geekette

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Re: What comes after the ACA?
« Reply #5722 on: August 24, 2019, 11:59:28 AM »
Yes the HSA only works with a high deductible (Bronze) plan.

A high deductible plan is required for the HSA, yes, but it's not universally true that only bronze plans qualify. While the only HSA-compatible plans on the Seattle exchange right now happen to be at the bronze level, I've seen silver HSA-compatible plans there in prior years, and I've read there's a company planning to offer one again next year.
Just looked at the exchange and in my area there is one Silver HSA.
Note that if your income grants you the cost sharing reduction that brings your deductible down below the minimum (I think it was around $1,350 single, $2,700 family in 2019),  it will no longer be HSA eligible.
« Last Edit: August 24, 2019, 01:10:33 PM by geekette »

pecunia

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Re: What comes after the ACA?
« Reply #5723 on: August 24, 2019, 01:19:44 PM »
Capital gains are included in MAGI.

Yes but how much spending money you generate per unit of capital gains is the question.

Say you have invested $10k but the investment grows to $20k.. Then you sell. In this case you get $20k you can spend but only have a MAGI increase due to the sale of only $10k.

You will actually be paying more in a few years when you are of medicare age.  Maybe, we'll have universal health care by then, but there are extremely powerful forces allied against it.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #5724 on: August 28, 2019, 02:19:23 PM »
The level of health care problems people can face through no fault of their own is well illustrated in this excellent Netflix show called "Diagnosis"
It's truly extraordinary.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #5725 on: September 18, 2019, 07:10:16 PM »
I'm shocked by these statistics:

"And Americans are sick — much sicker than many realize. More than 100 million adults — almost half the entire adult population — have pre-diabetes or diabetes. Cardiovascular disease afflicts about 122 million people and causes roughly 840,000 deaths each year, or about 2,300 deaths each day. Three in four adults are overweight or obese. More Americans are sick, in other words, than are healthy."

Our Food Is Killing Too Many of Us
https://nyti.ms/2KTROA1

pecunia

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Re: What comes after the ACA?
« Reply #5726 on: September 18, 2019, 07:47:38 PM »
I'm shocked by these statistics:

"And Americans are sick — much sicker than many realize. More than 100 million adults — almost half the entire adult population — have pre-diabetes or diabetes. Cardiovascular disease afflicts about 122 million people and causes roughly 840,000 deaths each year, or about 2,300 deaths each day. Three in four adults are overweight or obese. More Americans are sick, in other words, than are healthy."

Our Food Is Killing Too Many of Us
https://nyti.ms/2KTROA1

NY Times doesn't like me.  It won't let me read the article.  I've read too many free articles in their opinion, but I've read similar stuff I'm sure.  What would cause people to have incentive to change their eating habits?

What if we didn't have free market medicine?  There is little incentive for free market medicine to want us to be healthy?  If we have all the diseases brought on by poor eating, they can charge big bucks to treat us.  If the government paid for the health care, it would be from taxes.  There would be a lot of money paid from taxes.  That money would be paying for all of the diseases we have developed from eating the contemporary American diet.  People don't like paying taxes.  There would be an incentive to look for ways to not pay so many taxes.  If there were less sick people, the taxes would be lower.  If people ate right, there would be less sick people.  There would be an incentive to encourage people to eat right. 

The government has had anti smoking campaigns.  They have had a great deal of success.  You can still smoke if you want, but you know some of the health risks.  There is not much of an anti bad food campaign.  Lots of money to be made shoveling fast fried food and junk food to the public.  If the government paid for health care there would be lots of tax dollars saved in keeping people from being sick.  It would not cost a lot of money to have a healthy eating campaign.

Here's another side issue.  If we didn't have to worry about keeping a job for health care, it would free us to do what we wanted.  Is it possible that there would be people who would take time away from present vocations to pursue more creative work?  Would there be new products developed since people would no longer be confined to the work which their employer wants?  Would we have more great novels written?  Basically, would people be more free?

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What comes after the ACA?
« Reply #5727 on: September 19, 2019, 01:44:55 AM »
I think to really address those problems you have to dig a bit deeper and address the farming and farming subsidies issue. The government spends big time to subsidize the types of foods that make us unhealthy. Refined flour and high fructose corn syrup are in everything due to farm subsidies. Meat is cheap due to subsidies as excess corn and soy are given to fatten animals that don’t naturally eat corn and soy. How about we pull subsidies for wheat and soy and corn and put them instead in fruits and vegetables and nuts?

Freakonomics had a good podcast recently on this entitled something like how the supermarket helped us win the Cold War.
« Last Edit: September 19, 2019, 01:46:54 AM by ysette9 »

pecunia

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Re: What comes after the ACA?
« Reply #5728 on: September 21, 2019, 06:42:31 PM »
You are right.  It's almost like a conspiracy to keep us unhealthy.  I wonder if people started to eat more healthy if subsidies would be needed.

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Re: What comes after the ACA?
« Reply #5729 on: October 02, 2019, 06:43:45 AM »
To be more specific, you can make a good case that it is the US government's dietary recommendations that are driving the spread of metabolic syndrome.  The recommendation for a high carbohydrate, grain-based diet is simply not consistent with human biology, and many people can't tolerate it.

The idea was based on a combination of shoddy science and personal preferences among a few politicians in the 1970s, and took on a life of its own because it happened to align very well with the needs of the commodity markets, big farming, and (processed) food industry. There are many sources to read more about this, but check out Dr. Malcolm Kendrick's blog as a starting point - he is a British GP who has made a career out of carefully investigating and debunking studies that supposedly support the diet/cholesterol/heart disease hypothesis.

I'm amazed at the depth of the misinformation that's been uncovered, and the fact that since the 1970s we've all been unwitting participants in a giant dietary clinical trial.  Time to stop it!

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Re: What comes after the ACA?
« Reply #5730 on: October 02, 2019, 07:47:10 AM »
To be more specific, you can make a good case that it is the US government's dietary recommendations that are driving the spread of metabolic syndrome.  The recommendation for a high carbohydrate, grain-based diet is simply not consistent with human biology, and many people can't tolerate it.

The idea was based on a combination of shoddy science and personal preferences among a few politicians in the 1970s, and took on a life of its own because it happened to align very well with the needs of the commodity markets, big farming, and (processed) food industry. There are many sources to read more about this, but check out Dr. Malcolm Kendrick's blog as a starting point - he is a British GP who has made a career out of carefully investigating and debunking studies that supposedly support the diet/cholesterol/heart disease hypothesis.

I'm amazed at the depth of the misinformation that's been uncovered, and the fact that since the 1970s we've all been unwitting participants in a giant dietary clinical trial.  Time to stop it!

+1,000,000

I can't even begin to describe how much my health improved after I eliminated nearly all grains/starches/sugars from my diet.  I scrutinize the labels on any groceries I buy.  I don't worry about eating a lot of healthy fats.  The dietary recommendations, the "heart healthy whole grains", the food pyramid -- It's all a bunch of horse shit.  I wish I would have discovered this so much sooner in my life.

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Re: What comes after the ACA?
« Reply #5731 on: October 03, 2019, 11:09:22 AM »
To be more specific, you can make a good case that it is the US government's dietary recommendations that are driving the spread of metabolic syndrome.  The recommendation for a high carbohydrate, grain-based diet is simply not consistent with human biology, and many people can't tolerate it.

The idea was based on a combination of shoddy science and personal preferences among a few politicians in the 1970s, and took on a life of its own because it happened to align very well with the needs of the commodity markets, big farming, and (processed) food industry. There are many sources to read more about this, but check out Dr. Malcolm Kendrick's blog as a starting point - he is a British GP who has made a career out of carefully investigating and debunking studies that supposedly support the diet/cholesterol/heart disease hypothesis.

I'm amazed at the depth of the misinformation that's been uncovered, and the fact that since the 1970s we've all been unwitting participants in a giant dietary clinical trial.  Time to stop it!

+1,000,000

I can't even begin to describe how much my health improved after I eliminated nearly all grains/starches/sugars from my diet.  I scrutinize the labels on any groceries I buy.  I don't worry about eating a lot of healthy fats.  The dietary recommendations, the "heart healthy whole grains", the food pyramid -- It's all a bunch of horse shit.  I wish I would have discovered this so much sooner in my life.

I'd love to know more about what you eat over a week's time.

rantk81

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Re: What comes after the ACA?
« Reply #5732 on: October 03, 2019, 11:32:29 AM »
I'd love to know more about what you eat over a week's time.

Breakfast: Usually not hungry. I have a couple cups of coffee with heavy whipping cream and a spoon full of coconut oil on work days.  On weekends, I'll have a late breakfast in lieu of lunch, typically a spinach or broccoli omelette, with cheese and sour cream.  Alternatively, hard boiled egg salad with avocado oil mayo and tuna.

Lunch: I pack a lunch that usually consists of the left-over protein item from the prior dinner, plus frozen veggies (usually broccoli, green beans, or brussels sprouts), drizzled with olive oil or avocado oil, and sea salt.

Dinner: Protein items are usually the fattier cuts of beef, pork, & chicken.  Occasionally canned tuna.  Non-starchy veggies (cabbage, broccoli, green beans, brussels sprouts, etc) cooked in avocado oil with fresh garlic or ginger or other spices.  Or baby spinach topped with avocado or olive oil, or sour cream, and sea salt.  Half an avocado. Some cheese.

Snacks: Small handful of macadamia nuts or almonds.

I avoid potatoes, pasta, bread, grains, rice, cereals, oats, anything with added sugar, the sweeter fruits, products with seed/vegetable/canola/soybean oils, low-fat diary.

mm1970

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Re: What comes after the ACA?
« Reply #5733 on: October 03, 2019, 11:40:30 AM »
To be more specific, you can make a good case that it is the US government's dietary recommendations that are driving the spread of metabolic syndrome.  The recommendation for a high carbohydrate, grain-based diet is simply not consistent with human biology, and many people can't tolerate it.

The idea was based on a combination of shoddy science and personal preferences among a few politicians in the 1970s, and took on a life of its own because it happened to align very well with the needs of the commodity markets, big farming, and (processed) food industry. There are many sources to read more about this, but check out Dr. Malcolm Kendrick's blog as a starting point - he is a British GP who has made a career out of carefully investigating and debunking studies that supposedly support the diet/cholesterol/heart disease hypothesis.

I'm amazed at the depth of the misinformation that's been uncovered, and the fact that since the 1970s we've all been unwitting participants in a giant dietary clinical trial.  Time to stop it!
I spent years reading about health and fitness.  And years trying to lose weight/ maintain a healthy weight.  But almost always based on the government recommendations - even had an account at mypyramid.gov.  Thing is, even for an active female in her 30s (back then), 6+ servings of grain was a LOT!

Eventually kept reading, found "Death by Food Pyramid" by Denise Minger, which led me to "What to Eat" by Luise Light.  She was in charge of coming UP with the food pyramid in the 1980s.  Hired a bunch of experts, reviewed all the literature...made her team's recommendations ... and got shot down because of the "don'ts".  She quit in frustration, and the bastardized food pyramid came out a few years later, looking nothing like she'd recommended.  (Hint: 0-2 servings of grain per day, whole grains only, active people and teenagers can probably tolerate more.)

For fun, I went into the government website a few years ago, looked at their current recommendations (still 6 servings of carbs), looked at their recommendations for caloric intake also.  You literally cannot have a caloric intake as low as recommended if you include all those carbs as well as the other recommendations.  I did the math.

radram

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Re: What comes after the ACA?
« Reply #5734 on: October 04, 2019, 08:05:40 AM »
  You literally cannot have a caloric intake as low as recommended if you include all those carbs as well as the other recommendations.  I did the math.

I would love it if you would post your math here.

bacchi

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Re: What comes after the ACA?
« Reply #5735 on: October 04, 2019, 08:36:33 AM »
There's no food pyramid anymore. It's now a "food plate." From http://www.foodpyramid.com/mypyramid/, though:

** at least 3 ounces of whole grains **
1.5 ounces of brown rice = 300 calories
2 slices of wheatbread = 200 calories

** 2.5 cups of veggies **
1 cup of bell pepper = 31 calories
2 cups of spinach = 14 calories
.5 cup of kale = 15 calories
= 60 calories

** 2 cups of fruit **
1 cup of banana = 135 calories
1 cup of blackberries = 65 calories
= 200 calories

avocado oil for cooking and in salad dressing, 2 tablespoons? = 250 calories

** 3 cups of milk/yogurt/cheese **
1.5 cup of milk = 220 calories
1 cup of yogurt = 250 calories
.5 cup of cheese = 225 calories


That's 1705 calories. Add in some lentils and you're there.


zolotiyeruki

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Re: What comes after the ACA?
« Reply #5736 on: October 04, 2019, 09:52:34 AM »
** 3 cups of milk/yogurt/cheese **
1.5 cup of milk = 220 calories
1 cup of yogurt = 250 calories
.5 cup of cheese = 225 calories
Is cheese really counted equivalent, volume-wise, to milk?  That's an awful lot of cheese if that's how you prefer to take your dairy.

bacchi

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Re: What comes after the ACA?
« Reply #5737 on: October 04, 2019, 10:32:44 AM »
** 3 cups of milk/yogurt/cheese **
1.5 cup of milk = 220 calories
1 cup of yogurt = 250 calories
.5 cup of cheese = 225 calories
Is cheese really counted equivalent, volume-wise, to milk?  That's an awful lot of cheese if that's how you prefer to take your dairy.

Good point.

One of the faults of the Pyramid I guess. I was just throwing in foods to meet the minimums.

mm1970

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Re: What comes after the ACA?
« Reply #5738 on: October 04, 2019, 11:05:40 AM »
  You literally cannot have a caloric intake as low as recommended if you include all those carbs as well as the other recommendations.  I did the math.

I would love it if you would post your math here.

I don't have it anymore, and it came from the "Super Tracker", which was shut down last year.  It would make a recommendation for each food group, and a total calorie recommendation.  But the total calorie recommendation was around 1700-1800, if my memory serves, and the minimum calories when you added everything up came to 1900-2000.

Quote
** at least 3 ounces of whole grains **
1.5 ounces of brown rice = 300 calories
2 slices of wheatbread = 200 calories

Note that the myplate site STILL says "total of 5-6 ounces of grain for women" (yes, at least 3 should be whole grain, but they are still recommending a total grain intake of about 2x that).

bacchi

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Re: What comes after the ACA?
« Reply #5739 on: October 04, 2019, 11:44:21 AM »
Quote
** at least 3 ounces of whole grains **
1.5 ounces of brown rice = 300 calories
2 slices of wheatbread = 200 calories

Note that the myplate site STILL says "total of 5-6 ounces of grain for women" (yes, at least 3 should be whole grain, but they are still recommending a total grain intake of about 2x that).

For women, from http://www.foodpyramid.com/myplate/:

** 5-6 ounces of (whole) grains **
1.5 ounces of brown rice = 300 calories
4 slices of wheat bread = 400 calories
= 700 calories

** 2-2.5 cups of veggies **
1 cup of bell pepper = 31 calories
2 cups of spinach = 14 calories
.5 cup of kale = 15 calories
= 60 calories

** 1.5-2 cups of fruit **
.66 cup of banana (=1 banana) = 90 calories
1 cup of blackberries = 65 calories
= 155 calories

** 3 teaspoons of veggie oil ***
avocado oil for cooking and in salad dressing, 1 tablespoons = 125 calories

** 3 cups of milk/yogurt/cheese **
1 cup of milk = 150 calories
1 cup of yogurt = 250 calories
1.5 ounce of cheese (=1 cup) = 175 calories
= 575

Total = 1615 calories

Leaving precious little for 5 ounces of protein (legumes, nuts, meat, etc.) There's enough calorie room for 1-2 tablespoons (=1-2 equiv. ounces) of peanut butter. :)

However, protein equivalents include milk and yogurt and cheese and whole wheat bread, so it's not quite as bad as it seems.

I'm confident the creators worked it out but only on specific food choices. They might've gone through different foods and kicked out those that didn't fit until they got exactly the right combination. "This works! Publish it!"


As a grainarian+legumarian, I generally eat lentils and beans and skimp on the dairy.
« Last Edit: October 04, 2019, 11:45:55 AM by bacchi »

seattlecyclone

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Re: What comes after the ACA?
« Reply #5740 on: October 04, 2019, 01:23:44 PM »
For women, from http://www.foodpyramid.com/myplate/:

** 5-6 ounces of (whole) grains **
1.5 ounces of brown rice = 300 calories
4 slices of wheat bread = 400 calories
= 700 calories

From https://www.choosemyplate.gov/eathealthy/grains, they define grain consumption recommendations in terms of "ounce equivalents." They have a table on that page for what that means in terms of common grains. For brown rice, an "ounce equivalent" is a half cup of cooked rice. That's 108 calories per Google. A slice of bread counts as on "ounce equivalent." Also roughly 100 calories. Your woman eating 5-6 "ounce equivalents" from rice and bread would probably be getting 500-600 calories from grains, not 700.


Quote
However, protein equivalents include milk and yogurt and cheese and whole wheat bread, so it's not quite as bad as it seems.

If you eat cheese does that mean it counts as a full serving of both dairy and protein, or does that just mean that you can have an extra serving of cheese in lieu of meat or beans or nuts?

bacchi

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Re: What comes after the ACA?
« Reply #5741 on: October 04, 2019, 02:03:07 PM »
For women, from http://www.foodpyramid.com/myplate/:

** 5-6 ounces of (whole) grains **
1.5 ounces of brown rice = 300 calories
4 slices of wheat bread = 400 calories
= 700 calories

From https://www.choosemyplate.gov/eathealthy/grains, they define grain consumption recommendations in terms of "ounce equivalents." They have a table on that page for what that means in terms of common grains. For brown rice, an "ounce equivalent" is a half cup of cooked rice. That's 108 calories per Google. A slice of bread counts as on "ounce equivalent." Also roughly 100 calories. Your woman eating 5-6 "ounce equivalents" from rice and bread would probably be getting 500-600 calories from grains, not 700.

Thanks for the correction. This pyramid/myplate thing is complicated.

Quote
Quote
However, protein equivalents include milk and yogurt and cheese and whole wheat bread, so it's not quite as bad as it seems.

If you eat cheese does that mean it counts as a full serving of both dairy and protein, or does that just mean that you can have an extra serving of cheese in lieu of meat or beans or nuts?

I've no idea. I'm sure it's on the site somewhere but I'm not dedicated enough to look.

The best thing for American diets might be as simple as: Stop eating (frozen) processed foods. Stop eating fast food. Stop drinking cola.

seattlecyclone

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Re: What comes after the ACA?
« Reply #5742 on: October 04, 2019, 02:08:41 PM »
The best thing for American diets might be as simple as: Stop eating (frozen) processed foods. Stop eating fast food. Stop drinking cola.

I think you've captured much of part 1 of Michael Pollen's "Eat food. Mostly plants. Not too much." That simplicity really resonates with me.

Our understanding of dietary science changes. I remember in the 90s it was all "Fats are bad! Eat lots of grain instead!" Now it's gone a bit far in the other direction "Grains are bad! Eat lots of fat and protein instead!"

Just eat a reasonable amount of real food, most any kind, and you'll probably do okay.

freya

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Re: What comes after the ACA?
« Reply #5743 on: October 04, 2019, 02:44:33 PM »
The best thing for American diets might be as simple as: Stop eating (frozen) processed foods. Stop eating fast food. Stop drinking cola.

I think you've captured much of part 1 of Michael Pollen's "Eat food. Mostly plants. Not too much." That simplicity really resonates with me.

Our understanding of dietary science changes. I remember in the 90s it was all "Fats are bad! Eat lots of grain instead!" Now it's gone a bit far in the other direction "Grains are bad! Eat lots of fat and protein instead!"

Just eat a reasonable amount of real food, most any kind, and you'll probably do okay.

That was my sentiment also - I was very much on the no processed food, minimize added sugar, eat whole grains and beans bandwagon.  After I hit menopause the pounds just kept climbing no matter what I did.  I finally crossed the line into "overweight" territory at my last checkup, and worse yet it was all around my middle.  Hello metabolic syndrome.

I tried the keto diet because a friend had started it and was getting great results.  To my astonishment, I have shed about 15 lbs in 2 months, feel SO much better, and a whole litany of nagging health problems that I thought was just part of getting older went away.  Completely!  And, I'm no longer dead exhausted at night, or tired in the morning.

I could care less what Michael Pollan or the US food plate says. I do care about properly interpreting studies, which leads one to completely opposite conclusions from the standard mantra of "low-fat, you should base your diet on grains and vegetable oils and avoid red meat like the plague".  This is it for me. Once I'm at a weight I'm happy with, I will add foods back one at a time to find out what my limits are, and then I plan to stay within those limits forever. 

bigote2032

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Re: What comes after the ACA?
« Reply #5744 on: October 04, 2019, 04:22:26 PM »
Ok, I have been reading this nutritional non sense in the last few days.  Some of you deserve a good amount of friendly punches to try to make you healthy and undo the brainwashing from the mainstream media and the meat and diary industry.

In the following points, I  will debunk a bunch of myths first:

Note that my advise is for regular people that don't have any specific digestion issues with some foods.

- You have a war against grains and carbs.  WAKE UP! This is total BS rumors spread by the meat/diary industry people!  Our bodies run on carbs.  Good quality carbs won't make you fat.  My dad told me he gained 5 points by eating potatoes, but then my mom told me about all the pork and beef he ate during that period.

- Stop prioritizing weight loss and focus more on being healthy.  Don't put your health at risk with these diets. One example is the Get-Cancer-Fast diet, I mean, Keto diet.  This diet was manufactured by the meat industry.  You think it is healthy to load yourself with dead animals? Again, don't take advise of those friends hyping and focusing on weight loss, this will make you sick and it is not sustainable.

- You have experience figuring out the truth, you did it with the FIRE movement, you were able to stop listening the mainstream media and the financial apparatus.  You ignored the lies telling you that the only way to retire is until you reach 65.  You might not make it to 65 if you keep harming yourself.  Adopt the FIRE diet.  You ask what is that? The whole foods plant based diet.  It will make you lose weight if you are overweight, it will make you gain weight if you are under your recommended weight range, in other words it will put your body where it is supposed to be.  It will prevent you from dying by one of the top American killers: cancer, cardio-disease, Alzheimer's, dementia, and the list goes on.

- Why is this the FIRE diet you ask? a) You care about money? Good news, this is the cheapest diet you can get, I live on potatoes, rice, beans and bread.  How much is that steak? b) FIRE is about having freedom to do what you want, living a less stressed life, hence being healthy.   Plant based will give you the longest mileage c) Environment: yeah, people go nuts about cars polluting the environment but nobody talks about the largest contributor to climate change, all those cows you are eating.

- Stop coming up with excuses on why you won't eat healthy.  Number one excuse: I need my protein.  Boom, you deserve a big punch in the face now.  You think meat is the only food that has protein? All foods have some level of protein, this is another lie brought to you by the meat industry.  Excess of protein in the American diet is destroying thousands of kidneys every diet.  Kids getting stones in very early ages.  Another excuse? I am a macho macho man and I need my meat.  Boom, uppercut punch for you.  Meat is bad for your blood pressure which eventually affects that genital instrument down there, it won't go up anymore pretty soon, so not too macho.  I practice body building and follow plant based and have actually experienced increased performance and endurance after I stopped eating dead things.  I don't use any of those expensive protein shakes that none of us need, my protein comes from beans, lentils, quinoa, peas, tofu, heck, so many great options for protein.

- Accept the consequences of your decisions, look in the mirror and say to yourself: "I can't give up my great steak, eggs and cheese.  I love it so much.  I have been eating it for long, this is the only way I know of eating.  I accept my destiny, I accept that I can die at any moment.  An artery will eventually be blocked, stroke, heart attacks are very likely.  If these compilations don't kill me before reaching old age, I will experience a slow and painful death caused by dementia or Alzheimer's.  Just be truthful to yourself and the people that care about your health and stop telling people lame excuses.  What you eat is very personal, people are conditioned to eat what society tells you what to eat, what it's considered to be delicious.

- All independent research studies (does not include all studies sponsored by the meat and diary industry which are the ones you most likely will find in mainstream media) have found how bad meat and diary is for you, period!

- Restaurants are not in the business of taking care of your health - STOP eating out! The reason why we love eating out is because restaurants load their foods with the things we love: salt, sugar, oil and butter.  It is good for the FIRE movement but allow yourself to go out for special occasions.

- For most doctors, your health is not their best interest.  The older generations (say my mom who is 75 years old), trust their doctors unconditionally.  The new generations (some X and millennials), thanks to the Internet know much better how the health system works, it is a factory of money.  Your doctors are better off by recommending blood pressure pills than recommending you a natural way to decrease your BP.  Example: my uncle, a man on his early 60s that seems to be a very healthy individual, had a three artery blockage, he is lucky to be alive.  The doctor told him to decrease eating steak and eat chicken instead! Chicken is as bad as steak (BOOK, debunked another falseness), it is fat.  THIS IS AN EMERGENCY, my uncle should stop eating all kinds of meat and diary and oil NOW.  He was given another chance to live but he loves his tasty/unhealthy food too much.  I tried to convince him, no luck, he is just like most humans, nutrition is too personal, don't mess up with what I eat.  He will probably die from cardiovascular complications.

- Still concerned about your weight? Don't kill yourself at the gym! The main thing is what you eat, you are what you eat.

- Stop eating oil!!! Yes, that goes for ANY kind of oil (canola, olive, coconut, you name it).  Oil has very close effect than eating meat.

- If you are willing to change, start slow. Decrease the amount of bad stuff you are eating, eventually become a flexitarian (a plant based dude that occasionally eats meat and diary, say no more than once a week).  Becoming a flexitarian will have tremendous positive effect on your health and the environment.

- We don't have the digestive tract of a lion, our system if not designed to eat meat (this is a fact people, science) , it starts rotting inside of us before we can get it out.  Think about it for a moment, gross right?

- Plant based diet is delicious.  Another lie: plant based is not good or tasty.  Trust me, there are TONS of amazing recipes out there with no dead things on them.  I am the most picky person and I became plant based, you can do it too.

- Meat and diary replacement processed foods are NOT HEALTHY (loaded with sodium and oil) - however, they do give you options to have less negative impact on the environment.  There is the impossible burger and beyond meat burger, but consider BBQ beans burgers, tons of recipes and they are delicious and super healthy.

- Who are you? I am a guy that comes from a family with long tradition of BBQ and steak and eggs, with many relatives dying young (example, an uncle that died at 33 of enlarged heart due to cardio disease) and with high blood pressure.  It is true that some genes in the family can make you more sensitive to cardio decease when you eat unhealthy foods, but you have all the power to control that by eating healthy.  I decided I wanted to live until I get gray hair.  I was like many of you, I was living in denial, took me a period of 5 years to come to terms and decide to give up the foods that I grew up eating and that I love.  It took multiple conversations with friends of  fans of keto, paleo, extreme vegans and plant-based.  I studied the motivations of why people brought diets to their lives, I found great and bad motivations.  I was concerned about my physical performance at sports.  I had so many doubts.  I wanted to keep eating meat without hurting the planet, I though about many alternatives.  In the end I gave up, I tried plant based and never looked bad, it took a couple of years to find my best recipes to make at home or plant based oil free restaurants.  Once I found the, I finally had my system to support my healthy lifestyle.  My BP went down, I sleep better, I have the highest energy levels, my digestive system is doing so much better, heck, even my dental health improved so much by not having pieces of meat rotting between my teeth.  Do you have bad breath? Give plant based a try and you will be surprised!  I took a lot of reading and a lot of research, but I made it here and I am a better version of myself thanks to all that.  And best of all, plant based id sustainable, it is a life style and will keep you healthy forever.  The human body is amazing! It is resilient, if you feed it right, it is capable to reverse chronic disease! Be good to it!

Sorry for the long post, but if this can save somebody's life, it is all worth it.  Remember there are people that love you out there, maybe do it for them?

If this makes any sense to you, here are some resources:

China Study:
https://www.amazon.com/China-Study-Comprehensive-Nutrition-Implications/dp/1941631568/ref=sr_1_2?keywords=china+study&qid=1570227280&sr=8-2

The Starch Solution:
https://www.amazon.com/Starch-Solution-Regain-Health-Weight/dp/1623360277/ref=sr_1_1?keywords=starch+solution+mcdougall&qid=1570227474&sr=8-1

All the best!

Thanks.

All the best
« Last Edit: October 04, 2019, 04:42:08 PM by bigote2032 »

mm1970

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Re: What comes after the ACA?
« Reply #5745 on: October 04, 2019, 04:46:14 PM »
Quote
Good news, this is the cheapest diet you can get, I live on potatoes, rice, beans and bread.

Ah ha ha ha

Quote
- You have experience figuring out the truth, you did it with the FIRE movement, you were able to stop listening the mainstream media and the financial apparatus.  You ignored the lies telling you that the only way to retire is until you reach 65.  You might not make it to 65 if you keep harming yourself.  Adopt the FIRE diet.  You ask what is that? The whole foods plant based diet.  It will make you lose weight if you are overweight, it will make you gain weight if you are under your recommended weight range, in other words it will put your body where it is supposed to be.  It will prevent you from dying by one of the top American killers: cancer, cardio-disease, Alzheimer's, dementia, and the list goes on.

Been there, done that, I'm a pre-menopausal woman who actually figured out what to eat by...you guessed it...experimenting.  Beans, rice, potatoes = extra pounds, overweight, could NOT drop that baby weight (had a baby at 42), kept weighing in at 168 pounds - could get down to 153, then back up to 168.

Managed to get back down to eh...153, then really cut down the carbs to 2 servings a day and got to 140-ish.  It was great!  No more afternoon sleepies, no more constant hunger.  Lots more fat (avocado, nuts, olive oil, whatever.)  Started having digestive issues and then dropped wheat / gluten - BOOM, 8 pounds dropped off like that.  No more digestive issues.  I do MUCH better with a moderate carb (2-4 servings per day) and higher fat diet.

Might I suggest "What to Eat" by Luise Light?  If you are actually interested in reading all types of books, not just the ones that fit your agenda.  (Yes I read the China Study, it's cherry picked to high heaven).

bigote2032

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Re: What comes after the ACA?
« Reply #5746 on: October 04, 2019, 04:57:42 PM »
mm1970, glad you found something that works for you.

You are laughing about how cheap plant based is? This is not for debate, it is a fact.

My wife is gluten intolerant and has IBS, so most carbs hurt her, and she avoids them, that is an edge case.

China study is cherry picked in the sense that the cherries are facts that most people hate to read about.

I have a vague idea on the struggles women go trough in this society since I am married to one.  But keep in mind that just because you are losing weight does not mean you are healthy, you might look good but you are doing harm to your organs.  Take the case of my uncle with the bypass surgery, he could have mistaken for an athlete but he was very unhealthy inside. 

Is actually impossible to gain weight eating rice and beans period.  This is one of the main arguments people have, "I gained ton of weight by eating rice and beans!", but they fail to tell you what other things they were eating (hint: fats, nuts...)

Nobody is going to put their body measurements in their grave's tombstone, make sure you eat something that makes you look good inside and outside.

It is very irresponsible to support an industry that is destroying the planet just because you want to look good.

Make no mistake, meat and fatty diets will manifest themselves in your body one way or the other, short term or long term.  You might feel good know, but down the road a chronic disease will start showing up.  They will come, as certain as taxes. My father in law eats lots of meat, and his BP is perfect, however, he already had some other serious kidney complication because his diet.

I will break it down to you: I don't have an agenda, I work in the tech industry.  The ones with the agenda are the folks in the meat and diary industry, there is no big money in healthy foods.  A good friend of mine works as quality supervisor at a milk company, he talks about me just like you talk about me.  He does have an agenda.

I will read your recommended book, thanks for recommending it.
« Last Edit: October 04, 2019, 07:01:37 PM by bigote2032 »

mm1970

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Re: What comes after the ACA?
« Reply #5747 on: October 04, 2019, 08:49:40 PM »
The last "meat" I ate was a 3 oz piece of salmon on Sunday, so thanks my organs are fine.

The China Study specifically ignored stronger correlations in favor of a singular agenda. There are plenty of critical reviews out there, by people who reviewed the source data.

You cannot talk about carbs and calories without covering the insulin response, which lots of people ignore.  A calorie is not a calorie.

So let me point out this: when keeping caloric intake constant...because yes, I weighed and measured everything...I lost weight after I reduced carbs in favor of fat.

mm1970

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Re: What comes after the ACA?
« Reply #5748 on: October 04, 2019, 09:12:46 PM »
Another good book that I read was "Refuse to Regain" by Dr. Barbara Berkeley. She is an obesity doctor who has worked with and studied obese patients for years. In her work, she found that the bodies function differently, specifically with respect to how they handle carbs.

People who are "NOW" never overweight can process carbs differently than people who were "FOW" formerly overweight. Basically, if you get to be obese, you have possibly permanently altered how your body functions with respect to carbs, and weight loss does not fix it.

It was fascinating.

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Re: What comes after the ACA?
« Reply #5749 on: October 04, 2019, 09:39:44 PM »
I have had a few friends of the family (ranging in age from early 30s to late 50s) have great success following diets from Dr. Dean Ornish.

I see he has authored a book that came out earlier this year with rave reviews entitled Undo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases.

I believe, though, that this was the book all my acquaintances used:  https://www.amazon.com/Ornishs-Program-Reversing-Heart-Disease/dp/0804110387/ref

Note: I have not read any of his books myself.