Richard G. Petty, MD

Healing Everything

I get a huge number of requests for more information about my philosophy of health and healing; where it came from, and why people believe that my approach is the medicine of the future: hence the amusing title of “The Future Doc.”

My belief in an “integrated” approach to health and healing, that engages the physical, psychological, social, subtle and spiritual aspects of life is not confined to the treatment and personal growth of individuals. It also encompasses ecology, sociology and business practices. In many respects I have followed a similar path to Ken Wilber, but while he has been the theorist par excellence, whose ideas are now being test-driven in a multitude of different applications, I started from personal perception and clinical practice. I talk about some of the origins of my work in Healing, Meaning and Purpose.

It is well-known that I had the privilege of working with the Prince’s Foundation for Integrated Medicine, which is now the Foundation for Integrated Health, and I recently came across this statement by His Royal Highness The Prince of Wales in the magazine Temenos that beautifully summarizes the philosophy that underlies the entire approach.

“As I have grown older I have gradually come to realize that my entire life so far has been motivated by a desire to heal - to heal the dismembered landscape and the poisoned soil; the cruelly shattered townscape, where harmony has been replaced by cacophony; to heal the divisions between intuitive and rational thought, between mind, body and soul, so that the temple of our humanity can once again be lit by a sacred flame; to level the monstrous artificial barrier erected between Tradition and Modernity and, above all, to heal the mortally wounded soul that, alone, can give us warning of the folly of playing God and of believing that knowledge on its own is a substitute for wisdom.”

Most of us realize that the world has become terribly unbalanced, with an extraordinary over-emphasis on the intellect and a tacit assumption that the world is an object to be plundered. In the halls of academia, “heart,” “intuition” and “soul” have often become dirty words, even though it is difficult to see how we can repair our imbalanced world without acknowledging the importance of all of them. This is not to decry the importance of reasoning, but it is an appeal to acknowledge the existence of the soul, to heal our connection with and to listen to her intuitive urgings.

Prince Charles has also said that,

“In medicine, as in architecture, the doctrine of man as a machine has held sway. God was declared dead - I remember it happening. The soul was declared moribund and redundant. Ancient well-tried therapies and diagnostic techniques were simply abandoned and thrown away. The balance of the rational and the intuitive was destroyed.”

I totally agree, and it is this balance that we have to restore.

Our lives depend on it.

Mold, Dampness and Depression

It matters where you live.

I have lived or stayed in many countries, and there is no doubt that some places are a lot more congenial than others. I don’t just mean a beach in Thailand compared with the North of Scotland in winter. Some places just make you feel better. There are many physical, psychological, social and subtle reasons, but here is a relatively new one.

There is an important paper in this month’s issue of the American Journal of Public Health looking at the possibility of a link between dampness and mold in the home and clinical depression.

Molds are fungi that are found in many environments but most of them grow best in warm, damp, and humid conditions. Therefore, dwellings that have problems with damp also commonly have problems with mold. Although the physical health consequences of living in a damp and moldy dwelling are quite well known, the effect of living in such an environment on mental health has not.

Some of the known health problems associated with high levels of airborne mold spores include^:

• Allergic reactions
• Asthma
• Irritations of the eyes, nose and throat
• Sinus congestion and other respiratory problems
• In people with with weakened immune systems, inhaled mold spores may germinate, attaching to cells along the respiratory tract
• Immunocompromised individuals exposed to high levels of mold may get a systemic fungal infection
• Infections of the digestive tract, lung and skin

The researchers used survey data from 8 European cities. They created a dampness and mold score from resident- and inspector-reported data. Depression was assessed using a validated index of depressive symptoms.

The results showed that dampness and mold were associated with depression, independent of individual and housing characteristics. This association was independently mediated by perception of control over one's home and by physical health.

This link is most likely because of the psychological and physiological consequences of living in poor housing conditions. But there could also be a direct pathological effect of mold itself.

Television and High Blood Pressure in Overweight Children

After learning that watching too much television may cause behavior problems in children, a new report in the American Journal of Preventive Medicine indicates that watching too much television may push up a child’s blood pressure, but only if he or she is overweight.

Researchers from the University of California, San Diego; the Rady Children's Hospital - San Diego; the University of California, San Francisco; and the University of South Alabama collected data on 546 young people, aged 4 to 17 years, who were evaluated for obesity at pediatric subspecialty weight management clinics in San Diego, San Francisco and Dayton, Ohio, from 2003 to 2005. Children and their parent(s) were given a written questionnaire, which was used to estimate the average daily time spent watching TV, and then a physician verbally reviewed and confirmed the time estimate. The height and weight of the children were measured to determine a Body Mass Index and their blood pressures were recorded.

The investigators found that TV time was positively correlated with the severity of obesity. After controlling for race, site, and BMI score, both the severity of obesity and daily TV time were significant independent predictors of the presence of hypertension. Children watching 2 to 4 hours of TV had 2.5 times the odds of hypertension compared with children watching 0 to 2 hours. The odds of hypertension for children watching 4 or more hours of TV were 3.3 times greater than for children watching less than 2 hours of TV.

Yet more evidence that as wonderful as the television can be, too much of anything is not a good idea.

Well, almost anything...

“I find television very educating. Every time somebody turns on the set I go into the other room and read a book.”
--Groucho Marx (American Comedian, 1890-1977)

Broccoli and Skin Cancer

This one is going to launch a thousand gags on the late night talk shows, but it is actually quite serious.

Despite what you hear on some of those infomercials, there is a strong link between ultraviolet radiation (UVR) and many kinds of skin cancer. You can even use ultraviolet radiation to induce cancerous change in cells cultures in a Petri dish.

In an article from Johns Hopkins University published in the Proceedings of the National Academy of Sciences damaging effects of UVR can be significantly reduced by the topical application of a broccoli extract called sulforaphane that comes from broccoli sprouts. Sulforaphane was first identified over 15 years ago, and it has been shown to play a role in preventing the development of several types of tumors that can be induced by cancer-causing chemicals. It may also have a role in fighting some established tumors.

The research involved both animal and human studies, and showed that the level of erythema (skin reddening) caused by UVR is substantially reduced when this extract is applied to the skin.

The broccoli extract is not acting like a sunscreen; it does not absorb the UVR, neither does it stop it from entering the skin. Instead it enters the cells and switches on the production of several enzymes that protect cells from UV damage. The result is that the protective effect is sustained for days after the extract has been removed.

The advantage of this is that it is much longer-lasting than any sunscreen - several days, in fact. The scientists said the protection is still there when no extract is present on/in the skin.

The researchers first tested sulforaphane on mouse models of skin cancer, and then on six healthy human volunteers.

Each of the volunteers had small patch of skin exposed to a pulse of UVR. Some of the patches were treated with the broccoli extract while others were not.

At the highest UVR dosages, UVR-induced redness and inflammation was on average 37% lower when the extract had been applied, and the protection was sustained for at least three days. They also found that protection varied greatly depending on the person - protection ranged from 8% to 78%.

These variation may be due to the volunteers' different skin types, dietary habits and genetic differences.

In these trials, the conventional sunscreens did not provide significant protection.

This research is important for several reasons:

• The research re-emphasizes the importance of recognizing inter-individual differences. An approach that works for one person may not help another
• There are many times in life when we cannot do much to prevent something bad happening to us: radiation, stress or somebody being mean. The new approach s not just to prevent exposure, but also to work on resilience: how can we stop ourselves from having a bad reaction? The whole of us, from our cells to our soul?
• It is inevitable that people will start telling you that broccoli is the way to protect yourself against skin cancer, and I am just waiting for the advertisements to start coming in. Do not be fooled! This research involves a specific extract applied to a precise area of skin. As far as we know, it does not apply to eating broccoli

Television and Behavior Problems in Children

The debate about the possible association between watching television and children’s behavior has been going on ever since this window on the world entered our lives fifty years ago.

A new study, indicates that consistent, heavy television viewing (more than two hours a day) throughout early childhood can cause behavior, sleep and attention problems.

Yes, you did read that correctly: heavy viewing is just two hours a day!

Researchers from the Department of Population, Family, and Reproductive Health at Johns Hopkins assessed data from the Healthy Steps for Young Children national evaluation effort that looked at the effects of early, concurrent and sustained television exposure at age two and a half and again at five and a half. They also measured the effects of having a television in the child's bedroom at age five and a half.

Sixteen percent of parents said that their child watched television for more than two hours a day at age two and a half years only, which they called “early exposure;” 15 percent reported that their children watched more than two hours of television daily at five and a half years only, which they called “concurrent exposure;” and 20 percent reported more than two hours of television viewing daily at both times (sustained exposure).

Forty-one percent of children had a television in their bedroom by the age of five and a half. Sustained television viewing was associated with sleep, attention and aggressive behavior problems, and what is known as “externalizing” of problem behaviors: throwing or breaking things.

Excessive television exposure was associated with fewer social skills. Having a television in the bedroom was associated with sleep problems and less emotional reactivity in the five year olds. Early exposure to television for more than two hours a day, which decreased over time, did not cause behavior or social problems.

The American Academy of Pediatrics recommends no television viewing for children under age 2, and no more than two hours of daily media exposure for ages 2 and older.

This is scary research. How many children are parked in front of a television for hours at a time, just to get them out of the way. And what kinds of problems are we creating for our future?

One of the smartest people I know has several children who have never watched television. They are instead all multilingual and each is an expert in at least one musical instrument.

Makes you think, doesn’t it?

Taking Action on Food Additives and Hyperactivity

Regular readers will remember my recent article concerning food additives and hyperactivity in children.

I have just read that he British Food Standards Agency (FSA) has been accused by campaigners of "chickening out" of banning additives linked to hyperactivity in children even though they funded the research that was published in the Lancet.

After the research was published, the FSA issued updated advice that eliminating the artificial colorings from the diet might have some beneficial effects in hyperactive children.

But critics said it did not go far enough and several environmental and children's campaign groups, including the National Union of Teachers, called on the watchdog to extend that advice to all children since the additives posed a threat to psychological health.

The FSA responded by saying that the evidence was not strong enough to justify a ban and it would wait for the European Food Safety Authority (EFSA) to make a decision on use of additives in food.

EFSA says that it is considering the research as a matter of urgency and will be making an initial response within the next month.

We shall see what they have to say.


These were the main additives incriminated in the Lancet study:
Sunset yellow (E110) - Coloring found in some drinks
Carmoisine (E122) - Red coloring in jelly
Tartrazine (E102) - New coloring in some frozen and carbonated drinks
Ponceau 4R (E124) - Red coloring
Sodium benzoate (E211) - Preservative
Quinoline yellow (E104) - Food coloring
Allura red AC (E129) - Orange / red food dye

Solar Cycles and Human Disease

We have all heard about the supposed association between full moon and mental illness, though most of the research has failed to find an association between phases of the moon and mood disorders or psychosis.

But something that we have not heard so much about is the possible association between solar activity and human problems.

Investigators from Chile presented some interesting data (NR308) at the 2007 Annual Meeting of the American Psychiatric Association in San Diego last month.

They used a measure of solar activity called the Wolf number that is based on the number of sunspots. The sunspot cycles are usually between 9.5 and 11 years. They examined the clinical records of 1862 individuals who had been seen at a psychiatric clinic in Santiago over a sixteen-year period, which corresponded to one and a half solar cycles. They found that there was a big rise in admission for severe depression during years with low solar activity and a slight increase in the number of admission for mania during years of high solar activity.

This is not the first time that a connection has been found between the sun and human affairs.

The same authors published a paper in Spanish two years ago in which they also found that depression is more common when there is less solar activity and mania increases when there is more activity. They cannot say whether it is just light that is causing this or some other form of radiation.

Two researchers used the Maine Medicaid database to look at the relationship between solar cycles and human disease, and found that that radiation peaks in solar cycles and particularly in chaotic solar cycles (CSCs) are associated with a higher incidence of mental disorders. The same researchers had previously used the same database to suggest that CSCs produce more ultraviolet radiation and it is this that limits human longevity by causing chromosomal damage.

Interestingly, in 1993 two researchers also suggested a relationship between solar activity and longevity. They looked at the mean longevity of birth cohorts from 1740 to 1900 for United States of America (U.S.) Congressional Representatives exhibited oscillations that coincided with the 9- to 12-year sunspot cycle. They found that the mean longevities of these cohorts were 2-3 years longer during times of low sunspot activity than at peak activity. This phenomenon was confirmed in data from members of the House of Commons of the United Kingdom Parliament and from University of Cambridge alumni.

Researchers in Slovakia have suggested that there may be an association between solar radiation and cerebral strokes, though their data is a little difficult to interpret.

It is clear that the Heavens have more of an impact upon us than many scientists realized, and need to be factored into studies of human mood and behavior.

Negative Ions to Help Treat Mania

Last year I talked about some of the nasty problems that can be caused by the hot dry winds that blow in many parts of the planet.

I have just seen that a paper that I was asked to look at a few months ago has just appeared in print, though according to the journal it came out in February!

The investigators used a negative ionizer to augment the treatment of 20 acutely manic people. It was a standard double-blind crossover study with raters who did not know who had received what treatment.

The negative ions did indeed produce a significant improvement in manic symptoms. We already know that atmospheric ions can have an impact on serotonin levels in some parts of the brain, and that could be the mechanism of action.

It is surprising that there has been so little research into such a simple intervention, though it is important to note that the patients were also receiving medications. But it would be valuable to see if such a simple environmental change could modulate serious mood problems before they get to the level of needing hospitalization.

Non-pharmacological and Lifestyle Approaches to Attention-Deficit/Hyperactivity Disorder: 5. Exercise, Environment and Sleep

One of the most valuable things to do to help children or adults with ADHD is to help them to structure their time.

All the approaches that we have already discussed, from medications to diets, herbs and homeopathy are all tools designed to help people get to the point where they can create, accept and maintain more structure in their lives. Exercise, the environment and regular sleep are all essential contributors.

Exercise
Aerobic exercise may be particularly helpful for people who also have a mood disorder or anxiety probably by reducing inflammatory mediators in the blood.

There is a movement therapy called eurythmy that was developed by Rudolf Steiner. It is quite popular in central Europe, and there has been a report that it could help children with ADHD. 


Environment
There is evidence that children with ADHD do better if they are outside, and even being a green room seems to help them. 


There are plenty of anecdotes about children and some adults with ADHD improving if they have classical or New Age music in the background. Paradoxically some like and claim benefit from “heavy metal.” There is recent evidence from New Zealand indicating that music therapy may contribute to the reduction of a range of ADHD symptoms in adolescents, as it does in younger children. With the advent of the iPod, it is easy to make a playlist of music that helps attention and concentration.

The data on the effect of watching television, computer time or playing video games is a mixed bag. There are people who say that children under the age of three should not watch television at all, and the American Academy of Pediatrics recommends that children under the age of 2 years should watch no television, and that television time should be limited to less than 2 hours daily in older children. The research data has not produced a clear answer one way or the other. Some of the most recent research does suggest a link between the amount of time that children spend watching television and attention-deficit/hyperactivity disorder, but it remains unclear as to whether elevated levels of television viewing are the cause or result of ADHD symptoms. Other researchers have failed to find a connection. The best thing is to play safe and to keep television viewing to a minimum: there are so many other things for a child to be doing.
   
There have been questions about whether other environmental factors, particularly lead, mold and Candida could cause ADHD.

Lead toxicity is well-known to cause neurological problems, but studies of a link between lead levels and ADHD have usually failed to find a link, and in a study in which children with minimally elevated lead levels were given a drug – penicillamine - to remove lead, there was no change in ADHD rating scores. So it is unlikely that lead is a factor in most children.

Because of the high rates of allergies in people with ADHD, there have been attempts to see if mold or other environmental pollutants could be causing ADHD. So far the data has drawn a blank.

Another environmental factor that has been look at is the yeast Candida albicans. It can produce nasty infections in people with compromised immune systems. But in addition, some people have claimed that Candida infections can cause an array of medical problems, including ADHD-like symptoms. People who are thought to have Candida have been treated with diets as well as the antifungal agent nystatin, with mixed results. It would be good to do a formal study of Candida in ADHD and see if there is a link and if treatment helps. So far we just do not have one.

Sleep
Sleep disturbances are extremely common in ADHD. They often get better once an individual is treated, but it is still a good idea to practice good sleep hygiene.

1. Stress management
2. Exercise a couple of hours before retiring
3. Keeping mentally stimulated until it is time for bed
4. Though we want to have a regular bedtime and bedtime ritual, to begin with don't go to bed until you are tired
5. No caffeine, alcohol or nicotine after 6pm. (Preferably, of course, no nicotine ever!!) {Remember that many over the counter painkillers contain caffeine, as does chocolate}
6. Try to keep the bedroom atmosphere relaxing, and establish a sleep ritual
7. Keep the room quiet and dark
8. If you like aromatherapy, lavender and chamomile are usually best
9. If you cannot sleep, get up and do something relaxing: struggling to go to sleep is virtually impossible.
10. Do not have a television in the bedroom. Bedrooms should be reserved only for sleep in children and for one other activity in adults
11. Always get up at the same time in the morning, to try and re-set your brain, and as soon as you get up, be exposed to as much bright light as possible

Sunscreens Are a Last... Resort

We talked recently about the ongoing discussion about whether sunscreens are harmful, and perhaps even the “cause” of skin tumors. The theory doesn’t make much sense.

And now there is a new report from Switzerland published in the Lancet, suggesting that thick fabrics such as denim and wool offer the best protection against the sun's rays, while traditional thinner summer fabrics such as cotton and linen are much less effective. I can attest to that, having been burned through a cotton shirt on a cloudy day in Singapore.

The researchers reviewed 500 studies and recommended staying out of the sun, or wearing thick clothes and hats. They say that using sunscreen is the least effective option, and should really be seen as a last line of defense against the potentially harmful rays of the sun.

Obviously we need to be practical: living in the Southern United States, there is no way that we could work outside wearing our winter woollies.

There are some lightweight clothes that offer up to 50+ UPF (ultraviolet protection factor). Another good option is to wash clothes in a specialty detergent that boosts the UPF of your everyday clothes for up to 20 washes.

So sunscreens it will have to be.

Sadly many people do not use them properly.

Here are the rules for using sunscreen:

• Use plenty: incorrectly applied SPF 30 is about the same as SPF 15-20
• Apply it before being exposed to the sun: most sunscreens work by reacting chemically with the skin, so they don't start absorbing damaging rays immediately and should be applied generously at least 20 minutes before going outside to reach maximum protection
• Reapply after swimming or sweating
• Try and avoid being outside between 11AM and 3PM
• Reduce you exposure to an absolute minimum if you have a personal of family history of skin cancer
• Make sure that you do not have any illnesses that may make you photosensitive
• Be extra careful if you are on any medications that can increase your sensitivity to the sun

   
If you are in any doubt about any lesions on your skin, have them checked by an expert.

It can be fun in the sun and nobody wants to be a killjoy.

But my own mother had a melanoma in her forties, almost certainly at a site that had burned repeatedly when she was a teenager. And for people who say that these cancers are caused by sunscreens, I'd like them to explain how a young man lost an eye after developing an ocular melanoma. I have it on good authority that he had never applied sunscreen to his eyeball.

There is little doubt that some people are more sensitive to the sun's rays than others, and if you have a family history, your may have the high risk genes.

Enjoy the sun, it can do you a lot of psychological as well as some physical good.

Just please be careful out there.


"May the sun bring you new energies by day. May the moon softly restore you by night. May the rain wash away any worries you may have. May gentle breezes refresh your soul and all the days of your life. May you walk gently through the world and know its beauty.”
--Unknown Author

Alzheimer’s: “A Disease of Civilization?”

I have had the pleasure of receiving some excellent comments after the recent article about Alzheimer’s disease.

One suggestion was that Alzheimer’s is a modern illness caused by mercury in dental fillings. This has been a popular idea for several years, and I knew an holistic dentist in Philadelphia who told me about some people who seemed to be relieved of an array of symptoms after their mercury-containing fillings were removed.

Over the last few years I have spent a long time reading books on the topics and analyzing published studies in detail.

These are some of the books with which I started:

1. Warren T. Beating Alzheimer's: A Step Towards Unlocking the Mysteries of Brain Diseases. Garden City Park, New York: Avery Publishing Group Inc., 1991.
2. Huggins HA. It's All in Your Head: The Link Between Mercury Amalgams and Illness. Garden City Park, New York: Avery Publishing Group Inc., 1993.
3. Walker M, Whitaker J. Elements of Danger: Protect Yourself Against the Hazards of Modern Dentistry. Charlottesville, Virginia: Hampton Roads Publishing Company Inc., 2000.
4. Hardy JE. Mercury Free: The Wisdom Behind the Global Consumer Movement to Ban "Silver" Dental Fillings Glassboro, New Jersey: Gabriel Rose Press Inc., 1996.

One of the best resources that I’ve found for people interested in the potential problems that may be caused by dental amalgams is here.

Clearly there is a potential for harm. At one time I considered having my fillings removed, but in the end I didn’t.

Why did I make that decision?

After all, mercury is neurotoxic, which is one of the reasons for all the concern about thimerosal in vaccines, and its alleged link to autism. And I would prefer to avoid getting Alzheimer’s disease. I have no family history of it. In fact the opposite: my father was estimated to have an IQ in the 170-180 range when he was in his nineties. But it is still a concern.

While some people seem to have benefited form having their fillings removed, many have not. So there must be some other factor or factors, likely including a genetic predisposition. People have created genetically deformed animals with all the signs of Alzheimer’s disease, but without a molecule of mercury in sight.

It is constantly being said that Alzheimer’s disease is a modern illness, and that its appearance roughly coincided with the introduction of mercury fillings. But that’s not true. Alois Alzheimer did describe the classic pathological signs of the disease in 1906. It was only made possible by the development of a new silver staining method developed by Alzheimer’s colleague Franz Nissl. For the first 70 years after it was first described, Alzheimer’s disease was regarded as a “Pre-senile” dementia.

But dementia had been described at least two thousand years earlier by Lucretius.

Some of those early descriptions probably included a ragbag of different illnesses, but for at least 2,000 years, from Rome to China, there were clear descriptions of something that looks just like modern Alzheimer’s disease. There are descriptions by the great English physician Thomas Willis, and the term “demented” entered the English language in 1644. There was a famous description of Sir John Roberts of Bromley, who was described by his physician, William Salmon as “decayed in his intellectuals.” That was in 1694.

There are extensive descriptions of “senile dementia” from many of the famous names in the history of psychiatry, including Cullen, Pinel and Esquirol. So the idea that it is a modern illness is not correct. Has it been becoming more common? Possibly, but it is difficult to say, because in 1905 the average life expectancy in the United States was 47 years.

When I really started analyzing the research in detail, I was not impressed by the data linking mercury with Alzheimer’s disease and multiple sclerosis. There are definitely some reports (1.2.) of possible links between neurodegeneration and mercury, but the most recent epidemiological studies have failed to find a link. Indeed there has been a great deal of research indicating that – for most people – amalgams are safe. ( 1. 2. 3. 4.) although it is important that the research should continue. Last year the U.S. Food and Drug Administration (FDA) panel called for an additional review of scientific studies on the safety of dental amalgam fillings. Some of the responses are here.

My own take on this is as follows:

1. The evidence for a causal link between mercury – primarily from fillings – and Alzheimer’s disease is thin.
2. The quality of the evidence for many other conditions, such as multiple sclerosis is also not of good quality.
3. There is still a great deal that we do not know about the medical consequences of mercury containing amalgams, particularly in children and pregnant women.
4. I am going to continue to update this information as more data is published.

At the moment I still have my fillings.

But there is another reason: the few that I have were done in England, and for years now there have been restrictions on the use of mercury-containing amalgams.

Asthma, Air and Allergies

After a couple of weeks away I was distressed to see that I was going to be returning to a city which has just been rated as the most challenging place in America for people with asthma.

This is the list according to the Asthma and Allergy Foundation of America:

1. Atlanta
2. Philadelphia
3. Raleigh, North Carolina
4. Knoxville, Tennessee
5. Harrisburg, Pennsylvania
6. Grand Rapids, Michigan
7. Milwaukee
8. Greensboro, North Carolina
9. Scranton, Pennsylvania
10. Little Rock, Arkansas

I am pleased to say that I do not have asthma, though I have a strong family history of it. If you live in one of these cities, or any other with a high rate of pollution, there is nothing much to be done apart from:

Staying indoors when the weather is bad

Using an air purifier

Keep to a diet designed to reduce your risk of inflammation

Use homeopathy and tapping therapies to help when necessary.

And sadly, for some people, medicines are the only option. But I always try the other approaches as well.

Pesticides, Weight Gain and Insulin Resistance

On this blog and in Healing, Meaning and Purpose, I have talked about some of the less well recognized contributors to obesity, including:

1. Stress
2. Salt
3. Viruses
4. Pesticides
5. Intestinal bacteria

There is some new evidence from Korea published in the journal Diabetes Care, supporting the possible contribution of pesticides to insulin resistance.

People with high levels of persistent organic pollutants (POPs) in their blood were more likely to develop insulin resistance, which may lead to type 2 diabetes. Insulin resistance may also lead to obesity, hypertension and an array of other diseases. It is well recognized that increasing amounts of intra-abdominal fat may increase insulin resistance. It is less well known that this obesity is part of a viscous circle, with insulin resistance being associated with elevated insulin levels that may cause fat to be laid down throughout the body. Once the fat is laid down in the abdomen, it can break down, releasing fatty acids and triglycerides that in turn affect the breakdown of insulin by the liver and the release of insulin by the pancreas.

Previous research by the same group found a link between POPs and type 2 diabetes. This study confirms that background exposure to some POPs, chemicals such as organochlorine pesticides and polychlorinated biphenyls (PCBs), is also associated with insulin resistance among people who do not yet have diabetes.

The researchers also found that the association between organochlorine pesticides and insulin resistance became stronger as people got fatter. However, among people who had very low concentrations of pesticides in their blood, the researchers found little association between waist size and insulin resistance.

Some studies have suggested an association between background exposure to POPs and a variety of adverse health effects in humans and wildlife. POPs can be particularly problematic because they persist for long periods of time in the environment, accumulate up the food chain, and can travel great distances through the air and water. Therefore, even people and animals that live nowhere near a place where POPs are being applied often show high levels of these chemicals in their bloodstream.

An international treaty banning a dozen of the world's most dangerous POPs has helped reduce exposures, but many harmful chemicals remain in use and even those that have been banned may linger in our environment for years to come. For example, chlordane was banned two decades ago in the United States but continues to be present at high levels in our food supply.

The researchers concluded that some POPs "may be involved in the pathogenesis of insulin resistance." They advise urgent prospective studies among those who have background exposure to POPs, which mostly comes from eating fatty animal foods. Since obesity may increase the toxicity of POPs, controlling weight could also help to reduce the impacts of these molecules.

In separate research involving mice, Frederick vom Saal from the University of Missouri in Columbia, Missouri has studied the effects of a different class of endocrine-disrupting chemicals, including bisphenol-A (BPA). Not long ago, BPA made news in San Francisco, where there was a lot of controversy over an ordinance that seeks to ban its use in children's products. vom Saal's most recent work was presented at the 2007 Annual Meeting of the American Association for the Advancement of Science (AAAS). He found that endocrine-disrupting chemicals cause mice to be born at very low birth weights and then very rapidly gain abnormally large amounts of weight: they could more than double their body weight in just seven days. Vom Saal followed the mice as they got older and found that these mice were obese throughout their lives. He said studies of low-birth-weight children have shown a similar overcompensation after birth resulting in lifelong obesity.

(Regular readers might remember the concept of the thrifty phenotype, and see how this research ties in with that concept). More research must be done to determine which chemicals cause this metabolic effect. According to vom Saal, there are approximately 55,000 manmade chemicals in the world, and 1,000 of those might fall into the category of endocrine disrupting. These chemicals are found in common products, from plastic bottles and containers to pesticides and electronics.

These chemicals are so pervasive that it is difficult to avoid them, and there is scant evidence that "detoxification" helps clear them. That being said, and depsite the lack of evidence, we recommend certified organic produce and regular mild detoxification programs, together with nutritional support and  tapping therapies.

People Watching

For the eighth time in a week your humble reporter found himself at the Atlanta airport. Ahem, I should say, of course, the Hartsfield-Jackson Atlanta International Airport.

It’s a perfect place for people watching. New statistics out today have shown that in 2006 it held its position as the world’s busiest airport, followed by O’Hare in Chicago and London’s Heathrow.

I was chastened to realize that I have been in every one of the top ten airports in the last year or so. For people who like such things, here’s the list of the top ten busiest airports with the number of millions passengers who’ve been through each:

1. Atlanta    84.8
2. O’Hare    76.2
3. Heathrow   67.5
4. Tokyo’s Haneda    65.2
5. Los Angeles International    61
6. Dallas/Fort Worth    60
7. Paris, Charles de Gaulle    56.8
8. Frankfurt    52.8
9. Beijing Capital International Airport    48.5
10. Denver International    47.3

Spending a lot of time in airports can stress the physical, psychological and subtle systems of the body, as well as making it easy to lose touch with your spirituality.

I’m going to let you in on a secret: for over two decades I had learned and then taught methods for building resilience and bouncing back from adversity. But it wasn’t until I started flying a quarter of a million miles a year that I got the chance to test and refine the methods under the most extreme conditions. Engineers often talk about taking their constructions and “testing them to destruction.” I did the same thing with the methods I teach. If they couldn’t help people cope with flights, illness or job loss, then I discarded them and looked for something else. And if they didn’t also have another piece – a way to grow in response to adversity, they were out too.

The result has been a whole raft of techniques and methods that have been tried and tested again and again. Over the next year I shall be rolling out a great many of these techniques in a novel format.

Watch this space!

“Every adversity carries with it the seed of equal or greater benefit.”
--Napoleon Hill (American Founder of Personal Success Literature, 1883-1970)

“From the withered tree, a flower blooms.”
--Zen Buddhist Saying

“How you handle adversity in the workplace tends to have much more impact on your career than how you handle the good stuff. The people who know how to overcome adversity are the ones who rise to the top of the organization."
-- Martin E. P. Seligman (American Psychologist, Professor at the University of Pennsylvania and Former President of the American Psychological Association, 1941-)

“Adversity is the diamond dust with which Heaven polishes its jewels.”
-- Robert Leighton (Scottish Presbyterian Bishop and Classical Scholar, 1611-1684)

“Adversity has the effect of eliciting talents which in prosperous times would have lain dormant.”
--Horace (a.k.a. Quintus Horatius Flaccus, Roman Poet and Satirist, 65-8 B.C.E.)

“Adversity is not undesirable. Because, it is only when you are down and out in life that you can realize its true value.”
--Swami Ramdas (a.k.a. Papa Ramdas, Indian Spiritual Teacher, 1884-1963)

Deep Vein Thrombosis

I am sorry to hear that the United States Vice-President Dick Cheney has just developed a blood clot in his leg and is being treated with anticoagulants (blood-thinning medications) that he will need to be on for several months.

He experienced some discomfort in his lower left leg this morning, and the diagnosis of deep vein thrombosis was made.

Mr Cheney is now 66 years old and has a history of cardiac problems. He has suffered at least four  myocardial infarctions (heart attacks) and has a pacemaker.

He had quadruple bypass surgery in 1988 after his third heart attack.He also had an operation to remove blood clots around his knees in 2005.

Mr Cheney recently returned to Washington after long flights to Japan, Australia, Pakistan and Afghanistan.

As I discussed a few months ago deep vein thrombosis - often shortened to "DVT" - can be associated with long-distance flying because it leads to inactivity and dehydration. Not, as was formerly thought, low oxygen pressure.

Blood clots in the legs are not in themselves life-threatening but they can be dangerous if they become wedged in the lungs (pulmonary embolism) or other organs, which can in severe cases be fatal.

Although the venous and arterial sides of the circulation are often thought of as quite different, it is not that unusual for someone to have problems in both, either because of immobility, metabolic disturbances or low grade inflammation.

With Spring Break and early summer vacations coming up, please don't forget to keep moving when you are on planes, limit the alcohol and coffee cnsumption, and have plenty of water to drink.

Bon voyage!

Air Pollution and Cardiovascular Disease

There a very important piece of research published in this week's issue of the prestigious New England Journal of Medicine, indicating that air pollution increases the risk of cardiovascular disease, at least in women.  The whole article is available for free download.

Researchers from the University of Washington studied 65,893 postmenopausal women without previous cardiovascular disease in 36 U.S. metropolitan areas from 1994 to 1998, with a median follow-up of 6 years. All the participants were aged 50 to 79 and part of the Women's Health Initiative, a major US Government funded investigation into the causes of heart disease in women. A total of 1,816 women suffered one or more cardiovascular event.

The investigators were particularly interested in tiny airborne particles called particulates, which are less than 2.5 microns across, and can lodge in the lungs. Previous research had incriminated them in heart disease. These are the dense clouds that you see coming out of chimneys or exhaust pipes. They found that pollution levels varied between four to nearly 20 micrograms per cubic meter.

Each 10 microgram rise was matched by a 76% rise in the chances of dying from heart disease or stroke. For women living within, rather than between, cities, the risk more than doubled, increasing by 128%, with each step up in pollution levels.

It is not clear whether women are more susceptible to pollution than men. Women's coronary arteries are smaller and this might render them more vulnerable.

These results suggest that the risk from air pollution is far greater than most doctors previously thought, though it is still not clear how these sooty particles lead to the development of heart disease.

I live just outside a city where we often have smog advisories for weeks at a time in the summer. This research adds to the growing evidence that air pollution should be taken seriously as a risk factor for cardiovascular disease.

That also means that when localized air pollution is particularly high, people with chronic lung disease or coronary heart disease should avoid staying outside.

This problem will likely get worse as the summers be progressively warmer.

Yet another reason for taking climate change seriously.

“For the first time in the history of the world, every human being is now subjected to contact with dangerous chemicals, from the moment of conception until death.”
--Rachel Carson (American Biologist and Writer, 1907-1964)

The Latest Report on Climate Change

As expected the Intergovernmental Panel on Climate Change (IPCC) concludes that there is more than a 90% chance that global warming has a human cause. The panel said that temperatures were probably going to increase by 1.8-4 degrees Celsius (3.2-7.2 degrees Fahrenheit) by the end of the century. It also projected that sea levels were most likely to rise by 28-43cm, and global warming was likely to influence the intensity of tropical storms.

The findings are the first of four IPCC reports to be published this year.

Also as expected, the attacks on the report began even before it was published. Some radio critics have committed a fundamental mistake of saying that people have been warning of this for years and nothing has happened. First, something has happened, and second, the report is careful to say that precise estimates are difficult. It is the direction of change which should be of greatest importance.

The Mail and Guardian Online is reporting that some scientists and economists have been offered $10 000 each by a lobby group funded by one of the world's largest oil companies - ExxonMobil - to undermine the report.

There is also a very well reasoned article about the semantics of climate change. The precise language of science and the quite different way in which politicians and many marketing people use language. It is well worth reading.

My main concern remains the impact of climate change on health and well-being. And many parts of the world, from Florida to the Horn of Africa are already experiencing that.

Here Comes the Sun: To Screen or Not To Screen?

I have been worried to see some people - all, I think, without scientific training - proclaiming that there is no need to protect ourselves against the sun because there is no evidence that sulight causes any health problems.

Ultraviolet radiation (UVR) from the sun has been part of the environment since the first cells began to form. When we discuss the effects of UVR on human health and the environment, the range of UV wavelengths is often subdivided into:

• UVA (400–315 nm), also called Long Wave or "blacklight"
• UVB (315–280 nm), also called Medium Wave
• UVC (< 280 nm) also called Short Wave or "germicidal”

The key questions are these:
Can sunlight cause health problems?
Do the benefits of sunlight outweigh their risks?”

UVB is required for the conversion of 7-deoxycholesterol to vitamin D, (the sunshine vitamin!) which is critically important in the maintenance of healthy bones, although there may also be another mechanism by which vitamin D is generated in the body. As we have seen research is making clear that vitamin D has other potential roles in the maintenance of human health. Low levels of vitamin D have been linked to:

• Rickets
• Osteomalacia
• Osteoporosis
• Maintaining the integrity of cell membranes
• Type 2 diabetes mellitus
• Schizophrenia
• Multiple sclerosis
• Pre-eclampsia (hypertension and accompanying problems during the late stages of pregnancy)
• Some types of cancer
• Fibromyalgia-like pains
• Immune deficiency: Africa Americans do not generate enough of a protein needed to ward off tuberculosis. Why? Because the protein needs vitamin D to be activated, and dark skin is inefficient at absorbing and converting UVR. It may also be that we see epidemics of colds and flu in the winter because that is when we have low levels of vitamin D, which allows the viruses to overwhelm our immune defenses.

This does not necessarily mean that taking extra vitamin D will ward off all of these problems.

In the days before the Industrial Revolution, unless we lived in the frozen North, we had no trouble in getting the amount of vitamin D that we needed. In most of the United States, during the summer months, 10-15 minutes outdoors at midday will generate around 10,000 international units (IU’s) of vitamin D in an average fair-skinned person. This is far in excess of the government’s dietary recommendations of 200 IU’s/day in people up to age 50, 400 IU’s up to age 70 and 600 IU’s in people over 70. Not surprisingly many experts – me included – believe and have provided evidence that these daily requirements are much too low. (Have a look at the comments here.)

Of course many of us do not spend much time outside and don’t take in as much in the way of vitamin D containing foods - such as milk and salmon – as we should. I’ve seen evidence to suggest that we in Atlanta are probably at the Northernmost point in the United States were we could hope to get enough sunshine and therefore vitamin D from modest winter exposure to the sun.

Recent data has suggested that if you spend no time at all in the sun, then you may need as much as 4,000 IU’s of vitamin D/day, though that figure has not yet been widely accepted.

Exposure to UVR, whether of solar or artificial origin, also carries potential risks to human health. UVR is a known carcinogen and excessive exposure, at least to the solar radiation in sunlight, increases the risk of cancer of the lip, basal cell, and squamous cell carcinoma of the skin and melanoma, particularly in fair-skinned populations. There is also evidence that solar UVR increases risk of several diseases of the eye, including cortical cataract, some conjunctival neoplasms, and perhaps also melanoma of the eye.

We have good data for the existence of a threshold amount of UV-B exposure that may lead to the formation of cataracts. The amount needed to cause cataracts depends in part on the amount of pigment in the eye, so albino rats get cataracts with much lower exposures to UV-B.

So what to do?

Sunlight has a definite benefit in preventing or treating many clinical problems and it is no surprise that after 3000 millennia we are adapted to make use of the sun’s largesse. What is less easy to understand is why an excess of sunlight can cause so many problems, unless it is our hairlessness and environmental change that has lead to a loss of the ozone layer.

Some years ago it was suggested that sunscreens may themselves cause skin cancer, but the data has shown that to be false. Indeed modern sunscreens almost certainly reduce melanoma risk.
So how do we balance the positive and negative effects of sunlight? A recent review precisely reflects my own thinking:

• We need some sunlight
• Depending on where you live, you need only a few minutes each day
• Sunscreens confer protection on the skin without blocking all the health benefits
• If you have a medical reason for avoiding sunlight, then your health care provider should measure your vitamin D status.

 

The Red Tide

There is an important report about the impact of environmental change in this month's issue of the journal Chest.

Red tide is a common name for a phenomenon known as an algal bloom, a well known event in which marine algae accumulate rapidly in the water column, or "bloom". These algae, more correctly termed phytoplankton, are microscopic, single-celled, plant-like organisms that can form dense, visible patches near the water's surface. We know that red tides have been occuring in the Gulf of Mexico for centuries, but they appear to be spreading and to be becoming more common and severe.

The main type of plankton is a species of dinoflagellate known as Karenia brevis, that is  concentrated along shorelines and produce highly potent aerosolized toxins. The new research shows that Florida red tide toxins - called brevetoxins can impact respiratory function and increase respiratory symptoms in patients with asthma.

In otherwise healthy people inhaled aerosolized red tide toxins can lead to eye irritation, runny nose,  postnasal drip, nonproductive cough, and wheezing. The symptoms usually subside after leaving beach areas. But things can be far more serious for people with asthma, who may experience respiratory problems and decreased lung function after just one hour of beach exposure to the toxins.

This was a fine piece of research funded by the National Institute of Environmental Health Sciences, and makes it clear that not only that asthma sufferers need to be aware of this potential source of trouble but that we all need to be alert to the possibility that human activities are increasing the red tide and with it, the risk of further health problems.

Parkinson's Disease and Cholesterol

Within the last week we have talked about the association between Helicobacter pylori and Parkinson's disease and the way in which Parkinson's disease may often get better if people are treated with a cocktail of antibiotics. We have also discussed the association between Parkinson's disease, allergies and inflammation.

Now new research from the University of North Carolina at Chapel Hill has  found that people with low levels of LDL cholesterol are more likely to have Parkinson's disease than people with high LDL levels. This is the form of cholesterol sometimes referred to as "bad cholesterol." This study followed the strange observation that people with Parkinson's disease have a lower rates of heart attack and stroke than people who do not have the disease. It is also known that known that cigarette smoking, which increases a person's risk for cardiovascular disease, is also associated with a decreased risk of Parkinson's disease. 

Few scientific stories are clear cut: it usually takes a while to get things right. Just to prove it, a study from the Netherlands found that high total cholesterol levels were associated with lower rates of Parkinson's disease, but only in women.

So what to make of all this: infections, allergies and now cholesterol?

To try and understand this, I think that we need to introduce another actor to the stage. Since the early 1950s the medical community has been concerned about a striking concentration of amyotrophic lateral sclerosis (ALS) and Parkinsonism-dementia among the Chamorro people on the island of Guam. A number of lines of evidence have suggested that this group of illnesses has been caused by some neurotoxic agent in the environment, though nobody has been able to work out exactly what it is. One of the most attractive recent theories is that it might have something to do with toxins from Cycas plants. So the idea is that similar cholesterol-containing neurotoxins can come either from Helicobacter or from eating Cycas plants, or animals that have fed on the plants.

There is a complex inter-relationship between LDL- and HDL-cholesterol, and HDL-cholesterol appears to be anti-inflammatory: high levels of HDL-cholesterol are associated with low levels of inflammation. And it has recently been shown that simvastatin may cut the risk of developing Parkinson's and Alzheimer's diseases. Not just by lowering cholesterol but from its inflammatory activity.

It may also be that low levels of cholesterol may impair the activity of another factor: one that interests me is coenzyme Q10.

From a practical perspective, this new evidence reinforces a point that I made in Healing, Meaning and Purpose and on this blog: "boosting" one component of the blood or lowering another is not sensible. Whether dealing with cholecterol or immunity, we need to moduate and harmonize all the systems of our bodies and our minds.

Follow our systems for modulating the inflammatory mediators in your body and that alone should - theoretically - reduce your risk of many illnesses.

I shall keep you posted as this story continues to develop.

Reducing Your Cancer Risk

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.”
-- Thomas Alva Edison (American Inventor, 1847-1931)

I am sure that you will agree that prevention is better than cure. And this is a good time of the year to review where you are in your life and what you want or need to do for yourself and your loved ones.

According to a study reported in the Lancet in November 2005 more than one third of cancer deaths are attributable to nine modifiable risk factors.

To evaluate exposure to risk factors and relative risk by age, sex, and region, the investigators analyzed data from the Comparative Risk Assessment project and from new sources, and they applied population-attributable fractions for individual and multiple risk factors to site-specific cancer mortality provided by the World Health Organization.

Of the seven million deaths from cancer worldwide in 2001, approximately 2.43 million (35%) were attributable to nine potentially modifiable risk factors. Of these deaths, 0.76 million were in high-income and 1.67 million in low- and middle-income nations; 1.6 million were in men and 0.83 million deaths were in women.

Smoking, alcohol use, and low consumption of fruits and vegetables were the leading risk factors for death from cancer worldwide and in low- and middle-income countries. In low- and middle-income regions, Europe and Central Asia had the highest proportion (39%) of deaths from cancer attributable to the nine risk factors studied.

For women in low- and middle-income countries, sexual transmission of human papilloma virus (HPV) was also the leading risk factor for cervical cancer. Smoking, alcohol use, and overweight and obesity were the most important causes of cancer in high-income countries.

Between 1990 and 2001 mortality from cancer decreased by 17% in those aged 30 to 69 years and rose by 0.4% in those older than 70 years, according to the authors, but this decline was lower than the decline in mortality rates from cardiovascular disease for men and women. The decline in mortality in men was largely due to reduction in mortality from lung, prostate, and colorectal cancers, while in women, lung cancer increased in the 1990s, and death rates for breast and colorectal cancer decreased. An article published almost ten years ago in the journal Cancer Epidemiology, Biomarkers, and Prevention, it was estimated the worldwide attributable risk for cancer to infectious agents as 16%.

The nine factors were:

1. High body mass index
2. Low fruit and vegetable intake
3. Physical inactivity
4. Smoking
5. Alcohol abuse
6. Unsafe sex
7. Urban air pollution
8. Indoor use of solid fuels
9. Injections from healthcare settings contaminated with hepatitis B or C virus

This all makes good sense, but it is good to see high quality research in reputable journals confirming what we suspected. The research also gives us further compelling reasons for taking a good look at our lifestyles and hopefully the motivation to do something to improve them. And in the case of air pollution and injection of contaminated products, to be active in getting things cleaned up.

“Keep your own house and its surroundings pure and clean. This hygiene will keep you healthy and benefit your worldly life.”
-- Sathya Sai Baba (Indian Spiritual Teacher, c.1926-)

“Length of life does not depend so much on a good physical constitution as it does on the best use of the six non natural things, which if we rule aright, we shall live long and healthy lives: to divide the day properly between sleep and waking; to adjust our air to the needs of the body; to take more or less food and drink according to our age, our temperament and whether we live an active or inactive life; to take exercise or rest according to the quantity of food and whether we are lean or fat; to know ourselves and be able to rule our emotions and subject them to our reason.  Whoever handles these wisely will live long and seldom need a doctor.”
--Giorgio Bagliivi (Italian Physician, Pathologist, Researcher and Author of De Fibra Motrice, 1669-1707)

“The best doctor prevents illness, a mediocre one treats illnesses that are about to occur, and an unskilled one treats current illnesses.”
--Chinese Proverb

Another Reason Why Breast Is Usually Best

Last month we looked at some of the extraordinary benefits of breast feeding.

There is an interesting paper in this month's issue of the journal Pediatrics.

Approximately 19 percent of children are prone to the chronic and recurrent ear infections collectively known as otitis media. These infections can cause deafness and thereefore interfere with the development of language and lead to learning difficulties. We have known for many years that there can be a genetic predisposition to otitis media, but there has been little research to try and pinpoint the specific genes involved. There is also a complex relationship between genes, specific infectious agents and environmental factors such as exposure to cigarette smoke and breast-feeding.

The new research from the University of Texas Medical Branch at Galveston examined genetic samples taken from 505 children in Texas and Kentucky, about 60 percent of whom were classified as "otitis media susceptible" because they had:

• Suffered an ear infection before the age of 6 months
• Or undergone three or more episodes of acute otitis media within a six-month period
• Or four or more episodes within a 12-month period
• Or had six or more episodes by age 6.
• Or had required drainage tubes to reduce recurrent or persistent ear infections

The researchers looked for small genetic variations called "single-nucleotide polymorphisms," - or SNPs - in three important genes that produce inflammatory signaling molecules for the immune system.

Two genes known known to generate the immune proteins known as tumor necrosis factor-alpha (TNF-alpha) and  interleukin 6 (IL-6). SNPs in each individual gene were enough to create an increased risk for childhood ear infections, and simultaneous SNPs in both genes increased the risk even further. These particular genetic variations cause a greater production of inflammatory signaling molecules and reduce the effectiveness of the immune system.

But here is the fascinating thing: the researchers found that the genetic effect could be counteracted by breast-feeding, which is well known to increase immune resistance.

We have here another fine example of how a healthy practice can overcome a genetic predisposition to illness. Remember what I have said many times before: Biology is not destiny.

On the hand another environmental factor - exposure to cigarette smoke - increased vulnerability to otitis media in children with the TNF-alpha gene variation. Cigarette smoke exposure alone was not enough to increase the risk for ear infections. 

Genes, Environment and the Brain

We recently looked at the worrying suggestion that environmental toxins could, in susceptible individuals, be contributing to the apparent increase in autism over the last three decades.

There is increasing evidence that there are complex genetic and environmental interactions that contribute to abnormal aging and neurodegenerative disorders like Alzheimer’s, Parkinson’s and Huntington’s diseases.

A new study from Duke University Medical Center in Durham, North Carolina, has done more to dissect this interaction. They collected information on 1136 consecutive patients who presented to the Joseph and Kathleen Bryan Alzheimer Disease Research Center. They showed possible significant contributions of toxic environmental and occupational exposures to pathological aging in 21% of the patients, and interactions of these exposures with common genetic polymorphisms that affect cell injury and inflammation. They found a series of genes that could partially account for differences in the type of cognitive problems that people experience, the age at which they developed them as well as the rate of progression.

The researchers targeted three genes in particular - apolipoprotein E, alpha-1-antitrypsin and the hemochromatosis gene. All three are expressed in the liver and in macrophages: cells that play a critical role in immune responses, inflammation and the body’s response to stress and infections. The first two genes are particularly involved in the metabolism of lipids and the third in the balance of iron and trace minerals. This ties in with another observation. Many chronic illnesses are associated with anemia. It is now thought that this also is a defensive reaction. Not to chronic illness, but to the problem that was far more common during evolution, and that was infection. The liver pulls iron out of the circulation so that bacteria cannot use it for their own growth. This is one of a number of adaptive responses that I discuss in the book and CD series, Healing, Meaning and Purpose.

But it was also clear form this new study that genes were not the only factor. I have spoken before about the small number of strategies that can dramatically reduce our risk of developing Alzheimer’s disease. The authors of this study agree about the importance of factoring in environmental factors including, alcohol use, nutritional deficiencies and sleep and mood disorders, all of which can have an impact on cognition.

This study is yet another step toward clarifying the role of genes, inflammation and cell injury in the development of degenerative changes in the brain.

While pharmacologists can use this information to help devise new ways to protect your brain, you can use it immediately. There is a range of behavioral and dietary strategies that can reduce the burden of inflammation in the body. I shall write about some of them in articles and an eBook in the near future.

We do not know whether these strategies can reduce the risk of Alzheimer’s and Parkinson’s diseases, but there are some intriguing suggestions that they can.

Arsenic and Water Safety

Here is a new study that may turn out to be one of the most important of the year.

Tens of millions on people around the world, most particularly in Bangladesh, are forced to drink water containing dangerously high amounts of arsenic. The very same stuff that has been used by countless poisoners.

The classic symptoms of arsenic poisoning are:

• Headache
• Abdominal pains
• Vomiting
• Difficulty breathing
• Light headedness
• Delirium
• Neuropathy
• Stroke
• Skin lesions: usually thickening of the skin of the palms and soles with wart-like excresences
• Reduced production of red and white blood cells
• Increased risk of cancers of the lung, skin, bladder, liver, kidney and prostate
• Death

The exact pattern of symptoms depends on the acuity of the exposure, the amount of arsenic to which a person is exposed and the individual's own makeup.

The new research - published this week in the journal Science - is from Rice University's Centre for Biological and Environmental Nanotechnology in Texas, and it may give us a quick and cheap way of getting most of the arsenic out of drinking water. The investigators used minute particles of iron oxide - very similar to common rust - to bind large amounts of arsenic. The iron oxide particles are really tiny: just 12 nanometres (billionths of a metre) across, about 5,000 times smaller than the width of a human hair. When mixed into contaminated water, the tiny crystals became coated with the poison and began behaving like iron filings. The iron oxide/arsenic combination can then be removed from water using a simple hand-held magnet.

One of the investigators, Professor Doug Natelson had this to say, "The idea of using magnetic particles to filter and clean water is not particularly new. The trick here is that these particles are very, very small, which means they're essentially all surface. So the arsenic sticks to the surface of the particles, and what we've found is that when the nanoparticles are in the right range of sizes, you can pull them out of solution with a relatively small magnetic field gradient that you could get from, say, a permanent magnet."

As an additional refinement, the scientists needed to develop a technology that would be usable in one of the poorest parts of the world. In one experiment flakes of rust were made into nanoparticles by heating them in coconut or olive oil at 350C. They could then be used in water purification.

This is excellent news, and if confirmed, it could save hundreds of thousands if not millions of livees, and unspeakably awful chronic ill health.

Industrial Chemicals and Autism

There is an exceedingly important article in this week's issue of the Lancet, that has not yet received the attention that it deserves.

I have time and again discussed the extraordinary burden of artificial chemicals now born by the human body. None of which was present 100 years ago. It is not rocket science to ask whether this toxic burden may have soething to do with the the rise of many neurological and psychiatric illnesses, given the sensitivity of the growing brain to any kind of environmental insult.

The article, entitled "Developmental Neurotoxicity of Industrial Chemicals," is written by two senior academics from Denmark who also hold positions at the Department of Environmental Health at Harvard School of Public Health, the Departments of Community Medicine and Pediatrics at Mount Sinai School of Medicine in New York.

What they say is this. The report begins by saying that neurodevelopmental disorders such as autism, attention deficit disorder, mental retardation, and cerebral palsy are common and can cause lifelong disability. Indeed, 1-in-6 children has a developmental disability, which mostly affect the nervous system. The causes of these problems are largely unknown.   

Secondly, the prevention of neurodevelopmental disabilities is hampered by the great gaps in testing chemicals for developmental neurotoxicity and the high level of proof needed for regulation.

Next, the list of potentially damaging chemicals is extremely long. A few industrial chemicals  are recognised causes of neurodevelopmental disorders and subclinical brain dysfunction, for instance methylmercury, arsenic and lead. we simply do not know how manyother chemicals may affect the brain. Exposure to these chemicals during early fetal development can cause brain injury at doses that are much lower than those affecting adult brain function. Recognition of these risks has led to evidence-based programmes of prevention, such as the gradual elimination of lead additives in petrol. Although these prevention campaigns have been highly successful, most were initiated only after substantial delays. Another 200 chemicals are known to cause clinical neurotoxic effects in adults. That being the case, since the young brain is so much more sensitiv, we can only assume that many of these chemicals must also be dangerous to the fetus, baby and growing child.

This article is published at the same time as an investigative report in the National Geographic. The magazine paid $15,000 for a reporter to have a full toxicological analysis, and if you have any doubts about toxins, I would urge you to read the article.

As a side bar, many clinical practitioners offer different kinds of toxicological analysis based on hair, skin, blood or electrical testing. Some years ago we looked into many of these methods using confirmatory analyses using a full scale research laboratory at Northwick Park Hospital in London. We found very poor correlations between the results obtained by the laboratory and three labs doing hair and blood analysis. I'm sure that some labs do a good job using hair and other types of analysis for a good deal less than $15,000. But It's good to be a little cautious before relying too much on some of these unorthox evaluations. Just ask the lab to give you the methods that they use, the standard errors of their testing, their false positive and false negative rates, and how often they get their results checked by an independent laboratory. Then you can be confident that you or your practitioner is using a good one.

The conclusion from all the published literature, some of which is summarized in the Lancet?

Environmental toxins are there, growing and they may be responsible for the catstrophic rise in some neurodevelopmental disorders, in particular autism.

We probably have enough empirical evidence toadvocate some serious cleaning up of the environment, which will likely only happen once people begin to vote with their feet. Governments are taking notice of global warming now that it is being suggested that it may damage national economies.

We need urgently to see whether, if the are present, we have - or can develop - viable methods for clearing these toxins from the human brain
and restoring normal structure and function.

The Death of Fish

“Thank God men cannot fly, and lay waste the sky as well as the earth.”
--Henry David Thoreau (American Essayist and Philosopher, 1817-1862)

The BBC has just run a gloomy report based on an article  published this week in the journal Science.

For years now, fisherman have been reporting that many of the larger game fish have been getting smaller and younger, and the same has been reported of smaller fish in the major fishing grounds.

Now this research, which seems quite impeccable, predicts that there will be virtually nothing left to fish from the seas by 2048 if current trends continue. Stocks of fish have collapsed in nearly one-third of sea fisheries, and the rate of decline is accelerating.

When the first reports came out, they quickly became fodder for the late night comedians: “You think they use a lot of batter now? Just imagine how much they’re going to have to put around a minnow, come 2050.”

But that quickly gave rise to an understanding of he gravity of the situation: the decline in numbers of fish is closely tied to a broader loss of marine biodiversity. And that is the point. I’ve heard people say, “I’m a vegetarian, so I don’t care,” or “I don’t like fish anyway.” The ocean, like every other known ecosystem, is like a vast interlocked organism.

Everything that lives in the ocean is important. The diversity of ocean life is the key to its survival. The areas of the ocean with the most different kinds of life are the healthiest. If we knock out entire species the whole will cease to function, and then we have dead oceans. Ocean fish filter toxins from the water. They protect shorelines, and they reduce the risks of algae blooms such as the red tide.

In addition, a large and increasing proportion of our population lives close to the coast; the loss of services such as flood control and waste detoxification can have disastrous consequences.

These findings are not a computer model, or some prediction of future trends. They are based on actual observations of what is happening right now.

Why are we talking about this issue in a blog dedicated to personal growth, integration and wellness? Because seeing the larger You - the You that is interconnected with the rest of the Universe, the You that transcends your physical body, your brain and your emotions – is crucial to all of those three goals.

Yes, you can certainly feel a lot more healthy by eating better. Breathing exercises are valuable too. Do the two together and you get the advantage of synergy: they leverage each other. But you will really make progress when you begin to feel, really feel in a deep down visceral way, that You are something much larger and more grand. And that You also have responsibilities for the welfare of the planet. Because You are part of it, and it is a part of You.

Once You – the whole Big You – really “gets that,” you will feel the need to leave an enduring legacy, and You become an unstoppable force for good. Then you progress rapidly. Not because you are working on yourself, but because you are now acting from your Higher Self.

“I have had the experience of being gripped by something that is stronger than myself.”
--Carl G. Jung (Swiss Psychologist and Psychiatrist, 1875-1961)

“In the end we all must turn to the inner Source of all our best human sources, to the Guru of all the gurus, to the Overself. Then why not now?”
--Paul Brunton (English Spiritual Teacher and Author, 1898-1981)

Tips for Trips

I’ve not written any new items for a couple of days while I was in England and out of range of anything resembling a decent Internet connection.

But a grand total of seventeen hours on planes made me think that it’s high time to tell you about some of my tips and techniques for dealing with the rigors of flying.

I’ve got so many of them that my tips will stretch over more than one article.

By now most people will have heard about the importance of:

1. Maintaining hydration: the low pressure and dry atmosphere on planes can quickly dehydrate us. I try to drink at least 20 fluid ounces every two hours that I’m in the air.
2. Avoid drinking alcohol and coffee.
3. Keep mobile. When it is safe to do so: walk up and down the aisle. Stretch your legs and arms and gently rotate your neck while sitting in you seat.

The most worrying things about flying is the risk of developing a Deep Vein Thrombosis (DVT).  This is an important topic: one in 2,000 long-distance passengers will suffer a blood clot, which can be fatal if the clot detaches and reaches the lungs: this is known as pulmonary embolism. DVTs are more likely to occur if there is a change in the rate of blood flow, the character of the blood of the normal functioning of the walls of the large veins. There are a number of well-recognized risk factors for the development of DVTs:

1. Obesity
2. Immobility
3. Oral contraceptives
4. Some cancers
5. Cigarette smoking

There is a great long list of potential causes, but our focus today is on factors that can increase your risk of developing a DVT if you fly.

DVTs have been recognized to occur not just in passengers on planes, but also in people at extremely high altitude.

For many years it has been assumed that the low pressure and the immobility together increase the risk of DVT. But new research from the Universities of Leicester and Aberdeen was published in the Journal of the American Medical Association in May.

In a study of 73 people, the researchers found that sitting for long periods was the main cause, and warned people about all forms of travel.

During the study, the volunteers spent eight hours sitting in chambers with reduced air pressure and oxygen. They were allowed to move around for a couple of minutes each hour. They were then also tested in a chamber without changes in the atmosphere. The idea was to simulate the conditions on a plane. Blood samples were taken before and after each "flight" to check for factors involved in blood clotting.

For all these factors, no significant differences were seen between blood samples taken from volunteers on a simulated flight or exposed to normal air pressure. So it is not the low air pressure and oxygen saturation that is to blame: it is the lack of movement.

It is also unlikely that the advice to take an aspirin before a flight is going to be much help.

During my travels I have seen people selling extracts of horse chestnut (Aesculus hippocastanum) to prevent DVTs. There is actually some research that horse chestnut can help with chronic venous insufficiency. But there is no credible evidence that taking a couple of horse chestnut capsules will prevent a DVT, or the less severe problem of ankle swelling. And horse chestnut is well known to have a number of side effects, so there doesn’t seem to be much point in taking it to prevent ankle swelling and DVTs when flying.

The smart move (ha!) is to do regular exercise during flight, and to avoid dehydration.

I’ll tell you some of my tips for turning flights into highly productive work time and how to avoid jet lag in other posts.

Climate Change and Civilization

I have several times now sounded warnings about the impact of climate change on health and the re-emergence of some infectious diseases.

Today I’d like to tell you about a remarkable theory that could have profound implications for how we see ourselves and our place in the world.

Dr. Nick Brooks from the Tyndall Centre for Climate Change Research at the University of East Anglia has recently proposed a remarkable hypothesis. It has long been assumed that civilization started where is did because conditions had become very hospitable, but people banded together for mutual protection and for hunting and agriculture.

By contrast, Nick Brooks proposes that severe climate change was the primary driver in the development of civilization. He proposes that without climate changes thousands of years ago, we might have remained farmers, herders and hunter-gatherers.

The early civilizations of Egypt, Mesopotamia, South Asia, China and northern South America were founded between 6000 and 4000 years ago when global climate changes, driven by natural fluctuations in the Earth’s orbit, caused a weakening of monsoon systems resulting in increasingly arid conditions. These first large urban, state-level societies and monumental architecture such as the pyramids, emerged because diminishing resources forced previously transient people into close proximity, in areas where water, pasture and productive land was still available.

It is certainly remarkable that all of these places where the first urban civilizations developed, arose in once humid and productive environments that are now largely covered by desert. One theory has been that many of these deserts, as well as the Sahara desert, were the result of over-grazing by goats.

In a presentation to the British Association Festival of Science earlier this month, Dr. Brooks said, “Civilization did not arise as the result of a benign environment which allowed humanity to indulge a preference for living in complex, urban, ‘civilized’ societies. On the contrary, what we tend to think of today as ‘civilization’ was in large part an accidental by-product of unplanned adaptation to catastrophic climate change. Civilization was a last resort - a means of organizing society and food production and distribution, in the face of deteriorating environmental conditions.”

He added something that we now see all over the world: for many, if not most people, the development of civilization meant a harder life, less freedom, and more inequality. The transition to urban living meant that most people had to work harder in order to survive, and suffered increased exposure to communicable diseases. Health and nutrition are likely to have deteriorated rather than improved for many.

The new research challenges the widely held belief that the development of civilization was simply the result of a transition from harsh, unpredictable climatic conditions during the last ice age, to more benign and stable conditions at the beginning of the Holocene epoch some 10,000 years ago.

This work also presents some profound philosophical implications, because it challenges deeply held beliefs about human progress, the nature of civilization and the origins of political and religious systems that have persisted to this day. It suggests that civilization may not be our natural state, but the unintended consequence of adaptation to climatic deterioration - a condition of humanity “in extremis.”

Dr Brooks said: “Having been forced into civilized communities as a last resort, people found themselves faced with increased social inequality, greater violence in the form of organized conflict, and at the mercy of self-appointed elites who used religious authority and political ideology to bolster their position. These models of government are still with us today, and we may understand them better by understanding how civilization arose by accident as a result of the last great global climatic upheaval.”

This is an extraordinary throwback to the ideas of romantic philosophers like Jean-Jacques Rousseau  who contended that Man is good by nature, but it corrupted by society and civilization.

Though we need to continue to be very alert to the dangers inherent in climate change, could it be that it is actually an invitation to evolve?

Peripheral Neuropathy

Treating peripheral neuropathy can be one of the toughest problems facing a clinician. Peripheral neuropathy simply means disease affecting the peripheral nerves.

There are a great many cause of peripheral neuropathy. This is just a partial list to give you an idea of the things that a clinician has to think about before starting treatment:

1. Metabolic illnesses: Diabetes mellitus; porphyria; chronic renal failure; amyloidosis and disturbances in circulating proteins
2. Vitamin deficiencies: Vitamins, B1, B3, B6 and B12
3. Drugs and chemicals: Alcohol; Heavy metals like arsenic, lead and mercury; organic pesticides; several drugs used in cancer chemotherapy; isoniazid; nitrofurantoin
4. Infections: Lyme disease; Herpes zoster (shingles); Diphtheria; Brucellosis; Leprosy; Tetanus; Botulism
5. Malignant illnesses
6. Inflammatory and autoimmune illnesses: Rheumatoid arthritis; Systemic lupus erythematosus; Polyarteritis nodosa; Sarcoidosis; Guillain-Barre syndrome; Celiac disease
   
7. Physical injury: Trauma, stretching and compression of nerves, which can include things like carpal tunnel syndrome.
8. Congenital illnesses

Many causes of peripheral neuropathy, particularly diabetes, may also damage the autonomic nervous system that controls the heart, blood pressure, swallowing, intestinal and bladder function.

Neuropathic symptoms typically start in the feet, because the nerves running down there are longer and more vulnerable than the ones going to the hands.
The most common symptoms are:

1. Numbness
2. Tingling
3. Abnormal sensations called dysesthesias
4. A characteristic form of pain, called neuropathic pain or neuralgia: people usually describe it as “pins and needles,” a steady burning sensation or “electric shocks.” These pains can be difficult to describe: typically pains, like stubbing your toe or stepping on something sharp, are transmitted through pain fibers. Neuropathy also involves other neurological pathways, so that the brain receives impressions that it cannot process.

There has been a revolution in out understanding of neuropathic pain in recent years. It is now considered to be a disease rather than a symptom. Normal pain is designed to protect you: you put your foot on a hot plate and you pull it away immediately. Neuropathic pain is different: it is non-protective and it persists and therefore behaves like a disease.

Multiple different classes of medications have been shown to be effective in some people with neuropathic pain, though most are not approved for use by the Food and Drug Administration:

1. Lidocaine patches and creams
2. Capsaicin creams
3. Opioid analgesics
4. Tricyclic antidepressants
5. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
6. Anticonvulsants: Carbamazepine; gabapentin; pregabalin

Earlier this week, data presented at the European Federation of IASP (International Association for the Study of Pain) Chapters (EFIC) indicated that an innovative combination of painkillers might hold the key to unlocking the severe and relatively untreatable pain of peripheral neuropathy.

Dr Magdi Hanna, Director of Pain Clinical Research Hub at King's College Hospital in London, has been studying the combination of the strong opioid oxycodone (OxyContin) with gabapentin (neurontin) in over 300 patients with severe diabetic neuropathy. This combination demonstrated a significant 33% improvement on top of the best pain relief achievable using the maximum tolerated dose of gabapentin as monotherapy. The study was part funded by one of the medicine manufacturers.

This study is good news, but even in this study there were a great many people who were not helped. In another blog item, I’m going to talk about some of the unorthodox approaches that have helped some people.

It’s Not Just Spinach!

The news yesterday of E. coli contaminated spinach must have been enough to make Popeye weep.

According the Centers for Disease Control and Prevention in Atlanta, as of today, 102 people have been infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 19 states, and one person in Wisconsin has perished.

Just to re-iterate what you’ve probably heard on the news already: E. coli is often a nasty resistant little bug that is not always killed by cooking. So the best advice is to throw away any spinach that may be suspect. The bacterium can make you very sick. You may have heard that one person has already died and at least a dozen more are in the hospital.

Several years ago there was an egg-borne Salmonella outbreak in the United Kingdom, and we’ve heard of several outbreaks of hepatitis A related to food contamination. There are outbreaks of food poisoning every now and then. And then there is the constant worry about “Mad cow disease,” that led to the wholesale slaughter of animals in the United Kingdom a couple of years ago.

Overall, Secretary Johanns and his team at the United States Department of Agriculture are doing a good job of protecting us.

Be aware, though, that apart from food, there are many other places that bacteria and occasionally viruses can lurk:

1. Makeup: the ingredients in makeup can make good breeding grounds for some bacteria. Don’t keep makeup for too long, particularly if it’s been in a hot damp place
2. People carry a lot of bugs. That doesn’t mean that you have to become worried about being around them, but it’s best not to get in an elevator is someone’s coughing or sneezing. I’d like to say the same thing about planes, but that’s usually not practical. I’ve many times had to use homeopathic remedies after a flight to prevent a cold – or worse – from emerging. Others have even taken antibiotics after a long flight next to someone nursing a cold. A bit illogical in my view: most upper respiratory tract infections are viral.
3. Many bacteria and a few viruses get transferred to hands and doorknobs. You cannot spend your life being terrified of such things: it ruined the life of Howard Hughes, and in real life Adrian Monk would really be suffering. But you can wash you hands – with soap – in warm water for one minute whenever you get the chance. Studies have shown that most people don’t wash their hands properly. And I like those little sterilizing towels that you can carry with you.
4. Change your toothbrush every 2-3 weeks.
5. If you can afford them, those Ionic Breeze devices do seem to help keep the air cleaner.
6. And I’m sure that I do not need to remind you, gentle reader, of the importance of carefully washing your hands after visiting a rest room.

Psychiatric Illnesses and Fibromyalgia

There’s an interesting and important article in last month’s issue of the Journal of Clinical Psychiatry, by a group of investigators from the University of Cincinnati.

They have shed important new light on fibromyalgia. We’ve recently learned how it is linked to disturbances of the serotonin transporter, as well as anti-inflammatory proteins, and that is may respond best to the kind of comprehensive multi-leveled approaches that we use in Integrated Medicine.

The new research compared people with fibromyalgia with people with rheumatoid arthritis, and it found that fibromyalgia, but not rheumatoid, may be associated with a range of psychiatric illnesses:

1. Major depressive disorder
2. Bipolar disorder
3. Comorbid anxiety disorders including panic disorder, social phobia, posttraumatic stress disorder and obsessive-compulsive disorder
4. Eating disorders and
5. Substance abuse

What was particularly important in this study was that the psychiatric problems usually preceded the onset of fibromyalgia. So it wasn’t that people were developing psychological problems because they were in chronic pain.

It’s beginning to look as if fibromyalgia is part of a larger group of disorders that all share common etiologies or causes. Family studies have indicated that fibromyalgia and mood disorders share some of the same - perhaps genetic - determinants.

The study also confirms what we have said before: fibromyalgia is not only associated with some psychiatric problems, but also with other medical disorders, several of which may also co-exist with the same psychiatric problems. They include:

1. Chronic fatigue syndrome
2. Irritable bowel syndrome
3. Interstitial cystitis
4. Multiple chemical sensitivities and
5. Migraine

Not only does this research highlight the need to check people with fibromyalgia to see if they might also be struggling with a psychiatric problem, but it is helping us home in on some of the mechanisms linking these apparently separate problems.

This particular study was done mainly in white women, and the investigators knew who had fibromyalgia, so there’s more work to be done.

But if you or a loved one is struggling with fibromyalgia, it is good news to know that we are making rapid progress in unraveling this horrible illness.

Global Warming

My interest in global warming is three-fold: the first is scientific: is this all just a political bandwagon, driven by a misunderstanding of normal climatic cycles? Secondly, if it is a real phenomenon, then we have a responsibility to future generations: a part of what we refer to as a central philosophical plank: “Legacy.” Third is the impact of global warming on patterns of illness, in particular infectious and environmental pathogens, and how we can build resistance and resilience to them.

Some of the more recent evidence had a good airing on the Scientific American website.

My own view is that global is now clearly proven: I have just seen too much evidence, from walking the balmy streets of Stockholm in dead of winter when the temperatures should have been tens of degrees lower to an analysis of changing patterns not just of temperature, but of disease. The warming is a consequence of a lack of balance and harmony: too much Yang activity overwhelming the Yin necessary to stabilize the world. Or, in the language of spiral dynamics, too many people and social structures being stuck at the levels of the Red and Orange Memes.

The only thing that I find a little irksome is the number of people who lecture us about global warming while continuing to engage in all kinds of activities that contribute to the problem. Your humble reporter first became interested in installing solar panels while still living in England. Not practical in a country where once the sun rarely shone very much, and where the panels used to be prohibitively expensive.

We plan to install some next year, while continuing drastically to conserve other resources. And to try and anticipate the impact of global climate change on illness.

Chronic Fatigue, RNase Deficiency and Spiritual Development

I was very sorry to hear that Ken Wilber, whose work I admire enormously, has recently been very unwell. While weakened by an underlying chronic illness, he took a nasty fall that has left him pretty badly bruised, and with some possible neurological problems. Fortunately he is already somewhat better.

According to Ken, his underlying illness is a form of chronic fatigue syndrome called or caused by RNase-L Enzyme Dysfunction. People with the problem develop a number of bizarre symptoms apart from fatigue, including muscle weakness, fevers and immune dysfunction. The RNase enzyme is normally activated when a cell has to deal with viruses, some toxins and some bacteria. There is a good introduction here.

There is a growing literature on the subject: investigators from Brussels have recently shown a link between exercise performance and immune dysfunction in some of these patients. It may be that elevated RNase-L enzyme activity may provide us with a biological marker for some cases of chronic fatigue syndrome. Despite this research, I still have many colleagues who continue to say that chronic fatigue syndrome and a probably related condition, Chronic Fatigue and Immune Dysfunction Syndrome, are purely psychological problems.

I am quite sure that they are wrong.

Not least because there are very few illnesses that can be reduced to just psychological or just physical causes. These artificial distinctions do little to help people suffering with genuine problems. (You may be interested to have a look at a brief piece that I wrote about this artificial distinction.)

I do know that the most difficult problems that I have ever faced in clinical practice have been the chronic fatigue syndromes and a possibly related problem: interstitial cystitis. The only things that have helped have been approaches employing the five dimensional approach: physical, psychological, social, subtle and spiritual.

And now I’m going to go out on a limb and do something that normally I do not. I will normally not make even the broadest comments about someone’s diagnosis and treatment unless I’ve seen them myself: there are few things worse than people trying to diagnose at long range and when they only have half the information. But when I see symptoms like these: fatigue and fever, physical weakness and sometimes profound psychological effects, I have to ask whether the biochemical markers are actually telling us something different: that some people with these problems may actually have what used to be known as “diseases of discipleship.” An old-fashioned term used to describe some of the physical challenges and changes that may accompany spiritual evolution. If I am correct, I would predict that Ken - and many other sufferers - should also have profound disturbances of their normal circadian rhythms, some predictable but subtle endocrine disturbances, and otherwise inexplicable sensations roughly corresponding to the channels identified in Chinese and Ayurvedic medicine.

One of the most startling recent discoveries in medicine has been that some of the time-honored laws of healing are changing, because we are ourselves changing very rapidly. In Healing, Meaning and Purpose, I spent a long time talking about some of the reasons for coming to that understanding, and how to use it to improve our health and well-being. I fully expect to spend the remainder of my career showing people how these new laws and principles can help us all, as well as ensuring that appropriate research continues to help us develop these new understandings about health and wellness.

So I’m going to suggest that Ken’s problems might never have happened if he hadn’t been on such a deep spiritual quest, and if he hadn’t been turning up a lot of answers that matter.

Get well Ken!

Technorati tags: Ken Wilber Chronic fatigue syndrome RNase deficiency Chronic Fatigue and Immune Dysfunction Syndrome Interstitial cystitis Spiritual development Circadian rhythm Integrated medicine Integrative medicine Laws of Healing 

Surviving Airplanes

I’m an extremely frequent flier: in an average year I fly the equivalent of ten to twelve times around the world, or all the way to the moon and part of the way back. So I’ve had to learn all the tricks for surviving countless hours in the air.

Some of them you will know already: keep hydrated, avoid alcohol, move and stretch whenever you can. I’ll soon be posting my jet-lag strategies.

But I wanted to let you know about a product that I’ve been using for years: it’s now called Yarrow Environmental Solution. I’ve certainly found that it’s been very helpful in reducing some of the exhaustion that is a common part of long haul air travel.

There is a piece of unpublished research that seems to confirm that the remedy is having a measurable effect. I wish that I had the time to do a more extensive study to see whether my observations have a scientific basis.

Current scientific models can’t explain how the flower essence could possibly work. Yet my observations and those of many students and patients are that it can be very helpful indeed. Not just to frequent fliers, but also for people who spend a lot of time in front of computer screens or under artificial light.

If you are exposed to any of these things, and find yourself constantly drained and exhausted, you may find this essence very helpful, as part of a package of Integrated Medical care.

Regular readers know that I’m most insistent on full disclosure. So I can reveal that I have absolutely no relationship with the manufacturer, other than buying bottle of their essences.

Technorati tags: Yarrow Environmental Solution Flower Essence Society Biofield Subtle energyIntegrated medicine Integrative medicine Environmental illness 

Another Controller of Appetite and Weight

We recently discussed the role of cytokines in modulating appetite and energy balance. Now a study in mice has shown that animals deficient in interleukin-18 (IL-18) develop a voracious appetite, very marked obesity and insulin resistance. The insulin resistance is secondary to the obesity that was induced by increased food intake and occurred in the liver as well as muscle and fat.

When the little creatures were given recombinant IL-18 their food intake returned toward normal.

Only recently discovered, IL-18 is an important regulator of innate and acquired immune responses. The fact that a modulator or immunity and inflammation has a key role in feeding and in energy metabolism shows us once again just how closely all these systems are tied together. You lose weight when you are sick or depressed because the body is battling the illness. As you recover, the body needs to replace everything that was lost and re-establish your resilience. These systems don’t just exist in humans, they are found in all mammals and even some birds and fish. So they have evolved over millions of years and we need to be very careful about tinkering with these complex systems. Or of allowing stress or environmental toxins to compromise these protective mechanisms.

This finding may well pave the way not just for new pharmacological approaches to weight management, but also to some non-pharmacological approaches.

Technorati tags: Cytokines Weight management Insulin resistance Interleukin-18 Inflammation

A New Way of Looking at – and Treating - Inflammation

Diseases of both large and small blood vessels are two of the biggest problem facing people with diabetes. Not only is it a huge clinical challenge, but also nature sometimes does our experiments for us. The high rates of coronary and peripheral vascular disease in diabetes can be seen as a kind of experiment of nature: a recognizable set of chemical abnormalities that might shed light on vascular diseases in general. It was those twin factors: a huge clinical problem, and an experiment of nature, that lead me to pick the topic of my research doctorate. 

When I was working on my research doctorate in the mid 1980s, I came across a lot of old research that seemed to show links between inflammatory and autoimmune conditions like systemic lupus erythematosus and rheumatic fever, and the eventual development of coronary artery disease. There was also a lot of old and largely forgotten research about the link between some viral infections and the development of coronary artery disease and acute coronary artery occlusions, because some infections can make blood more “sticky.” Inflammation evolved as one of the body’s defence mechanisms.

So I made the proposal – revolutionary at the time – that diabetes, coronary artery disease and a range of other illnesses might be inflammatory rather than degenerative. I soon found inflammatory markers in people with diabetes, that helped predict when someone was running into trouble with their eyes, kidneys or heart.  Even with stacks of data, I had to spend a lot of time defending that position, because it also implied that some illnesses thought to be irreversible might not be.

With the passage of time, it has tuned out that I was probably correct. Chronic inflammation, wherever it starts, mat have long-term effects on the body and on the mind. Chronic inflammation increases the risk of diseases of many blood vessels, as well as causing anemia, organic depression and cognitive impairment. Here is a partial list of common conditions in which inflammation is a prominent factor:
1.  Rheumatoid arthritis
2.  Systemic lupus erythematosus
3.  Fibromyalgia
4.  Chronic infections
5.  Insulin resistance or metabolic syndrome
6.  Arteriosclerosis
7.  Diabetes mellitus
8.  Hypertension
9.  Asthma
10. Inflammatory bowel disease
11. Psoriasis
12. Migraine
13. Peripheral neuropathy
14. Alzheimer’s disease
15. Autism
16. Gingivitis
17. Cystitis

The reason for raising the issue is not to say “told you so!”

It is instead that we need to think about inflammation a little differently. There is a mountain of information about the physical aspects of inflammation. We can stop at the simple description of inflammation as a condition in which part of the body becomes reddened, swollen, hot, and usually painful, or we can look below the surface: we can examine inflammation not only as a physical problem, but also as a psychological, social, subtle and spiritual problem. Why bother? Because the deeper approach allows us to understand and to treat and transcend inflammation as never before.

I am going to write some more about specific ways to address inflammation and what it means in future articles. I would also like to direct you to the book Healing, Meaning and Purpose, in which I talk about specific approaches in more detail.

But I would like to start with this.

In Ayurvedic and homeopathic medicine, inflammation is a sign of an imbalance in the vital forces of the body, and the traditional Chinese system agrees: here inflammation is usually a manifestation of an excess of Yang Qi, or a deficiency of Yin Qi. Most of our lives are seriously out of balance: Yang Qi is like a rampaging lion that has been stimulated by:
Acidic foods;
Environmental toxins;
Unwanted sexual stimulation:
Noise;
Discordant music:
Constant demands from others:
Toxic relationships;
Years spent in front of television sets and limitless multi-tasking.

It should be no surprise to learn that all of these inflammatory conditions are increasing rapidly throughout the Western world. Not because we are getting better at identifying them, or we are living longer, but genuinely increasing.

It is wrong to put all the blame on poor diets or inadequate exercise. The problem is more subtle and is a reflection of distorted Information being fed to our bodies, minds, relationships, subtle systems and spiritual relationships.

The great news is that this simple conceptual shift gives us a whole load of new tools for handling these problems, and for using them as catalysts to growth.

In the next few weeks, I am going to drill down and give you some specific guidance that ties into the material in Healing, Meaning and Purpose and the next two that are on the launch pad.

Fasten your seat belt!

Technorati tags: Inflammation Aging Alzheimer's disease Arteriosclerosis Neuropathy Autism Arthritis Systemic lupus erythrmatosus Fibromyalgia Inflammatory bowel disease Gingivitis 

Health Risks of X-Rays

There have been alarmist and often sensationalist stories about the health effects of ionizing radiation since it was first discovered. Wilhelm Conrad Röntgen won the Nobel prize in Physics in 1901 for his discovery of X-rays, and it was quickly discovered that over-exposure to X-rays was dangerous. Marie Curie – the Polish-born French scientist who won two Nobel prizes in 1903 and 1911 - died of leukemia. It has often been suspected that it was related to her long-term exposure to radiation.

As a child growing up in England, many shoe shops had primitive X-ray devices called fluoroscopes to allow kids and their parents to look at their little toes inside their shoes. Despite knowledge of the health effects of X-rays I reported in an article published fifteen years ago, that while working at a hospital in Nanjing, China, I was shocked that the ancient X-ray equipment had no shielding at all.

There is no doubt that X-rays and their more sophisticated progeny, like CT scans, have revolutionized medicine, and saved countless lives. So how do we weight the risks and benefits of diagnostic X-rays? The last thing that we want to do is to discourage people from having the medical help that they need.

Help has arrived in a new report Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2 from the National Academy of Science, published in September 2005. I think that this report should be considered the definitive and authoritative resource on the subject of radiation risk.

Dr. Richard C. Semelka has produced an outstandingly helpful summary of the report and its key recommendations.
1.    The report says that medical X-rays can cause cancer, and that there is no safe lower limit. The risk is very low, and, as one might imagine, is higher in children. It is also important to be aware that cancers are not uncommon and almost always have multiple causes, so claiming a causal link between a diagnostic X-ray examination and the subsequent development of a tumor is very difficult. The main tumors said to be associated with X-rays are leukemia, thyroid and breast. The time between exposure and tumor development can be very long.
2.    Therefore any use of X-rays, particularly CT scanning should be done judiciously. One of the problems in the United States is that many professionals have been forced to practice defensive medicine. They could be held legally liable if they do not do a test.
3.    Professionals already use the lowest possible dose of radiation.
4.    Professionals are already discussing whether there are any possibilities of substituting other types of diagnostic imaging.

Now I’m going to tell you a story. Some time ago I had a health problem that may well have been a result of exposure to radiation as a child. The health problem is now long gone, but it sensitized me to the issue. So what would I do now if a physician recommended that I have an X-ray or a CT scan? I would discuss the options:
How important is the test?
What would be the downside of not having it?
Is there any other way of getting the same answer without using X-rays?
If the answer to that one is “no, “ then what’s the lowest dose of radiation that we can use?
And how can we shield the bits of me that don’t need a dose of X-rays?
Then, even with my medical history, I personally would almost certainly go ahead and have the test. But every person would be well advised to have that discussion with their health care provider.

Many professionals read my articles, and for you, it would be worth considering getting the report, and going through Dr. Semelka’s thoughtful article.

I think it’s excellent that scientists have produced this report and that thoughtful radiologists around the world are working on the best ways of safe guarding the welfare of the public. I am going to continue to report the emerging scientific literature on this important topic.

Technorati tags: X-rays radiation carcinogenesis

Sick Building Syndrome

Sick building syndrome (SBS) was first recognized in 1982, and is a combination of symptoms associated with an individual's place of work - most often an office building -though there have also been instances of SBS in residential buildings. A 1984 World Health Organization report into the syndrome suggested up to 30% of new and remodeled buildings around the world might be linked to symptoms of SBS.

Many symptoms have been associated with SBS, including:

• Headache
• Dry or itchy skin
• Chronic fatigue
• Irritation of the eyes nose or throat, sometimes with a dry coughs
• Dizziness
• Nausea
• Difficulties in memory and concentration
• Extreme sensitivity to smells or bright lights

For SBS to exist, these symptoms must disappear soon after the occupants go outside.

There have been many explanations for these symptoms, primarily related to environmental pollutants. But I have something to add to that list. Some time ago I spent a happy year working at the Charing Cross Hospital in London during which I made an odd observation. On days that I worked in the laboratory on the tenth floor, I would be exhausted by the middle of the day, while on days when I worked in the outpatient clinic in the basement, I could easily get through a 5 hour clinic without difficulty. I mentioned it to a neurophysiologist friend who told me something very interesting: it had been discovered that on days when the wind blew at 5-10 miles an hour, the building began to vibrate like a giant tuning fork, and that the vibration was at its worst between the tenth floor and the top of the hospital. The vibration was imperceptible to most people, but I clearly had the misfortune to be sensitive to it. Yet without this experience, I might never have known of the potential adverse effects of vibration of the human body.

I have been consulted by a number of corporations and government organizations that have had trouble with people getting sick in certain buildings. Until now we have thought that it was all environmental, and that it could be anything from vibration to poor ventilation, chemicals, molds and many things in between. So I was very surprised to see a report published in the journal Occupational and Environmental Medicine from a first rate research group at University College London.

The British Inland Revenue Service demolished an entire 19-storey building in Bootle, Merseyside, after almost half of the employees had developed illnesses compatible with SBS. In a study published two and a half years ago, it was claimed that adding ultraviolet light to ventilation systems to kill microbes could vanquish the symptoms of SBS. But this new research suggests that the cure may actually be better management.

The new study included 4,052 civil service workers between the ages of 42 and 62 who were enrolled in a larger general health study. The men and women in the study worked at 44 different office buildings around London. The workers completed surveys designed to assess their general health and whether they had symptoms linked to SBS. They were also asked questions about the physical properties of the offices that they worked in and the stresses associated with their jobs.

As in earlier studies, women tended to have more symptoms associated with SBS than did men. Younger workers also had more of the symptoms than older workers. Almost one in five women and one in seven men reported five or more symptoms associated with sick building syndrome.

Now here was the surprise: the authors found little association between physical work environment and the symptoms. But there was a strong association between the symptoms and feelings of having high job demands and little support in the workplace. They also found that the more control people have over their workstation, the fewer symptoms were reported.

Though the findings fail to support "sick buildings" as a common cause of worker illness, the study should not be interpreted as meaning that the physical quality of the workplace is unimportant. It is most likely that we are dealing with a combination of physical and work related factors.

As I was reading the report and reviewing the rather vague but often quite severe symptoms, I was reminded of some recent work that I have been doing on burnout: I’ve just published an article about it. My interpretation of this study is that many cases of SBS are likely a form of burnout that is partially modulated by physical factors in the environment.

Technorati tags: sick building syndrome, workplace, occupational medicine, burnout, Stress

Climate Change and Your Health

When I hear the continuing arguments about climate change, I often fancy that I can in the far distance hear Nero playing his lyre while Rome burns. In March the BBC reported faster than expected warming of the Antarctic over the last 30 years. This report was based on a paper in the journal Science by a team from the British Antarctic Survey.

Gradual climate change is drawing particular attention in Europe, where the climate is exquisitely dependent on the Gulf Stream. In some places records have been kept for centuries, and there seem to have been genuine changes in a short space of time. A few years ago I was in Stockholm in the week before Christmas, and it was so warm that I was able to walk around in my shirtsleeves. That made it the warmest December in almost 800 years. People notice things like that, and governments and populations are eager to do something before the Arctic is reduced to a puddle.

Even if we are just seeing a natural climatic cycle, the consequences could be disastrous. Leaving aside the obvious matter of a rise in sea level, there is also the impact of global climate change on health. Earlier this year the BBC reported a speech by Professor Paul Hunter from the University of East Anglia in Norwich, to the Society of Applied Microbiology at the Royal Society in London. He pointed out that global warming, with hotter summers and more frequent and heavy rainfall and storms, would create the right conditions for an increase in food poisoning and other gastrointestinal upsets caused by microorganisms.

Global warming could also create conditions favorable for a return of malaria to the United Kingdom. Professor Hunter has published papers on this important topic before. He is no alarmist, and his work underscores the way in which our environment and we are closely interlinked, and even small climatic changes may have major effects on illness.

We could discuss this topic in a great deal of detail. Suffice to say that it is more important than ever for all of us to get into the habit of washing our hands, ensuring the cleanliness of food, and even more so of the water that we use, and that we do all that we can to build our resilience.

There is also another matter of equal importance, and that is the dwindling supply of fresh water around the world. The number of us is growing fast and our water use is growing even faster. A third of the world's population now lives in water-stressed countries, and it is expected that this will rise to two-thirds by the year 2025. The cruelty of the situation is that there is altogether more than enough water available for everyone's basic needs. The water is in the wrong places and much of it is unusable.

The United Nations recommends that people need a minimum of 50 liters of water a day for drinking, washing, cooking and sanitation. Global water consumption rose six-fold between 1900 and 1995 - more than double the rate of population growth - and goes on growing as farming, industry and domestic demand all increase.

As important as quantity is quality - with pollution increasing in some areas, the amount of useable water declines. Each year, more than five million people die from waterborne diseases, which is 10 times the number killed in wars around the globe. Most of the victims are children.

Seventy percent of the water used worldwide is used for agriculture. Much more will be needed if we are to feed the world's growing population, which is predicted to rise from about six billion today to 8.9 billion by 2050. And consumption will further increase as more people expect Western-style lifestyles and diets. Here is a useful statistic: one kilogram of grain-fed beef needs at least 15 cubic meter of water, while a kilo of cereals needs only up to three cubic meters. Many futurists are already predicting that water will become as much of a strategic issue as oil is today, with wars being fought over the water supply.

As of today, we should all start thinking about ways in which we can reduce our own water consumption and make provision to collect and purify water ourselves.

“Everybody talks about the weather but nobody does anything about it.” -- Charles Dudley Warner (American Author, 1829-1900)

Technorati tags: global warming, water, Environment, Climate Change, pollution

Sun Bed Addiction

One of the most pernicious claims of some purveyors of medical misinformation is that there is no connection between exposure to sunlight and skin cancer.

I just saw that repeated by someone on an infomercial promoting his latest book. The person speaking was a marketer with, I understand, no scientific or medical training. The fact is that exposure to ultraviolet light has been shown to damage DNA in cells grown in culture in the laboratory, and the pattern of damage is exactly what we predict would cause cells to become malignant.

There are protocols for transforming normal cells into malignant ones using ultraviolet light alone. We also know from epidemiological studies that exposure to sunlight is linked to the development of skin cancer. The best predictors are both the number of hours exposed, and the number of times that the skin has been burned. Despite this information, there was a 300 percent increase in the number of indoor tanners in the United States between 1986 and 1996.

So why do people continue to use sun beds? Apart from vanity, there is now increasing evidence of another factor. Earlier this year investigators from the University of Minnesota published a study suggesting that the over-use of indoor tanning by adolescents could be addictive. The age at initiation of usage, the frequency of use and the relationship between use and difficulty in quitting indoor tanning are consistent with other potentially addictive behaviors taken up during adolescence.

Now a team from Wake Forest University in North Carolina has published a small study  in which they showed that in four of eight frequent tanners, giving them the opioid antagonist naltrexone caused them to experience symptoms very much like those that we associate with drug withdrawal. I recently came across a case of a young person who was tanning obsessively, at least once a day. It turned out that she also had a substance abuse problem. Though this study is small and preliminary, it certainly seems to fit with clinical observations.

We already knew that ultraviolet light can elevate mood: it has been known for many years that in people with bipolar disorder, they are more likely to become manic as the days become longer and they are exposed to more sunlight. There is also some evidence that ultraviolet light may elevate testosterone levels, which is one of many possible reasons why some people report increased libido while vacationing at the beach. (I feel sure, gentle reader, that you can come up with a long list of other reasons for that observation…)

Technorati tags:  utltraviolet light, sun bed, mood