Drink up, Belgium. Stay dry, Canada

The ideas and innovators shaping health care

Jan 25, 2023 View in browser   By Erin Schumaker, Carmen Paun, Ben Leonard and Ruth Reader WORLD VIEW A full stein exceeds the recommended daily limit in many countries. | AP Photo/Matthias Schrader No amount of alcohol is healthy, the World Health Organization announced this month, adding that drinking beer, wine and spirits contributes to millions of annual deaths. That may have given a boost to proponents of a dry January, but it probably surprised many Americans who've heard that a little red wine is good for the heart or that beer is packed with protein and B vitamins. Study whiplash: While nutrition research is often contradictory, a growing body of evidence suggests that even moderate drinking is linked to health problems, including cancer and high blood pressure. An estimated 1 in 8 deaths among U.S. adults ages 20 to 64 is attributable to excess alcohol use, according to research published in JAMA Network Open in November. But how much the public health experts say you can drink depends on where you're drinking: — In the U.S., dietary guidelines from the Departments of Health and Human Services and Agriculture suggest men can safely have two drinks a day while women should have only one. — Among other wealthy nations, the Belgians are the most blasé about imbibing, saying that men can safely enjoy up to 21 drinks a week, no matter whether they're tripels, dubbels, lambics, trappist or commercial. — Next door in the Netherlands, the Dutch are told to eschew their Heineken and Amstel altogether or have at most one glass a day. — The Canadian Centre on Substance Use and Addiction's new guidelines advise Canadians to reduce their alcohol intake as much as possible, making the recommendations some of the most conservative among wealthy countries. "It doesn't matter what kind of alcohol it is," the centre warns. "Drinking alcohol has negative consequences. The more alcohol you drink per week, the more the consequences add up." Complicating matters is that countries define a serving of alcohol differently. A standard serving in the U.S. is 14 grams of pure alcohol, while in the U.K., it's 8 grams. Some countries, like the U.S., use separate guidelines for men and women; other countries don't distinguish between the genders. The CDC says alcohol affects men and women differently because of biological differences in body structure and chemistry that cause women to absorb more alcohol and metabolize it more slowly than men. Time to teetotal? Even as health officials worldwide have steadily reduced the number of drinks they say is safe, they've mainly stopped short of advising their citizens to abstain altogether, perhaps because of alcohol's popularity and cultural significance.   JOIN POLITICO ON 2/9 TO HEAR FROM AMERICA'S GOVERNORS: In a divided Congress, more legislative and policy enforcement will shift to the states, meaning governors will take a leading role in setting the agenda for the nation. Join POLITICO on Thursday, Feb. 9 at World Wide Technology's D.C. Innovation Center for The Fifty: America's Governors, where we will examine where innovations are taking shape and new regulatory red lines, the future of reproductive health, and how climate change is being addressed across a series of one-on-one interviews. REGISTER HERE.     WELCOME TO FUTURE PULSE Mt. Washington, N.H. | Sam Oates This is where we explore the ideas and innovators shaping health care. In some not-so-good news, adults who had any kind of head injury over a 30-year study had twice the mortality rate of people that didn't, according to a new study. That increased with moderate or severe head injuries. Share any other thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, Lauren Gardner talks with Alice Miranda Ollstein about anti-abortion groups that are pushing back against Republican lawmakers in some conservative states because they fear GOP-controlled legislatures will water down their near-total abortion bans. Listen to today's Pulse Check podcast FORWARD THINKING The European Union hopes a database of cancer images will help advance diagnoses by artificial intelligence. | American Cancer Society/Getty Images The European Union is putting together a database of cancer images to help train artificial intelligence to detect cancer, reports POLITICO's Carlo Martuscelli from Brussels. The European Commission launched on Monday the European Cancer Imaging Initiative, which will allow health systems across the EU to pool medical imaging data in a secure way that respects patient privacy, the commission said. How it will work: Existing hospital networks, research repositories and national and EU-level databases will provide the images. Patients can volunteer their own data to build the datasets. The aim is to compile 100,000 cancer cases by 2025 that small- and medium-sized businesses working in AI cancer diagnosis can use to test their technology. The database will include anonymized images of common and rare cancers. Big picture: The initiative is part of the EU's Beating Cancer Plan, a $4.3 billion effort to improve cancer prevention, early detection, diagnosis and treatment in the EU's 27 member countries.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     TECH MAZE A new study casts doubt on the theory that telehealth will prompt more people to see their doctors. | AP Photo/Alan Diaz "Telemedicine by itself is probably not a magic solution to what is a multifactorial problem with deep societal, cultural and political barriers that get in the way of people having adequate access." Michael Barnett, associate professor of health policy and management at Harvard's T. H. Chan School of Public Health In theory, telehealth expands patients' access to treatment by removing transportation and other barriers to seeing the doctor. But a new study in JAMA Network Open found no evidence that virtual care for opioid use disorder expanded access during the pandemic. The findings are a blow to a key argument for allowing continued virtual prescribing of drugs used to treat the disorder once a pandemic emergency waiver ends. The researchers also found that: — Patients who received their medicine via either virtual visits or in-person visits had similar outcomes. — Telemedicine didn't seem to lead to wasteful or unnecessary visits, a key concern of skeptics. Telehealth patients for opioid use disorder treatment more often resided in high-income metro areas than in low-income and rural areas, according to the study. The researchers suggested their finding on care access could be due to the digital divide in broadband. The access finding isn't cause to stop experimenting with telemedicine, said Michael Barnett, associate professor of health policy and management at Harvard's T. H. Chan School of Public Health. "I was not expecting there to be a major expansion of access … for me, the major take-home was telemedicine maintained business as usual." The policy angle: During the pandemic, the Drug Enforcement Administration issued waivers that allowed doctors to prescribe buprenorphine and other controlled substances to treat opioid use disorder without first meeting with patients in person. Congress tasked the DEA in 2008 with setting up a special registration process for prescribing controlled substances via telemedicine, but the agency hasn't done so yet. The Biden administration's policy agenda for 2023 includes proposed rules slated for this month to facilitate virtual prescribing. Advocates have been lobbying for the DEA to act before the public health emergency ends to avoid a gap in virtual care access.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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