Health

Approaching a Cure for Cancer

James Watson, co-discoverer of DNA’s double-helix structure recently called for a back to basics approach in dealing with cancer.  In previous post threads I’ve discussed cancer’s complexity and in particular the confounding and scary implications of somatic evolution, which underscores some of the reasons we are not winning the “war on cancer.”  Here I will discuss some cutting edge approaches to treating and preventing cancer and how they might pan out in light of the complexities of the disease.  The categories below are not mutually exclusive, and the examples cited are nowhere near exhaustive, but this should give you some food for thought.  If you have ideas, questions or know of approaches that should be highlighted, please comment.

Target & Kill Approaches

Biris and Zharov are making some exciting progress in using nanotubes to tag and then track cancer cells inside the body as they move around.  They propose to kill the cancer cells by heating up the nanotubes using lasers, while others are

How Many Calories for a Dollar?

Michael Pollan, as always, making perfect sense:

Now watch Will Allen on urban farming…

Egyptian Mummies Yield Ancient Secrets of Good Journalism

This is based on an LA Times article here

What strikes me most is how athlerosclerotic the science itself is.  Or perhaps it’s just the reportage?

The opening line of the article is “CT scans of Egyptian mummies… show evidence of… hardening of the arteries, which is normally thought of as a disease caused by modern lifestyles….”  One of the researching cardiologist draws this conclusion: “Perhaps atherosclerosis is part of being human.”

The LA Times reporter covering the story (Thomas Maugh) rightly points out at the end, “The high-status Egyptians ate a diet high in meat from cattle, ducks and geese, all fatty.”  Which of course entirely negates the hypothesis of heart disease being part of the natural human condition.

It’s clear why the researchers — both cardiologists — would want ancient evidence to support the notion that heart disease is normal.  But the fact is that the preponderance of evidence around the world in epidemiology as well as cardiology indicates that …

Daniel Nocera’s Gift

I just saw the most important talk I have seen in 300+ TED, Pop!Tech, etc talks that I’ve watched.  And at the risk of hyperbole, I will say that the worst case scenario is that Daniel Nocera simply wins a Nobel Prize (and yes, I’m willing to bet at even odds that it happens in under 10 years from today).  But if the system is able to scale through replication, it will be at least as important as penicillin in terms of ending human suffering and will have a bigger impact on the world as a whole.  Here’s why:

  • Input: Water (clean, saltwater or dirty water)
  • Outputs: Electricity + Pure drinkable water
  • By products: nothing (other than what was in the water)
  • Resources required to assemble: all abundant and most have substitutes
  • Knowledge required to assemble: simple
  • Cost to assemble: relatively cheap

Essentially what Nocera has done is reverse engineered and re-created a super-simplified photosynthesis process.  It’s a closed loop (i.e. autocatalytic) so …

The Link Between Food & Healthcare Reform

Also must-read this Sunday is Michael Pollan’s NY Times Op-Ed piece from Wednesday.  Nice cap to my week of ranting on the dismantling of rationality when it comes to lifestyle choices that directly impact one’s health, here and here.…

Rafe Issues Challenge to Statin Industry

I have been trying to get the straight scoop on whether statins actually decrease mortality and morbidity in a significant way and I haven’t been able to find any real evidence that they do.

If you ask a cardiologist it’s clear that they believe unequivocally that statins work, mostly because they see what statins to do blood cholesterol levels.  But remember, cholesterol numbers in and of themselves do not matter.  They are a proxy variable for cardiovascular health.  Plaque buildup matters.  At one time blood cholesterol numbers were the only non-invasive indicator we had of plaque buildup, but that’s not true anymore.  However, drug companies are highly incentivized to prove that statins improve health.  So they fund lots of studies.

Notwithstanding the systemic bias when there are profit motives and publication motives, we can turn to these studies and see if statins actually work.  The best way to remove bias is to look at large-scale meta-analyses, like this one.  If you simply read the …

I’m a Nutritarian

For the past year or so I’ve been eating about 80% vegan.  I hate the word “vegan” because it has political/ideological connotations I don’t ascribe to, and also because by definition that’s not what I am.  I think Dr. Fuhrman’s neologism, nutritarian sums up my position on food choices:

A person who [eats for health] is called a nutritarian, and understands that food has powerful disease–protecting and therapeutic effects and seeks to consume a broad array of micronutrients via their food choices. It is not sufficient to merely avoid fats. It is not sufficient for the diet to have a low glycemic index. It is not sufficient for the diet to be low in animal products. It is not sufficient for the diet to be mostly raw food. A truly healthy diet must be micronutrient rich and the micronutrient richness must be adjusted to meet individual needs. The foods with the highest micronutrient per calorie scores are green vegetables, colorful vegetables, and fresh fruits. For

Should You Use Sunscreen?

This is a very complex topic, as the following talk suggests:

The main takeaways from this that I got are:

  1. Cancers for which sunlight deficit is a risk factor are orders of magnitude more prevalent than the few for which overexposure is a risk factor.
  2. People who are using sunscreen regularly are precisely the ones who shouldn’t be.
  3. We should be very careful and sparing about recommending sunscreen usage or sun avoidance, and always temper such advice with the tradeoffs of not getting enough sunlight.

As someone who wonders on a regular basis whether the public has the right information to make informed decisions about health-related tradeoffs, I am curious… does the above strike you as surprising?  What do you currently do regarding sun exposure, and are you likely to change anything based on the above?  What do you think the overall message that reaches the masses is regarding sun exposure?…

What Obama Needs to Do

The old philosophical theory says that reason is conscious, can fit the world directly, is universal (we all think the same way), is dispassionate (emotions get in the way of reason), is literal (no metaphor or framing in reason), works by logic, is abstract (not physical) and functions to serve our interests. Language on this view is neutral and can directly fit, or not fit, reality.

The scientific research in neuroscience and cognitive science has shown that most reason is unconscious. Since we think with our brains, reason cannot directly fit the world. Emotion is necessary for rational thought; if you cannot feel emotion, you will not know what to want or how anyone else would react to your actions. Rational decisions depend on emotion. Empathy with others has a physical basis, and as much as self-interest, empathy lies behind reason.

This is part of a brilliant article by cognitive science and linguistics pioneer, George Lakoff (emphasis mine).  His argument about what …

Celiac Disease on the Rise

According to a new report in Gastroenterology (July 09), Celiac Disease is now 4 times more common in the US than it was during the 1950’s. The disease results from an intolerance to the protein gluten, found in wheat, barley, and rye.  When celiac patients consume gluten, they suffer an inflammatory reaction within the small intestine that can lead to a host of manifestations, including abdominal pain, diarrhea, weight loss, anemia, infertility, malnutrition, and premature osteoporosis.  It can develop at any age and is frequently misdiagnosed or undiagnosed because of its non-specific symptoms.  Based on this new evaluation, about 1 in 100 people have it and many are not aware.  Anyone with chronic gastrointestinal complaints or any of the features listed above, should be screened for this disease.  A simple blood test can determine the diagnosis in most cases.  Treatment entails lifelong adherence to a gluten-free diet.  The “silver lining” for folks diagnosed with Celiac disease is that it largely and forever commits them to

Health Care Parallels Education

I was listening today to a Fresh Air interview from a couple of weeks ago on the reasons for the high cost of health care:

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Highly informative and thought provoking. One thing that struck me was the discussion about how we don’t pay primary care physicians enough and that specialists make a majority of the dollars. This is not earth shattering news, but it I was reminded of a similar problem in higher education. Specialization is highly valued where as general studies and thinking/life skills are not, despite the fact that it’s these more general abilities and knowledge that determine how successful you are in your chosen trade (specialized or not). Same thing in medical care: it’s not the specialists who have the most impact on your health and mortality, it’s …

Something Fishy About Mercury

Here is a fascinating discussion on NPR’s Forum from earlier this year on the subject of mercury and fish:

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If you’ve listened to this the whole way through (which you should), I’m curious as to how it will affect your habits, if at all.  And why?…

Should We Tax Poor Nutrition?

I just tweeted on a subject that I suspected would cause a stir, and so it has, I’m moving it here:

RafeFurst: I strongly support a soda tax! RT @mobilediner: check it out:  a Soda Tax? http://amplify.com/u/dvl

coelhobruno: @RafeFurst what about diet soda? Would it be exempt?

RafeFurst: @coelhobruno no diet soda would not b exempt from tax.  Tax should be inversely proportional to total nutritional content.  Spinach = no tax

Lauren Baldwin: I do as well … and while they are at it they should tax fake fruit juice too.

Kevin Dick: I think this would be an interesting experiment. I predict a tax does not cause any measurable decrease in BMI.

Kim Scheinberg: New York has had this under consideration for a year.  Perhaps surprisingly, I’m against it. In theory, people will drink less soda. In reality, it will just be another tax on people who can afford it the least.

Leaving aside the “rights” issues and …

Is Hunger Really a Problem in U.S.?

Given everything I hear about obesity stats in the U.S. and malnutrition in the developing world, the last thing I was expecting to find in my inbox this morning was a plea to join a Facebook cause to help end hunger in America.  Really?

I’m usually not skeptical in this way, and I’m loath to focus on the negative when it comes to philanthropy, but I can’t get these thoughts out of my head and I’d like some perspective from those who are better informed about the alleged U.S. hunger crisis.  In the mean time, here’s my food for thought:…

Methuselah Foundation

If, like Aubrey de Grey, you believe that immortality is achievable, or you are just intrigued by the possibility, you should check out this news story on The Methuselah Foundation.

If Rafe Were In Charge: Major Medical Edition

Kevin started an interesting discussion that included a thoughtful proposal for the problem of major medical care costs risk mitigation.  You should read that here before reading my proposal below.

Part 1: Major Medical Annuities. Federally mandated/funded (similar to SSI/Medicare), with a specific initial lifetime value that is the same for everyone. The concept is that you pick a number slightly bigger than the average expected lifetime major medical bill and set aside that pot of money for everyone individually. At some point (e.g. 65) you can choose to start drawing down from your pot as taxable income. Prior to then, the only way the fund can be used is for major medical expenses not covered by other insurance you may have. Such payments go directly to providers and are tax-exempt. When you die, any leftover amount gets transferred to the MMA accounts of your heirs (per your desired breakdown, or according to probate law in the absence of a will).…

Decrease Red Meat Consumption

This is not news, health professionals of all sorts have been saying this for a long time.  ABC News features a recent study supporting this.

A relevant footnote near the end of the article though:…

Placebos Work Even If You Don't Believe in Them

This is one of the most important medical “breakthroughs” in recent memory.  You should read the entire article, because it makes some subtle points, but the upshot is that placebo has (at least) two components, one that is triggered by conscious belief in a putative cure, and another that is triggered by unconscious, Pavlovian association.…

Preventing Cancer Through DNA Replacement?

On the Cancer Complexity forum, I pose a question: if we could somehow replace all the damaged DNA in each of the cells of your body with an undamaged copy on a continuous basis, would that prevent you from getting cancer?

What do you think?…

Crohn's Disease

Debbie Maier asks us on the Upcoming Topics page to address Crohn’s Disease.

I don’t know too much about it except that it’s an autoimmune disease and has a complex, multi-causal etiology and pathology.  In my reading on autoimmune diseases in general there seems to be a direct link between latitude an incidence.   Specifically, the farther from the equator you live the more likely you are to get Crohn’s, Type 1 diabetes, rheumatoid arthritis, and so on.…

Health and Fitness Q&A with Kevin

Whenever I have a question about health matters that is too complex for an MD or academic researcher to get right, I ask Kevin.  Nobody I know has a better combination of broad-based current knowledge of the primary literature, plus a whole-system view and understanding of compex dynamics, plus the practical will and experience in living by (and updating) his conclusions.

Here are some questions I had for Kevin recently and his answers.

Rafe: Do the BPA results (such as they are) cause you concern?  Do you still use your Nalgene bottle?  Would you let your infant or child drink from a plastic bottle or sippy-cup?…

Early Detection: better late than never

Here is the scariest image in all of cancer:

cancermortality

Graph from Fortune Magazine article.

Third-Hand Smoke

Thanks to Daniel Horowitz for alerting me to third-hand smoke.  I guess then if you pass on epigentic mutations to your children from third-hand smoke exposure it’s called fourth-hand smoke?…

Homelessness

foodonfoot

This is a picture of what Food on Foot did on Christmas. …

Eben Pagan’s Birthday Webinar

This year for his birthday, Eben decided to host this webinar and invited all his contacts to join him online in lieu of a party and gifts.  What a brilliant concept and even more brilliant execution.  Eben (and Scott Brandon Hoffman, founder of CharityWater.org) truly epitomize the new philanthropy.  Watch the video here.…