Did you really believe that being fat shortens your life? Then you should know that this is not true. The truth is that overweight and obesity shortens life in some persons but extends life in others. For instance, weight loss is bad in heart failure: The risk od dying within three years is 70 percent higher in patients with a body mass index of less than 23, compared to obese patients with a body mass index of 30 to 35. A Harvard study in more than seven thousand heart patients has come to this conclusion, but only in those patients not suffering from fluid overload which is a sign of worsening.
In sick people, weight loss is often a sign of worsening, thus the «protective effect» of weight is easy to understand. Not only in heart patients but also in people suffering from cancer. Also smokers often lose weight and smoking kills, thus all serious studies about weight loss and life expectancy are controlled for this effect.
But you have not to be sick to be an exception from the generally accepted rule. For instance, obese and fit middle-aged men live longer than lean men of the same age - see my earlier post: Fitness may be more important than weight loss.
Age seems to be the major factor when it comes to weight loss: In eighty-year-olds, overweights live longer than those of normal weight, and underweights live shorter. This is not a weak effect: The risk difference between over- and underweight has been found to be four- to fivefold in more than six hundred old Japanese.
What does not kill you makes you stronger
Medical studies obviously confirm this saying. Overweight may be a killer, as some studies indicate. But if you are still alive with sixty years of age, your fat may make you stronger, giving you more reserves in fighting the aging process.
Conflict of interest: I am middle-aged and of normal weight, my father is moderately overweight and still trying to lose weight, not believing what his son has found.
Photo credit: flickr.com/photos/wyldkyss/440095388/
Tuesday, July 31, 2007
Monday, July 30, 2007
Suppose a study has been published when these two girls have been born, that is, five years ago. Can we still trust the results? Yes, we can, on average, according to a recent analysis of a hundred systematic reviews, covering more than a thousand medical studies with a total of more than two hundred thousand persons. It came out that it lasted about four to seven years in most reviews until differences in the study results began to emerge, indicating that some results have been outdated by new findings.
What you can read in this blog is mainly based upon medical study results. I always try to find out what is new and which of my earlier posts may need to be updated. But as a general rule I would guess that the average survival time of my posts should be somewhere about five years. This leaves more than four and a half years of filling my blog archive. I hope I'll still be blogging then.
Photo credit: flickr.com/photos/mcbeth/245162377/
Saturday, July 28, 2007
Fat bellies are contagious. Obesity is like a virus, spreading by close social contacts. The term obesity epidemic, often used by public health advocates, has got a new, literal meaning since new findings from the Framingham Heart Study have shown that a person is at risk of getting fat if he or she has fat friends.
Results in brief: A person's risk of becoming obese (body mass index 30 or more) increases by 57 percent if she or he has a friend who has got obese in a given time interval. It is important to note that, with a probability of 95 percent, the risk increase is somewhere between 8 and 123 percent. The influence is greatest in fat friends of same sex, it is less in spouses and siblings. Neighbourhood is not important because living distance between the friends seems to be of minor influence. The researchers claim that a considerable part of this influence is causal, that is, you make friends with a fat person and then you get fat yourself. The findings cannot be explained merely by fat people seeking the company of other fat people.
Bad news for fat friends?
Should fat people now fear to lose friends? I see two important reasons to calm down. Having good friends is a very important positive health factor. Breaking a close friendship causes stress which is bad for health and, above all, for life quality. Compared to this, an obesity risk change somewhere between zero and double is less important in my opinion. The big spread in risk figures means that there is much room for fighting the influence of fat belly virus.
Strengthen your immune system
If obesity is like a virus, the fact that its spread is limited (less than double risk) tells us that there must be something like an immune system. In order to find out what it might be we must look at possible mechanisms that make fat friends contagious.
Social eating is likely to be the most important one. Good friends spend much time eating together. People tend to adopt behaviours of close friends, using the same language, fashion style, food, gestures and the like, as psychologists have found. Eating habits cannot be an exception of this rule. In contrary, we all know situations where we eat one more portion just to please the host. And in a table round where eating three portions is normal it is not easy to listen to one's own appetite and stop in time. In other words: The real virus is not obesity but eating habits and their social influence.
Seven ways to get immune against social eating pressure:
- Take small portions even if all your friends take big ones. Read more about the importance of small portions.
- Eat slowly even if all your friends eat fast.
- Talk, talk, talk - this way you are social without taking up calories.
- If you like the food, take enough time to enjoy every bit of it.
- If you do not like the food, do not force yourself to eat more than you really want.
- Listen to your body telling you when you are fed.
- Resist friends urging you to take more.
Photo credit: flickr.com/photos/poppywright/208748410/
Friday, July 27, 2007
When I was a kid, my mother used to say hey, the sun is shining, go out and play! I am not sure if many mothers today still send their kids out into the sun as readily as my mother did. In the last couple of years, we all have been told time and again that sun causes skin cancer. All those campaigns have done their work, but they may have done more harm than good, as far as children are concerned.
Sun in childhood protects against multiple sclerosis (MS): In California, more than seventy pairs of identical twins have been examined. In each pair, one of the twins suffered from MS and the other did not. In addition, they differed in the amount of sun exposure in childhood. On average, the MS risk is less than half in kids that have been often outdoors playing in the sun, compared to children who have been well protected from the sun. MS is a nerve disease with considerable genetic risk factors, that's why identical twins have been selected for this study.
But skin cancer? I hear you ask, but let's do some comparing. Skin cancer (melanoma) and multiple sclerosis (MS) are both very bad diseases. Hard to tell which is worse. Against MS there is no cure at all, and melanoma can be cured by surgery if it is detected in time. If not, it is deadly. In our family we have and had both diseases. If you ask me, I would prefer not to have MS.
Now let's have a look at the facts and figures. In the United States, one in seven hundred persons has MS, but only one in five thousand has melanoma. Thus, MS is seven times more frequent than melanoma (source: Wrong Diagnosis?). If these figures are right, may (over-) protecting children from the sun do seven times more harm than good? Well, not really, because a greater amount of skin cancer risk than of MS risk reduction may be attributed to the sun. If this difference is less than sevenfold, harm still may be greater than benefit.
Yet more harm may be added due to inactivity: Sun exposure concern is linked to a sedentary lifestyle, according to an Australian study. Lack of physical activity, especially in childhood, is a major source of diseases.
Take home message: Playing outdoors in the sun is good for a child but it must be protected from sunburn. The acceptable dose of sunlight depends strongly on the skin type.
Photo credit: flickr.com/photos/childish/389947911/
Thursday, July 26, 2007
- Soft drinks increase the risk of metabolic syndrome by 44 percent.
- Soft drinks increase the risk of obesity by 33 percent.
- Soft drinks boost the risk of increased waist circumference by 30 percent.
- Soft drinks increase the risk of an impaired fasting blood sugar level by 25 percent.
- Soft drinks increase the risk of a higher blood pressure by 18 percent.
- Soft drinks increase the risk of a too high level of blood fats (triglycerides) by 25 percent.
- Soft drinks increase the risk of a too low level of the good HDL cholesterol by 32 percent.
- Water increases the burning of calories for a limited time: Read more about drinking water for weight loss.
- Water fills the stomach without adding calories: Read more about avoiding liquid calories.
- Water does not feed the bacteria that attack teeth and gums.
Photo credit: flickr.com/photos/danielygo/284511362/
Wednesday, July 25, 2007
If you suffer from pain, you may choose the western way and take pills or the eastern way and get pricked by an acupuncture needle. Both methods work and have their good and bad sides. The good side of acupuncture is that it has no unwanted side effects that are common in drugs. The bad side is that you cannot prick yourself unless you have studied Traditional Chinese Medicine (TCM) for many years.
The eastern way also works quite well in the treatment of anxiety, as a review of ten controlled medical trials has shown recently. Ear pricks in patients before and after surgery have been effective to fight anxiety, but positive effects also have been found in anxious neurotic patients.
It is hard to tell how acupuncture may be effective against anxiety. A substantial amount may be due to the placebo effect which always comes into play when mind is concerned. Acupuncture is always linked to a close contact between the therapist and the patient. The feeling of being cared of is very likely to damp anxiety. And one more point may be important: Acupuncture is something that looks like harm (being pricked) but does not really hurt. If one reason of being anxious has been overcome, other reasons may become easier to tackle. Thus, acupuncture may teach us new ways of coping with anxiety, even without being pricked.
Photo credit: flickr.com/photos/martinsphotoart/187771404/
Grand Rounds 3:44
We have another first-time host this week, Laurie Edwards, presenting her edition of the best medical blogging in a newspaper style, unfolding great front page stories, breaking news, and many more sections.
July 24, 2007 at A Chronic Dose
Personal Development and Life Success #10
In this edition, Tristan J. Loo presents posts about multiple levels of change and overrated fear, about communication, entrepreneurship, goal setting, law of attraction, life purpose, management, motivation, parenting, personal development (the largest section), relationships, success and time management.
July 23, 2007 at Synergy Institute
Skeptics Circle #65
This time, we are guided on a tour through the Skeptics Museum by Steven Novella, beginning with the largest Hall of Complementary and Alternative Medicine. But do not stop there, I recommend you to visit also the halls of Aliens and UFOs, and of Evolutionary Denial.
July 19, 2007 at Neurologica Blog
Tangled Bank #84
This carnival has a broad scientific scope and also a medical section, where Jeremy Bruno presents posts about genetics and mental diseases, about smoking and drinking, about bones and about modern medicine meeting science fiction.
July 18, 2007 at Voltage Gate
Tuesday, July 24, 2007
Today, Swiss newspaper headlines ran as follows: «Cannabis not that harmless», «More risky than many think», «Late adverse effects proven», «Do young men toke themselves into a psychosis?», «Does cannabis trigger schizophrenia?» - just to cite some. The newspaper reports and comments are based on new research findings and interviews with one of the study authors, Wulf Rössler, psychiatrist at the Zurich University Hospital.
Rössler and his team have monitored the rate of new admissions for schizophrenia in several age groups. In young men of fifteen to nineteen years of age, the admissions have tripled in the years between 1990 and 2002. A striking parallel increase has been observed in cannabis (marijuana) use of fifteen year old young men: In 1986, only twelve percent had ever smoked a cannabis joint, in 2002 this amount had increased to fifty percent.
In several interviews, Rössler admitted that this parallel increase of cannabis use and schizophrenia does not necessarily show a causal relationship. But he is convinced that cannabis is one of several causes of schizophrenia. He pleads for a better protection against cannabis in young age: «Someone who begins to smoke pot at the age of fourteen runs a higher risk of a mental illness than someone who begins at nineteen years of age.»
Photo credit: flickr.com/photos/smoking_gun/294232202/
Sunday, July 22, 2007
Earlier I have shown why the placebo effect does not exist in a strict sense and that it is rather a mind effect and how we can make best use of the powers of mind. Now it is high time to ask what we can expect of these powers.
Some guess that roughly one third of a medical treatment success is due to the placebo effect. They rely on a publication by Henry K. Beecher, «The Powerful Placebo», back in 1955. Beecher had analyzed the outcomes of fifteen medical trials, concluding that 35 percent of the patients had improved by placebo alone. Forty years later, two German scientists have re-analyzed Beecher's data and found that he had misinterpreted them, saying that «no evidence was found of any placebo effect in any of the studies cited by him».
Placebo work best in pain and subjective outcomes
In 2001, two Danish scientists have analyzed 130 medical trials with a total of more than eight thousand patients. In trials where the outcomes have been yes (improved) or no (not improved), no placebo effect has been detectable. But in trials where the outcomes have been a degree of how much the patients improved, an effect of placebo has been detected in roughly a third of the cases, compared to no treatment. But this has been the case only in subjective outcomes, as rated by the patients, and in trials with pain. In 2004, the authors have updated their review with 42 new trials, extending the data pool to more than eleven thousand patients. For trials with patient-reported outcomes, a placebo effect has been detected in 30 percent of the cases, but only in 10 percent of the cases where the outcome has been reported by a doctor. Conclusion: The placebo effect works best in subjective conditions like pain or mental well-being.
Placebo effect of psychoactive drugs
In antidepressants, a very large amount of benefit may be due to the placebo effect. In a total of more than nineteen thousand patients where antidepressant drugs have been tested against placebo, it came out that the antidepressants have reduced the depressive symptoms by 40 percent and the placebo have reduced them by 30 percent.
Placebo effect against heart attack
In a study with more than a thousand men where a drug to prevent heart attack has been tested against placebo, not all patients have taken the pill as prescribed. Of the good adherers to the therapy, 15 percent died within five years, compared to 25 percent of the bad adherers. Interestingly, this has also been the case in the placebo group: 15 percent of the good placebo adherers have died versus 28 percent of bad placebo adherers. Similar results have been obtained in a study with more than sex hundred women.
Colin Sutton from Australia has sent me a mail, stating that "it's nothing to do with what they were taking. (...) the compliant patients were more likely to be following other healthy regimes - regular exercise, diet or whatever, than those that don't adhere to a plan". I agree that this may be one explanation, but possibly not the only one. (September 5, 2007)Take home message: The placebo effect can be powerful on a subjective level, mainly against pain and mental conditions.
Placebo effect: How to make best use of it
Placebo effect: There is no such thing
Photo credit: Wellcome Library, London
Saturday, July 21, 2007
In my previous post I have taken a look at the so-called placebo effect and I have done it with the eye of the consumer or layperson or patient. The term placebo effect has been coined by scientists and doctors, and it turns out that it is not very useful for us consumers who care about our own health.
Sometimes, doctors give placebo to patients when they believe these to just imagine that they are sick. When patients find out later, they feel fooled. Or they take a pill and feel better and later read in a blog or somewhere elso that this pill is useless and just «a placebo». Again, if they believe in the negative report, they will feel fooled.
Therefore I have cast my critical consumerist eye on the placebo effect itself. My conclusion: it does not exist in a strict sense. Forget that red sugar pill. It is worth nothing, and it has no effect. What doctors call the placebo effect is in reality the power of mind, and this is real. You cannot be fooled by this power. It has two important dimensions: imagination and self-healing.
The power of imagination
Suppose you are suffering from pain, let's say six points on a ten point scale where 1 is no pain at all and 10 is unbearable. Normally, you will concentrate on the six pain grades, but you may also imagine the four grades that are not pain - just as in the often cited half-full or half-empty glass. Some more examples. With a sore throat you may put your focus on the spots that are not sore. With a broken leg you may put your focus on the non-broken leg.
Remember, this focus shift is one of the main elements of the placebo effect. But you do not need a red sugar pill turn it on, once you have got how it works. As a result, the condition where you put your focus becomes more prominent, and the condition that you put aside becomes less prominent. Thus, even without any objective improvement, you have the subjective impression of being better.
The power of self-healing
Mind has a powerful influence on the immune system that fights diseases (see psychoneuroimmunology) and on the release of natural pain killers of our body (see endorphins). By this way, mind can have a similar effect as a real drug. This effect is measurable by exact scientific methods and it is the second dimension of the placebo effect.
The self-healing powers of the body work best in a stress-free situation. Again, you need no red sugar pill to reduce stress. What you may need is a person that cares for you, not necessarily a doctor. What you need for sure is the feeling that the real healing job is done by your body and that many treatments from outside just give it more power. Not in every case, of course: In certain infections, your self-healing powers would be lost without the power of antibiotics.
How much can we expect from the self-healing powers of mind? I have seen that a lot of research has been done on this question, and I take a closer look in my last post of this series.
Photo credit: Wellcome Library, London
Friday, July 20, 2007
Placebo, those sugar pills without any drug, are widely used in medical studies in order to rule out the so-called placebo effect. In earlier posts I have mentioned placebo, sometimes in the meaning of a useless treatment, and I am going to use it in many more posts to come. Thus, it's high time to go a bit deeper into what is really behind a placebo. In the first post of my three-part series I deal with the fact that the placebo effect is not an effect of placebo but of mind.
Is skepticism a placebo killer?
After having posted about valerian being useless as a sleep aid, I have asked myself about possible unwanted outcomes: For instance, a valerian user reads my post, loses his belief, switches to a powerful tranquilizer, gets addicted and many years later his kidneys are destroyed. Of course this looks like ethical over-concern of a blogger who overrates his influence, but it may contain a grain of truth. Anyway, these have been the ideas that have pushed me to this series about placebo effect.
Back to reality. If someone takes valerian or Bach flower remedies and feels better, he may read negative reports, shrug his shoulders and say to himself I know better.
Even more important: The truth cannot be a placebo killer as far as we have got the point that the real cause of the placebo effect is not in the placebo.
Why there is no effect in placebo
As we all know there is no active substance in a placebo. Hence, simple logic tells us that a placebo as such cannot have any effect. If there is an effect, it is triggered by taking the placebo, but it is not caused by the placebo. Several theories have been set up in order to explain this effect.
The most simple theory (spontaneous remission) assumes that the patient would have improved anyway, without any treatment. In a strict sense, this is not an explanation of the placebo effect but an alternative scenario that should be ruled out before we speak of a placebo effect.
Another theory (autosuggestion) assumes that the patient feels better just because he expects to feel better, but that the objective conditions in his body remain unchanged.
A third group of theories (psychosomatics) assumes that mind, triggered by taking the placebo, has a positive influence on the self-healing forces of the body, either by conditioning or motivation.
Take home message
Taking placebo may have an effect but this is a mind effect. The second post of this series deals with the question of how to make best use of it.
Photo credit: Wellcome Library, London
Thursday, July 19, 2007
Every year, in many countries all over the world, there are Quit&Win contests. If you are a current daily smoker and at least 18 years of age, you may participate: Just stop smoking for at least four weeks after the quit date, apply for the drawing, and you may win up to ten thousand U.S. dollars.
Yesterday, at PubMed, I have discovered a study about the success rates of the Quit&Win contest: a meek 10.5 percent of participants stay smoke-free for only seven months after the quit date. With special intervention courses for better coping with relapse risks, the success rate has been increased to still meek 13.4 percent.
I am not surprised. When I first heard of such a contest in my country, I said to myself that money prizes cannot be the right way. They give the impression that smoking has a value that must be compensated by money. Wrong motivation, if you ask me.
While such a contest has not proven to be effective in participants, it still may be effective on the community level. But it is not: Fewer than one in five hundred smokers quits because of the contests, according to a Cochrane review.
The reward must come from inside
Now let's compare the Quit&Win success rate of 10.3 percent for seven months with Allen Carr's EasyWay success rate of 51.4 percent for twelve months. This is an in-house statistics, so we may mistrust it. Let's be very skeptic and accept only half of it, even then it is more than double as effective as the contest.
What is the main difference? It is motivation. It is getting rid of the illusion that the cigarette does any good for a smoker. It is coming to the point where no will power at all is necessary any more.
Image credit: International Quit&Win
Wednesday, July 18, 2007
Flowers may improve your health. Don't miss to use them. Some suggestions: Be generous when you buy a bride's bouquet. Don't stop being generous once you are married, continue to show her your love, buying flowers, preferably as a surprise. Or even better, go outdoors and discover their beauty just as mother nature shows them to you, enjoy them and forget everyday stress. Stress reduction, feelings of love and happiness, the joy of natural beauty must have a positive effect on health, as far as I guess. This is all I can safely tell you about flowers and health after having seen the most recent medical study on Bach flower remedies.
More than three hundred patients in the United Kingdom have been treated with Bach flower remedies. A small minority of them suffered from pain, and roughly half of them suffered less pain after the Bach flower treatment. There was no placebo control. All the same, the study author concludes that the results are «encouraging» as to a possible effect «above that of a placebo». Important to note: The study has been undertaken at the Bach Centre in Mount Vernon, England. My conclusion: This «study» does not meet minimal quality criteria, and the conclusion of the author is a joke.
In all placebo-controlled studies so far, Bach flower remedies have not shown any effect beyond placebo. For instance in a trial with ADHD children in Israel or in a test anxiety trial in Germany.
Wikipedia: Bach flower remedies
Proto credit: flickr.com/photos/sarey777/246918401/
Grand Rounds 3:43
This is one of the most carefully edited Grand Rounds I have ever seen. Vitum has illustrated every post with the favourite food of the blogger (as far as known), introduced it with a description and a reason why you should read it, and decorated it with a somehow latin-sounding award. Great posts and an excellent job, inviting to come back more than once.
July 16, 2007 at Vitum Medicinus
Brain Fitness Carnival
In this monthly carnival, Talia Mana presents brain-related posts about healthy mind, research, education and professional development, health and wellness, medicine, science, personal stories and techniques.
July 16, 2007 at the Centre for Emotional Well-Being
Gene Genie #11
I have had the pleasure to host this edition...
July 15, 2007 here at Med Journal Watch
Pediatric Grand Rounds 2:7
This week marks the ten year anniversary of blogs, as Brian Vartabedian points out and makes a nice celebration with his edition. He presents a bunch of excellent posts about (for example) circumcision, quality of life, cholesterol, true confessions, nutty mothers, antivax bias in Google, smoking, and infections paranoia.
July 14, 2007 at Parenting Solved
Carnival of Healing #94
In this carnival, Jenn Givier presents posts with a holistic approach to health and well-being: building community, end of life care, self-improvement, healthy eating, telltale signs of alcoholism, yoga, ethics and success, and many more.
July 14, 2007 at Thriving Business
Depression, Bipolar Disorder
Karen Delaney presents some interesting posts about depression, work, stress and dementia.
July 11, 2007 at A Strange Life
Tuesday, July 17, 2007
I have found the diagnosis and the cure for an annoying disease of my blog software. I have noticed this disease in many other blogs that use the same template at the blogger platform.
The disease: After inserting a quote or a list in a post, the normal space between the lines is lost and becomes narrow, not only in the quote and in the list, but also in all the paragraphs that follow.
The diagnosis: The style definition of the line height (space) is not applied to the whole post content but only to one paragraph of the post content.
Go to the Blogger admin page and take these five steps:
- Choose template, edit HTML.
- Save a copy of the existing template on your hard disk.
- Scroll down to /* Posts and then to .post p
- Insert «, .post-body» (see picture)
- Click the save template button.
Update: a solution for preformatted
I did not try this out, but Abhinav Srivastava has found a solution for putting code snippets in preformatted text (pre) format.
Monday, July 16, 2007
Medical studies can be dangerous. For example if you take for granted that something that has proven to be beneficial in a medical study also must be beneficial for you. Today I present you such a case. Much has been written about alcohol and the heart, but I strongly advise you to forget all you may have read if you are a smoker.
There are many many studies (I really cannot count them, let alone review them here) about alcohol and the risk of a heart attack. Most of them come to the conclusion that moderate consumption of alcohol reduces the heart attack risk.
There are also many many studies (let even more alone to review) about smoking and the risk of a heart attack: Smoking is one of the major and best proven risk factors.
Now, you may try to be smart and fight the tobacco risk with the alcohol benefit. Nothing could be more wrong, according to a study of the Shanghai Cancer Institute, based upon data of more than sixty thousand men.
The results show that moderate alcohol intake reduces the heart attack risk only in nonsmokers. This beneficial effect disappears with even moderate smoking. When more tobacco is smoked, the effect turns to the worse: Even moderate alcohol intake now increases the heart attack risk.
Photo credit: flickr.com/photos/cascadefoto/407586102/
Sunday, July 15, 2007
The Double Helix strikes back. As you can see here, it has invaded the very epicenter of creationism, the Vatican. Since the actual pope rules there, wind has turned more against them, gay men say. But they may have to fear the danger in genetics more than the Vatican, as Steve Murphy at Gene Sherpa tells us.
Genetic genealogy is a hot topic and a growing business these days, at least in the United States. Hsien Hsien Lei at Eye on DNA has interviewed genetic genealogist Dr. Blaine Bettinger on DNA and genealogy. As far as I got it, DNA is sort of a time machine that allows us to look at gene sequences of our great-great-great-great-grandmother. Fascinating, really! And she has one more hot topic: Should we prohibit the patenting of genes? Don't miss to drop your vote!
Junk DNA: from science to framing
Back to Vatican, will say, creationism. I really do not understand what the amount of function that may or may not be detected in junk DNA has to do with believing in Creation or Intelligent Design - we have no such controversy here in Switzerland.
Scientists are supposed to educate the public about the facts, but Larry Moran at Sandwalk is quite disappointed to see one of them use the press to boost his own ego instead, using inappropriate framing. T. Ryan Gregory at Genomicron plunges even deeper into the matter, discussing articles about junk and genomes in The Scientist. Both of these posts bring me to the conclusion that the term «junk DNA» has slipped from the hands of science and has become a political issue that has nothing to do with proven facts anymore.
Genes and diseases
But political issues in genetics may also make sense. Walter presents such a case: spinal muscular atrophy legislation to be introduced in congress, posted at Highlight Health.
Why do some children get asthma and some don't? Alfa King tells us more about one possible genetic reason in childhood asthma probe.
Charles Daney at Science and Reason hat interesting new facts about the role of histone deacetylase enzymes in turning genes on and off. Just imagine a sort of switches, but much, much more complicated, and closely watched by cancer researchers.
When it comes to cancer, the scope must not be confined to genes but must be extended to chromosomes, as Keith Robison at Omics! Omics! points out.
What is all this research good for? Bertalan Mesko at Scienceroll presents a vision of a world without genetic diseases. Wishful thinking or a real option for the future? Click by and make your own opinion. He discusses several findings about Duchenne muscular dystrophy; one very promising new approach has been published at Biomed Central.
Novel tools are vital for progress in genetic research: Medgadget presents fluorescent DNA probes that could shed new light on genetic disorders, and Microarray presents a new test to detect mutations in the largest human gene.
This concludes Gene Genie #11. Thanks to all who have submitted and to Berci who has selected me as a host. I have been strictly advised to include only clinical genetics and genomics posts. I have received more, very interesting submissions that have not been included here for this reason, and only for this reason.
Look at the Gene Genie carnival page for upcoming editions. Gene Genie #12 will be hosted by My Biotech Life.
Photo credit: flickr.com/photos/abrin/302496552/
Saturday, July 14, 2007
Sometimes I have to watch other things than medical journals. Horrible things that let me helpless with words. I cannot find them. All may be wrong. Only these: Take a look with your own eyes on Darfur, at the satellite website of Amnesty International. There is a saying that one image tells more than a thousand words. The images you can see there tell more than a million words. Here is an example:
The village of Ishma, before the attack.
What once has been the village of Ishma, after the attack.
Darfur: A Genocide We Can Stop
Wikipedia: Darfur conflict
Photo credit: Eyes on Darfur
Friday, July 13, 2007
In the early stages when Alzheimer's disease begins to attack, the brain does not just wait to be destroyed but fights back. This interesting fact has been detected at the Mayo Clinic in Rochester, Minnesota, where about two hundred patients have been followed during many years of memory decline, beginning ten years before the clinical Alzheimer's diagnosis. The researchers have found that memory decline is not steady but reaches a plateau, on average four years prior to the Alzheimer's diagnosis.
In the plateau years, memory stays more or less stable until a fast decline occurs that usually contributes to the diagnosis. The Mayo researchers assume that the brain, while its cells are being destroyed by the disease, is mobilizing hidden memory reserves in order to compensate the loss. As long as the compensation prevails, memory loss is stopped, but after the reserves are used up, the decline goes on all the worse.
Important: 10 warning signs of Alzheimer's disease
In order not to miss the plateau phase, early detection of the disease is vital. But this is not easy because the brain does its best to overcome the symptoms. The ten official warning signs are: Memory loss that affects day-to-day function, difficulty performing familial tasks, problems with language, disorientation of time and place, poor or decreased judgment, problems with abstract thinking, misplacing things, changes in mood and behaviour, changes in personality, loss of initiative. Many of these symptoms may also be caused by a depression. (Source and more detailed information: Alzheimer Society of Canada)
How to make use of the plateau
Plan your future and put your affairs in good hands: Work, retirement, money and legal matters, living arrangements, health care. Make the best of the years to come. Enjoy life with your partner. Take the trip that you always wanted - to the coast, to Paris, to Taj Mahal, ... before it is too late forever.
Photo credit: flickr.com/photos/inercia/541713912/
Thursday, July 12, 2007
Can we trust the rat? Can we be sure that results obtained from lab experiments with this animal may also hold true for us humans? No, we can't. At least not always, and surely not in the case of type 2 diabetes.
Of course, medical research in its first stages must rely on so-called animal models. They serve as a first step before possible treatments can be applied to humans. And they serve as a filter that allows researchers to put aside drugs, supplements or other treatments that prove to be not safe and not efficient in the animal trial. So far so good.
Such tests also have been undertaken with diabetic rats, and their sugar illness improved when they were fed selenium. Hence the idea of giving selenium supplements to people in order to prevent diabetes. This effect has been studied in more than a thousand persons who have taken either selenium or placebo supplements for seven or more years on average. During that time, more selenium users than placebo users became diabetic. (The trial originally has been designed for cancer prevention.)
Stay cool but skeptic
This result has caused dramatic reports in the mass media about a fifty percent increase of diabetes risk. But let us keep feet on the ground: The selenium supplements have caused no more than one additional case of type 2 diabetes in every two hundred and fifty person years on average.
The real point is that we have one more case of a useless supplement. Its harm may be minimal, but there is no proven benefit (the anticancer effect is controversial, see Wikipedia). Our body needs selenium but only in trace doses that we normally get from healthy food. In my opinion, there is no need for selenium supplements at all. Save your money to buy better food instead.
Related post: Useless vitamins against arthritis
Photo credit: flickr.com/photos/bigfatrat/102406726/
Wednesday, July 11, 2007
A low heart rate at rest is a sign of good fitness and hence is said to predict a long life as far as the heart may be concerned. This is true for men but not for women, according to a Swedish study: Longevity in women has nothing to do with heart rate at rest.
About five hundred men and an equal number of women have undergone a fitness test where their heart rate has been assessed. All deaths of these persons have been registered up to twenty-six years later. Among men with a heart rate above 75 beats per minute, the percentage of deceased has found to be 63 percent higher than among those with a low heart rate. In women, there is no such difference.
My wife is quite happy about this result because her heart rate is often above the 75 beat level. And I am happy, too, because mine is much lower. Of course we both are aware that this is just statistics and cannot be applied to individual persons. But good news is good news, at least it has some probability to come true.
Take home message: Exercise is one of the best ways to a better and longer life. It may lead to a lower resting heart rate, but the extent and the importance of this effect is different in men and in women.
Photo credit: flickr.com/photos/ericasimone/327846257/
Grand Rounds 3:42
In this edition of the week's best medical blogging, Tara C. Smith opens her excellent presentation with one of my favourite topics, health and critical thinking. In her own field, public health, she shows us posts about teen pregnancies, HIV in Africa, vaccination issues in the western world and more. The show goes on with research and findings, patient perspectives, musings on the job, controversies and best of the rest. Highly recommended as ever.
July 10, 2007 at Aetiology
Carnival of Life, Happiness and Meaning #10
This carnival presents a collection of posts about addiction, personal development, motivation and time management, coping with stress, distraction and learning issues, and many more.
July 9, 2007 at Life Insurance Lowdown
Mendel's Garden #16
Like Gene Genie, this is a scientific carnival with a public scope, discussing the implications of genetic research. Hsien Hsien Lei presents a bunch of very interesting posts - Med Journal Watch has the honour to be ranked top: stem cells, collaboration of genes, inner clock, genetic engineering and artificial intelligence, genetic aspects of various diseases, and other research findings and public issues.
July 8, 2007 at Eye on DNA
Carnival of Family Life
This carnival, presented by the Expatriate Chef, has a very broad scope: Besides personal experiences it also collects a number of health related and parenting tips.
July 8, 2007 at Expatriate's Kitchen
A Very Public Diet
In her weekly carnival, Anna Farmery presents tips about maintaining low weight, healthy habits, eating more often, keeping diary, low fat recipes and more.
July 6, 2007 at MiddleAgeShed
Skeptics Circle 64
Read what happens when the skeptics hijack the official website of the New Truth University (NTU). By following the links, you have the unique opportunity to earn degrees in Coldology, Malariology, Homeopathy, Mercurology (especially Mercury and Vaccines) and Alty Medicine. You even may take courses in Liberal Arts. Highly recommended although the NTU officials strongly warn against following the links.
July 4, 2007 at the skeptical alchemist
Tuesday, July 10, 2007
In this third edition of my post series I review thirteen studies about the impact of passive smoking on children. Twelve of them show negative impacts. I begin with the only exception: In New York, more than a thousand asthmatic children between four and nine years of age have been examined together with the air pollution at home. More than eighty percent of the homes have been heated by gas stoves with an exhaust of nitrogen dioxide, increasing the asthma symptoms. Passive smoking did not show an additional effect which is not very surprising given the fact that the damage already has been done by the gas exhaust.
Asthma in children and cigarette smoking of women at home both have increased in the past decades. Of course this is not a proof that passive smoking causes asthma in children, but it is an important piece of evidence. It is not the only one. In Finland and Russia, the asthma risk in children of smoking mothers has found to be more than triple.
In Spain, Greece and Tennessee, the risk of children's bronchitis has found to be higher when mother smokes, and the risk of middle-ear infections is increased fourfold according to a Finnish study. Other studies link maternal smoking to arterial damage, lower intelligence and ADHD in children.
The risk of maternal smoking begins in pregnancy. One effect, at first sight, seems to be positive: Smoking mothers have a lower risk of hypertension. But this is due to a poor growth of the fetus suffering from tobacco poisoning. A Swedish study has shown the risk of stillbirth to be increased by 35 percent in women smoking when pregnant.
In pregnant women exposed to secondhand smoke, the risk of defect genes is fourfold (with a higher risk of disability in the offspring) compared to non-exposed women.
The dangers of secondhand smoke (2)
The dangers of secondhand smoke (1)
Passive smoking (Wikipedia)
Photo credit: flickr.com/photos/pi-production/390228231/
Monday, July 9, 2007
Best advice for a pregnant woman is not to drink alcohol at all. Second best advice is not to drink alcohol every day. This is especially important in the beginning and in the end of pregnancy. The limit in these periods is one drink per day. Beyond this limit the risk for low birth weight and preterm birth increases substantially. The higher the alcohol consumption, the higher the risk. This is the result of a Dutch population study in more than seven thousand women.
According to this study, the average weight of babies whose mothers have consumed one or more alcoholic drinks per day is 129 grams less, compared with a consumption of less than one drink per day in pregnancy. For low birth weight, the risk is nearly five-fold and for preterm birth more than double.
Photo credit: flickr.com/photos/nadine_s/53111246/
Saturday, July 7, 2007
Do graphic warnings make smokers think over their habit and seek ways to quit or do they just provoke a defensive reaction - from pushing the pictures out of mind to wrapping the packs? A team of psychologists at the University of Sheffield has found that self-affirmation makes smokers less defensive against such warnings.
About forty young smokers have been given a task that increased their self-affirmation, forty others have performed a control task with no such effect. Immediately after the task, the smokers have been viewing four shock images intended for future use on cigarette packs in the European Union. After having viewed the images, they completed a psychological test that assessed their feelings and intentions. It came out that the images are more effective in persons with a higher self esteem. The effect lasted until a week later when the smokers have been tested once more. Those who had been boosted with self-affirmation still reported a higher motivation for quitting.
This is not very difficult to understand. Self-affirmation gives you a feeling of a higher value, hence you have more to lose when your health is in danger. This may also explain, at least partially, why people with a higher education and a higher income tend to live healthier than the average population.
For me, this is the main outcome of the study. I am a bit skeptic about the long-term effect of graphic warnings, because this has been a pre-test with images that have not yet been in use on cigarette packs. Although the self-affirmed persons reported a better motivation for quitting than the others, the actual cigarette consumption did not differ in both groups.
Photo credit: smoke-free.ca
Friday, July 6, 2007
I remember well when I was a kid and was put to bed too early in my view and complained I was not ready for sleep yet, my mother gave me valerian drops. This is more than fifty years ago. Since that time, millions of mothers have given valerian drops to their kids who have been reluctant to sleep. Millions of adults have taken it too, hoping it would help. Millions swear that it helps, but they all have been wrong and are wrong and will be wrong, according to a recent systematic review of 37 studies.
The good news is that all studies have found valerian to be safe. The bad news is that most of the studies have found valerian to be useless. Few studies have found an effect, but these have been of lower quality. All high quality studies show that the effect of valerian on sleep is not different from placebo either in healthy persons or in those suffering from insomnia.
My friend Jürg whom I reported this verdict does not agree. He swears on valerian and urged me to post his experience. Here it is: «Once I have discovered a small bottle with valerian tincture in our medicine chest. I asked my wife about it and when she told me that it is completely safe I poured a teaspoonful into my palm and took it, just out of curiosity. I forgot about it and two hours later I began to feel very tired and sleepy. So do not tell me that is is useless.»
I have no reason not to believe Jürg, but as an old skeptic I must add here that valerian is supposed to show an action within twenty minutes or so. And an old latin wisdom tells us that post hoc (after it) is not propter hoc (because of it).
Skeptic counter remark: Sleep is not a simple matter of drugs and chemistry, but of feelings and emotions. Placebo works on this level, and the feeling that valerian helps to sleep may help to sleep. It may be better to take a safe drug with no proven effect on the chemical level than a strong tranquilizer with negative side effects and addictive potential.
Related post: Drugs that shorten the end of life
Photo credit: flickr.com/photos/soapbox_superstar/381791425/
Thursday, July 5, 2007
According to six studies about cosmetic breast implants and suicide that have been conducted in the past years, women who have undergone breast augmentation run a risk of suicide that is approximately double the expected risk in the general population. The authors of this meta-study cannot explain this relation and ask for further research. In their opinion, plastic surgeons should check carefully the mental health of their clients and, if necessary, send them to a consultation.
I can hardly believe that any plastic surgeon would be so careful. In Switzerland, a popular TV show has sent a local beauty contest winner, supplied with a hidden camera, to several plastic surgeons. The young miss had a perfect body and asked the surgeons to make it more perfect because she «was not happy with it». All surgeons, with only one exception, offered her a surgical treatment.
Of course I have no explanation either why breast surgery might be related to suicides. Just some thoughts to be considered.
I think that a woman who undergoes a breast augmentation relies more on how others (especially men) see her than how she sees herself. Thus, self-awareness is not controlled by the woman but is the puppet of others. Her personality may be instable and weak, and the fact that she is not happy with her look makes this more of a problem. Maybe she has expected that her whole life will be better with her new boobs. If it is not, she may become depressed because all the money and the suffering have been for nothing. Just some thoughts, every woman is different.
My advice: Think twice before you consult a cosmetic surgeon. Your body may be best as it is. Remember that body satisfaction has nothing to do with beauty: No women are better clients of cosmetic surgeons than supermodels: Just look at the Celebrity Cosmetic Surgery blog of Dr. Tony Youn.
Photo credit: flickr.com/photos/malingering/81377594/
Wednesday, July 4, 2007
Antidepressants of the Prozac type (SSRI) have recently shown to weaken the bones in women and in men. In the two studies at the universities of Minneapolis and Portland, more than two thousand older women and more than five thousand older men have been examined. It came out that only SSRI (but not tricyclic antidepressants) had a negative impact on bone mineral density. With SSRI, the bone loss in women has been roughly double the value observed in non-users of this drug type.
The end of Prozac as a lifestyle drug?
For all those who take Prozac, the most popular of SSRI drugs just for feeling better, the new research outcomes should be a reason to stop. In persons with mild depression, the effect of the drug is very small and does not outweigh the serious side effects.
In case of a severe depression, the situation looks different: Ask your doctor about the pros and cons of SSRI and about the possibilities to switch drug types.
Photo credit: flickr.com/photos/morepork/449940253/
Grand Rounds 3:41
The lead theme of this edition, presented by Graham Walker, is Sicko. Read what the best medical bloggers have to say about the new Michael Moore movie. In health care systems, insurance and policy play an important role, and you can find nine interesting posts about this issue. The main section is called the practice of medicine, it presents posts about diabetes, surgery, exercises against low back pain, happiness, finding his right weight, allergy warnings, plastified dead bodies and many more. Humanity and humor conclude this edition. Enjoy!
July 3, 2007 at Over My Med Body
Brain Blogging, 12th Edition
This carnival is about brain and more. Shaheen Lakhan presents posts about crisis, bad online habits, Alzheimer's prevention, fool ideas about diet and bodyweight that turned out to be useful, various tips for optimism and emotional freedom, and much more.
July 2, 2007 at Brainblogger
Pediatric Grand Rounds 2:6
When Shinga Xavier put together the posts of this edition, London has been threatened by terrorist bombing attempts by (she did not know yet) medical doctors and students. Mad world. Anyway, emergency situations play an important role in this edition, in a parenting and medical view. The dangers of secondhand smoke (a pet topic of mine), video games, overweight and stress are discussed. Again, the vaccination, MMR and autism is a key issue with many posts that keep us informed about the latest ongoings.
July 1, 2007 at Breath Spa for Kids
Attention Deficit Disorder Carnival #29
In this carnival, John W. MacKenzie presents a bunch of posts about emotional and nutritional aspects, ADD-friendly sports, personal experiences of ADD adults and parents of ADD kids, positive aspects of ADD (yes, they exist) and many more. A must read for all who have to deal with ADD or ADHD.
July 1, 2007 at Adult ADD and Money
Gene Genie #10
This is a really scientific blog carnival and covers the forefront of research in the field of genetics, one of the hottest topics in medical science. Be prepared to not very easy stuff and peer over the shoulder of top science. In this edition T. Ryan Gregory presents the implications of so-called «junk DNA», the question of genes, birth order and IQ which is also covered by Pediatric Grand Rounds, and various diseases linked to genes.
July 1, 2007 at Genomicron
All Things Medical, June 2007
This monthly carnival of Aleksandr Kavokin presents a broad spectrum of posts about diagnosis, disease, health, medicine, health, medicine, symptoms and treatment. The posts are presented as submitted by the authors.
June 26, 2007 at RDoctor
Tuesday, July 3, 2007
This portion control plate has been designed as a weight loss aid for all those who hate diets and calorie counting. It has sections for every type of food: starchy carbohydrates (rice, pasta, potatoes and the like), protein (meat, fish, poultry), cheese, and a sauce circle. The general rule is that every type of food should stay within the borders that separate the sections on the plate. For pasta or rice with sauce, the food is first put to fill the carbohydrate section, then rearranged to a ring around the sauce circle, then the sauce circle is filled.
The plate seems to work better than a conventional diet. Both methods have been compared in a study of the University of Calgary: A hundred and thirty obese diabetics either used the portion control plate or have been taught by a dietician. The diet counseling was hardly successful, the patients lost only 0.1 percent of their weight on average. With the portion plate, weight loss was a bit better, at least 1.8 percent on average.
A different portion size trial has been undertaken with nineteen volunteers at a county medical center of Minnesota. They received free lunch for two months, one month with a normal portion and one month with a double portion of the same foods. With the double portions, daily intake was more than three hundred kilocalories higher on average, and the subjects gained more than a pound of weight in this month. In the month with normal portions, the weight remained more or less stable.
The problem of big portions is the norm that they set. It is very hard for the eater to ignore it and just eat as much as he or she likes. Most of us have been taught eat all up manners as a child. There is a close relation between portion size and obesity: Fast food portions are larger in the United States than in Europe and so is the obesity problem.
Portion-related weight loss tips: Take only half the amount of food on your plate than usual. Eat slowly and savour your meal. Do not finish your plate before the others have finished theirs. If you like, take another portion, but wait until the others have been served.
Photo credit: thedietplate.co.uk
Monday, July 2, 2007
If you want to lose weight, eat apples but do not drink apple juice. Common sense tells us that it takes more time to eat an apple, hence you get less calories in a given amount of time. But does this really matter? It does, as a food trial at Purdue University has shown.
A total of a hundred and twenty persons, sixty lean and sixty obese, have been tested either with a drink or with a matched solid food of the same type and calorie content: watermelon juice and watermelons with the same amount of carbohydrates, milk and cheese with the same amount of protein, and coconut milk and coconut meat with the same amount of fat. Besides this test meal, the persons were free to eat what they wanted for the rest of the day. The total energy intake has been calculated. It came out that total daily energy intake was twelve to nineteen percent higher with the drinks than with solid foods. This was the case in both the lean and the obese subjects. The scientists conclude that beverages lead to a smaller «dietary compensation» than solid foods.
In other words: When you take calories with a drink, your body is not really aware of having got them and he sees no reason for eating less.
Photo credit: flickr.com/photos/desirees/344772550/