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How a local doctor and a ‘life-changing' class are helping people lead healthy lives

How a local doctor and a ‘life-changing' class are helping people lead healthy lives

Yahoo01-05-2025

DES MOINES, Iowa — Metabolic dysfunction may be the most serious condition you've never heard of, and one in three Americans have it. That's the bad news. The good news is preventing it is actually pretty simple.
'We have made it way too complicated,' says Dr. Andy Nish. 'And why is that? Because we're always trying to sell something, right?'
Nish has been practicing medicine for nearly 40 years, but it wasn't until he was more than two decades into his career that he started studying nutrition, stress and sleep, all because of the alarming increase in cancer rates. Now, he's teaching a class called 'Aspire' in an effort to help people help themselves.
'It's not about just food. It's not just about movement. It's not just about, you know, what's in our food system,' he explains, 'It's about this concept called the exposome. And the exposome is everything we are exposed to from the time of birth till the time of death.'
Annie McCormick was in the pilot class two years ago.
'I knew I needed it,' she says. 'I'm diabetic and at that point I was a bad diabetic and I needed help.' She's been to every class since. 'Well, you learn something new in every class, or it's said a little bit different than it was said in the first class. So, you're going, 'Oh, yeah.' You know, the light bulb will go off.'
Dr. Nish explains what healthy aging is and how we can achieve it
Tim McCoy loves seeing those light bulb moments. He's the reason the Aspire class exists.
'I thought, well, hey, could you come and be the medical director for this new thing? We didn't have a name at the time. Yeah. So that was two and a half, almost two and a half years ago. '
Heather Charlson has also been there from the beginning.
'Oh, I've learned that it's more than just what people think it is, whether it's just nutrition and exercise. There's so many more things that go into it, whether it's your sleep quality, dealing with stress management or relationships.'
Big picture – that's called 'metabolic health' and many things can impact it. Metabolic dysfunction is when at least three of these symptoms are present — increased waist size, elevated blood triglycerides, low HDL cholesterol, high blood pressure, and elevated blood sugar. Those things increase the risk of having cardiovascular disease, diabetes, liver disease, kidney disease, and sleep apnea. Those conditions increase your risk of dying. That's why new participants start the class with specific screenings.
'And as I explain to people, that blood test is not the end all, be all. We're not trying to change a blood test,' explains Dr. Nish, 'we're trying to change how you feel. How do you feel emotionally? How's your energy level?'
The blood test may not tell the whole story, but it's definitely part of it. Annie lowered her A1C from eleven down to five, just one indicator of better health.
'When people are suffering, it's just it's very rewarding to see,' says Tim McCoy, 'changing lives, that's what it's about.'
Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Trump's EPA announces major rollbacks to power plant pollution limits
Trump's EPA announces major rollbacks to power plant pollution limits

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Trump's EPA announces major rollbacks to power plant pollution limits

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Opinion - Trump has a historic opportunity to save lives in the fentanyl crisis
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We're cancer doctors. Here's why Medicare Advantage fails America's elderly.
We're cancer doctors. Here's why Medicare Advantage fails America's elderly.

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'It's nothing,' Tom, a retired firefighter from rural Texas, thought when he had persistent stomach pain. After shedding 30 pounds in three weeks, his family physician ordered a CT scan. Tom was not concerned — after all, the 65-year-old had gotten Medicare Advantage earlier that year. Like millions, Tom switched his insurance after he was solicited by a broker who promised low premiums and a gift card. Absent from the sales pitch was the fact that Medicare Advantage plans — privately run and separate from government-funded traditional Medicare — often delay and deny coverage. One of us met Tom nearly three months after his CT scan, and his doctor discovered the abdominal mass. The job as the first oncologist he had been able to see after months of jumping through hoops was to get initial scans, identify an in-network provider, wait for further referral and approval processes and finally schedule and complete a biopsy. The delays became a death knell. 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After nearly two decades of experimentation and $450 billion of taxpayer money, Medicare Advantage has proven porous in terms of corruption, fraud and abuse. Yet, 32.8 million elderly Americans (54 percent of the eligible Medicare population) are currently enrolled in Medicare Advantage. In 2023 alone, Medicare Advantage plans fully or partially denied 3.2 million prior authorization requests. No one, especially among folks facing the daily drudgery of fighting cancer, truly understands how the cogs within the insurance machine work. Few of our elderly patients fight the goliath institution, and many succumb to poorer health outcomes in their quest for lifesaving treatment. Last year, countrywide and across disease groups, 79 percent of patients who experienced a delay or denial of coverage paid out of pocket for medication at least sometimes. Unsurprisingly, more than 100 million Americans are in medical debt. Of those who appealed between 2019 and 2023, over 80 percent were approved, implying that the initial claims were valid. This game of attrition directly contradicts Medicare Advantage's promise to provide efficient, patient-centered healthcare. These denials are not just medically dangerous because they enable deadly diseases to progress unchecked. They are also emotionally erosive. Daily, we see patients shrink in the face of denials, unable to emotionally navigate the complex Medicare system and the immense pain, isolation and depression resulting from this behemoth that stands between their disease and their hope to be free of it. During one of Tom's chemo visits, with thousands of dollars worth of IVs in his veins, his skin pale and translucent, he realized he was begging his insurance at every turn to support him. Stories like Tom's reveal the truth: Medicare Advantage is unapologetically failing its elderly cancer patients. Sick American seniors deserve more than insurance coverage in name only. We advise our patients to avoid Medicare Advantage. The better choice is traditional Medicare, plus a secondary or supplemental insurance. Often, people do not enroll in supplemental insurance because they do not understand its importance, believe they will never get sick, miss the deadline for approval without a medical exam (you must do this within three months before or after your 65th birthday), or think it is too expensive. Although supplemental insurance costs nearly $500 a month (exact amounts vary based on age and income), choosing this add-on — and paying roughly $6,000 a year — is much more affordable than Medicare Advantage's yearly out-of-pocket (potentially adding up to $8,500) and fighting for approvals for basic treatment. On Medicare Advantage, Tom quickly reached his maximum yearly out-of-pocket of $8,500, but then it reset on Jan. 1. After four months of treatment, he was responsible for paying $17,000 for 16 months of care, on top of his insurance premiums, simply to receive standard care. Of course, if you are one of the fortunate few to have never experienced illness — and we hope you are — Medicare Advantage can be a cheaper option. The question is, how can we make Medicare Advantage advantageous for the vulnerable? There is a bipartisan opportunity to change the narrative around this insurance model. During his confirmation hearing as the head of the Centers for Medicare and Medicaid Services, Mehmet Oz criticized Medicare Advantage insurers for some of their practices. Strategic change — omitting out-of-pocket costs for cancer patients, curbing insurance companies' rights to deny claims submitted by doctors and speeding up the process — along with more rigorous oversight of the program are worthwhile goals the Trump administration and Congress should take on. While Democrats and Republicans disagree on many issues, we believe we can all agree that people like Tom — and the millions of other Americans enrolled in Medicare Advantage — deserve comprehensive and just care. Dr. Pramod Pinnamaneni, MD, MBA, and Dr. Nitya Thummalachetty, DrPH, are founders of the Nau Project, a start-up dedicated to helping everyday Americans navigate the complexities of our healthcare system.

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