Richard G. Petty, MD

Sir Richard Branson’s Integrated Health

Sir Richard Branson is a hugely popular British entrepreneur and adventurer who has been able to keep the common touch and does not seem to be as ruthless as some other self-made billionaires.

For more than three decades Richard has also shown that he has a remarkably good nose for identifying important and/or lucrative new trends. Like all people, he has made the occasional bad call, but his overall success rate is astonishing.

So I was extremely interested to see that Richard Branson’s Virgin Group has launched a foray into the British National Health Service (NHS) primary healthcare market and they are trying to persuade family doctors to join them in establishing a network of branded clinics.

It is particularly interesting that British government ministers are welcoming Virgin Healthcare’s decision to open the first of six “one-stop-shop” health centers later this year. The plan is to offer services from homeopathy to psychotherapy alongside typical primary care services.

This project has been two years in the planning and the group has just started its first advertising campaign to generate interest among family doctors who could join its health centers.

The business model allows family physicians to retain their existing contracts but Virgin would manage funds the doctors receive for staff costs and rental. Virgin would then offer a range of additional NHS and private services to visiting patients, including dentistry, screening, a pharmacy “and a range of conventional and complementary therapies.”

The British government has identified the importance of providing more and better primary care services and has £250m a year earmarked for the new services and Virgin wants to be a provider.

What is different is that Virgin Healthcare is proposing to work with primary care physicians to help develop more integrated, accessible and personalized services for patients and that they are quite prepared to consider providing less conventional therapies for which there is patient demand and/or empirical evidence.

That last piece – including less orthodox therapies – will inevitably put the cat amongst the pigeons, but Richard Branson and his advisers have correctly identified that there are some good reasons for including some of these therapies, even if the research base is not yet as good as we would like.

Writing and Rewriting Your Own Life Story

I had the privilege of being on the Donna Seebo show yesterday. And when I say that it was a privilege, it really was. It is not often that I find someone who so fully understands the power of an Integrated approach to health and medicine. Toward the end of the call an interesting question came up about the value of journal writing in healing. I am a firm believer in it, I recently reviewed a terrific book by Sheppard Kominars on the topic and I have published a reading list on Amazon.

There is some empirical research to show that journal writing can improve our physical and mental health (1, 2, 3, 4). Why should this be?

One of our most fundamental and enduring needs is to tell people our stories. And even more than that: to leave our stories as the records of our lives. Our stories define us. They are the vehicles of meaning and they serve as the narrative of our views about our world and ourselves. And our stories create our legacy. We all constantly tell stories that shape virtually every human activity from our emotions to our personal relationships and our politics.

It has clear evolutionary advantages to be able to tell good stories, not only for social cohesion, but also as a device to pass on wisdom. But perhaps most of all, storytelling is a device to help us make sense of the world about us.

Jerome Bruner has indicated that children acquire language in order to tell the stories that are already in them. We learn through story telling. The brain breaks down when we no longer manage to make sense of the world around us. Patients with schizophrenia seem to lose the ability to tell a coherent story about themselves or about the world around them.

I am reminded of the tragic letter written by Dimitri Koesnikov, the young Russian submariner on the Kursk who continued to write a letter to his wife, even when he knew that death was inevitable, or the passengers on the Japanese jet liner that crashed in 1985. As the plane went down, people were writing letters. Or people in the Warsaw ghetto who wrote letters and poems even when they knew that they only had minutes to live.

Writing our stories introduces another dynamic: most of us find that putting out thoughts and feelings down on paper helps to give us mental and emotional clarity. Writing helps us to express our individuality and to make connections with others.

Our memories are not just videos of our life events; they are dynamic and malleable and are constantly being edited. So we can change our stories, and with that, remove some of the restrictions that they have imposed upon us. This is not an invitation to enter into a fantasy world or to start lying to yourself or to other people, but is instead an incredibly valuable tool to clear some of the blocks I our lives.

It is a good practice to think through your stories every day. If you care to write about them, that is even better. We need to answer the question: “What are the stories that have defined who you are and how you act?”

When we think about our relationships, isn’t it true that the ones that matter the most and have the most emotional charge attached to them are those in which our stories are intertwined? How often have you met an old friend, after a gap of many years, and found that you no longer have much to talk about, because your stories have diverged so far? How many people maintain family relationships even when their respective stories have nothing in common? Maintaining a relationship out of duty is unfair and disingenuous. Either the stories need to be repaired, or the relationship is doomed.

As an exercise, I would like you to examine some of the dominant stories that have determined some of your personality and your character. And I would then like you to write a brief story about how you would like your life to be.

To help you get started, let me make some suggestions:

•    What is your favorite type of story?
•    What is the first story about your family that you remember hearing?
•    What are your favorite stories about yourself as a child?
•    What are your favorite stories about yourself as an adult?
•    Who are the key characters in your life story?
•    How many of the key characters know each other?
•    Does your life story have a plot line?
•    Could you create a better one?
•    What stories would you like others to tell about you?
•    How would you like your story to end?

I would love to have some feedback if you find this helpful.



“A man's mind is hidden in his writings; criticism brings it to light.”
--Solomon ben Yehuda ibn Gabirol (Spanish-Hebrew Poet, Neoplatonist Philosopher and Mystic, c.1021-c.1058)

“Writing is a form of therapy; how do all those who do not write, compose, or paint manage to escape the melancholia, the panic and fear which is inherent in the human condition?”
--Graham Greene (English Writer, 1904-1991)

Forgiveness and Health

The January issue of Mayo Clinic Women's HealthSource summarizes a substantial body of research indicating that forgiveness may be good for your health.

Holding a grudge appears to affect the cardiovascular and nervous systems (1, 2). In one study, people who focused on a personal grudge had elevated blood pressure and heart rates, as well as increased muscle tension and feelings of being less in control. When asked to imagine forgiving the person who had hurt them, the participants said they felt more positive and relaxed and thus, the changes dissipated. Other studies have shown that forgiveness has positive effects on psychological health, too.

Forgiveness does not mean forgetting, condoning or excusing whatever happened. It is instead a matter of acknowledging hurt and then letting it go, along with the burden of anger and resentment.

There is no single approach to learning how to forgive. Talking with a friend, therapist or adviser (spiritual or otherwise) may be helpful during the process, to sort through feelings and stay on track. The January issue of Mayo Clinic Women's HealthSource recommends four steps that are included in most approaches to learning forgiveness.

-- Acknowledge the pain and anger felt as a result of someone else's actions. For forgiveness to occur, the situation needs to be looked at honestly.

-- Recognize that healing requires change.

-- Find a new way to think about the person who caused the pain. What was happening in that person's life when the hurt occurred? Sometimes, the motivation or causes for the incident have little to do with those most affected. For some people, this step includes saying, "I forgive you."

-- Begin to experience the emotional relief that comes with forgiveness. It may include increased compassion for others who have experienced similar hurt.

“When we forgive, we free ourselves from the bitter ties that bind us to the one who hurt us.”
Claire Frazier-Yzaguirre (American Therapist and Christian Minister)

“Fear binds the world. Forgiveness sets it free.”
--A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

“Forgiveness breaks the chain of causality because when someone forgives you - out of love - he takes on the consequences of what you have done. Forgiveness, therefore, always entails a sacrifice.”
--Dag Hammarskjöld (Swedish Statesman, Secretary-General of the United Nations from 1953-1961, and, in 1961, Winner of the Nobel Peace Prize, 1905-1961)

“Here is a mental treatment guaranteed to cure every ill to which flesh is heir: sit for half an hour every night and mentally forgive everyone against whom you have any ill will or antipathy.”
--Charles Fillmore (American Co-founder of Unity School of Christianity, 1854-1948)

“Forgiveness is the key to action and freedom.”
--Hannah Arendt (German-born American Political Philosopher, 1906-1975)

“Without forgiveness life is governed... by an endless cycle of resentment and retaliation.”
--Roberto Assagioli (Italian Psychiatrist, Theosophist and Founder of Psychosynthesis, 1888-1974)

“The weak can never forgive. Forgiveness is the attribute of the strong.”
--Mahatma Gandhi (Indian Nationalist and World Teacher, 1869-1948)

“Today I forgive all those who have ever offended me. I give my love to all thirsty hearts, both to those who love me and to those who do not love me.”
--Paramahansa Yogananda (Indian Spiritual Teacher and, in 1920, Founder of the Self-Realization Fellowship, 1893-1952)

“Judge not, and ye shall not be judged: condemn not, and ye shall not be condemned: forgive, and ye shall be forgiven.”
--The Bible (Luke 6:37)

Doctors, Integrated Health, Faith and Spirituality

I am often asked if there is any conflict between being a Catholic and a physician teaching holistic health. That always seems to me a slightly odd question: for me they fit together seamlessly.

Some time ago I was asked to see the son of two pastors from an evangelical church. They, their family, and congregation had been praying for him for three years, and they felt guilty about coming to see me. They only came because of the insistence of one of the congregation who had seen an article about my work, and thought that I looked as if I had a nice face. You, gentle reader can be the judge of that.

It was soon clear what was wrong with the son, but the family told me that they did not really believe in medication and felt that their prayers should have been enough.

My response was to ask them if they thought it possible that the Lord had led their parishioner to read the article? Is it not said that, “God works in mysterious ways?” “Is it possible that my team, and the pharmaceutical companies that make the medicines that I am recommending, could all be the answer to your prayers?” I do not know the answer, but they decided that was the case, agreed to the treatment, and the young man was back on track in a few weeks.

It is inevitably controversial whenever I talk about this kind of issue, but I think that it is important.

I would also like to share something that I had not read since I was a teenager. It came along yesterday, seemingly by chance. Except that I don’t really believe in change or coincidence.

“Honor the doctor with the honor that is his due in return for his services; for he too has been created by the Lord.”

“Healing itself comes from the Most High, like a gift from a king.”

“The doctor’s learning keeps his head high, he is regarded with awe by potentates.”

“The Lord has brought medicines into existence from the earth, and the sensible man will not despise them.”

“Did not a piece of wood once sweeten the water, thus giving proof of its virtue?”

“He has also given men learning so that they may glory in his mighty works.”

“He uses them to heal and to relieve pain, the chemist makes up a mixture from them.”

“Thus there is no end to his activities and through him health extends across the world.”

“My son, when you are ill, do not be depressed, but pray to the Lord and he will heal you.”

“Renounce your faults, keep you hands unsoiled ad cleanse your heart from all sin.”

“Offer incense and a memorial of fine flour and make as rich an offering as you can afford.”

“Then let the doctor take over – the Lord created him too – and do not let him leave you for your need him.”

“Sometimes success is in their hands, since they in turn will beseech the Lord to grant them the grace to relieve and to heal, that life may be saved.”

“If a man sins in the eyes of his Maker, may he fall under the care of the doctor.”

The Jerusalem Bible, Ecclesiasticus 38:1-15

National Acupuncture Detoxification Association

I had the pleasure and privilege of being on Scott Cluthe’s show on Lime Radio this evening. It’s on Sirius Satellite Channel 114, and if you are interested in the new holistic worldview that is emerging all over the planet, I highly recommend Scott’s show and, in fact, all the shows that I have heard on Lime. I have also had a link to Lime website for some time now, and it always has a great deal of excellent material.

There were some excellent questions from listeners, and one caused me to do some research. The question was about the National Acupuncture Detoxification Association (NADA). The Association is a nonprofit that conducts training and provides public education about the use of acupuncture as an adjunctive treatment for addictions and mental disorders.

There is a substantial body of research literature on the topic of using acupuncture as part of a package of measures for treating substance abuse, and although it is still considered controversial in some quarters, it is being used in over 1,500 places around the world, and that does not include China and Japan, where I have seen acupuncture used a great deal in addictive disorders.

My own experience has been mixed. I have had little success I treating smoking addiction with acupuncture, though I have many colleagues who say that it is extremely helpful. I have had more success in using thought field therapy and homeopathy for treating smoking addiction, even though there is so far no good research data on the use of either for smoking.

If you are interested in the use of acupuncture as an adjunctive treatment for substance abuse, the NADA website if a good place to start.

Work, Stress, Vacations and Exotic Drinks with Little Umbrellas in Them

Your humble reporter has often spoken about his brush with burnout. 

Even though I was a recognized expert on stress – and a former meditation teacher, no less! – I got perilously close to the edge. Fortunately someone noticed and I was packed off on vacation. It was remarkable that just a week in the Caribbean followed by an unforgettable one-week retreat in the Catskills was enough to cure me. My resting pulse rate fell from 68 to 48, where it stayed for more than a year, and I never again had any symptoms. The key point was that the short break was enough to interrupt the downward spiral and provoke the cognitive shift that prevented me from ever again making the mistakes that lead to the trouble in the first place.

I still work hard, but trust me when I say that working 16-17 hours a day, seven days a week is preposterous. Neglecting your emotional health and social life is bad enough. But the last straw was to stop engaging in spiritual practices that I had followed since childhood.

For a long time now I have been teaching that most people can make phenomenal changes in a very short period. It may take you a long time to prepare, but once you are ready change can be extremely quick. If you think about it, the actual physical business of an egg and a sperm joining to make a new life takes less than a minute. But the preparation for the event may take half a lifetime. At least I hope for your sake that it takes a lot longer than a minute…

And that’s all that I am going to say about that…

I was thinking about all this the other day when a stressed executive was telling me that he all he wanted was to spend six months sitting on a beach. In fact that would probably be a thoroughly bad idea.

It is not the time; it is the quality of the time, and the energy that you bring to it.

I cannot stress enough that for most people energy management is far more important than time management.

When it comes to beating burnout, the kind of vacation is likely more important than its length.

A summary of ten years of research by a team lead by Dov Eden, an organizational psychologist from Tel Aviv University's Faculty of Management, was presented at last year's meeting of "Work, Stress and Health" in Miami. The event is sponsored by the American Psychological Association and what Professor Eden had to say really supports what we have been talking about.

For the past ten years the team has been studying "respite effects," which measure relief from chronic job stress during and after vacations away from the workplace. They have also been looking at the impact of constant contact: the revolution in telecommunications has kept some people permanently wired into the office while they are supposed to be away putting their feet up and drinking exotic concoctions with little umbrellas in them. So we are losing true "respite relief," and that in turn is a cause of chronic job stress.

One recent study involved 800 professors from eight Universities in Israel, the United States, and New Zealand. The researchers measured stress levels before, during, and after a sabbatical leave of a semester or a whole year. They compared them with people who stayed home, and others who just took a long weekend or a one-week vacation. They found that those who took a long sabbatical break experienced about the same amount of stress relief as people who had taken either a week off or just a long weekend or long-weekend vacation. And all three groups returned to pre-sabbatical stress levels in about the same amount of time: approximately three weeks.

Some of Eden’s other studies have indicated that people who best succeed in uncoupling from work and detaching form its demands, get the most benefit from their vacations and they probably less likely to experience job burnout. It's the ones who cannot detach from the constant flow of job-related demands that are most likely to suffer from burnout.

The key to a refreshing vacation is to create as much space as possible between you and your work life. I once knew someone who spent a week on Tioman Island in the South China Sea. It is reputed to be one of the most beautiful places on earth, which was one of the reasons why it was selected for the filming of South Pacific. For the whole week she spent all day every day working, and every day the hotel’s fax machine got jammed with the 60-70 pages that she sent out. That is not a recipe for a refreshing, life affirming vacation.

This body of research confirms what most sensible managers have worked out for themselves. When someone goes on vacation they should leave their cell phones behind and not check their email. People who feel attached to the office 24/7 are setting themselves up for long-term stress-related illnesses.

I get a lot more email and phone calls than most normal mortals, yet many years ago I made a remarkable discovery.

I had been out of contact for a week, and even after disposing of the spam and junk mail, there were still well over a thousand messages “demanding” my immediate attention. But during that week away, events had moved on, most no longer needed any input from me at all. Matters had been resolved and solutions found. We lost no business, and I have it on good authority that the earth did not fall into the sun.

I came back rested and restored, and firing on all cylinders: everyone benefited.

Quite obviously it is not a good idea to be completely un-obtainable. I have had two friends, one of whom lost her mother and another his wife, and neither heard the sad news for more than a week. So even when I am in some far flung part of the planet I make sure that there is a way for me to be contacted, But only three people know how.

And I am no longer an electron junkie.

Try it the next time that you have a chance. It really is easier than you think.




“Let all bitterness, and wrath, and anger, and clamor, and evil speaking, be put away from you, with all malice; and be ye kind to one another, tenderhearted, forgiving one another, even as God, for Christ's sake, hath forgiven you.”
--The Bible, Ephesians 4:31-32

“Detach yourself from all that makes your mind restless. Renounce all that disturbs its peace. If you want peace, deserve it.”
--Sri Nisargadatta Maharaj (Indian Spiritual Teacher and Exponent of Jnana Yoga and Advaita Doctrine, 1897-1981)

“You must have been warned against letting the golden hours slip by, but some of them are golden only because we have let then slip by.”
--Sir James Matthew (J.M.) Barrie (Scottish Writer and Playwright, 1860-1937)

Music, Language and the Brain

For more than two centuries neurologists and others interested in music and language have wondered whether or not language and music depend on common processes in the mind. It has been known that some aspects of language and music are represented in different regions of the brain, but there are also many areas of crossover.

Now, researchers at Georgetown University Medical Center have published evidence in the journal NeuroImage, that the processing of music and language do indeed depend on some of the same brain systems.

Their findings suggest that two different aspects of both music and language depend on the same two memory systems in the brain. One brain system, based in the temporal lobes, helps us to memorize information in both language and music, for example words and meanings in language and familiar melodies in music. The other memory system is focused in the frontal lobes, and this one helps us to learn “unconsciously” and use the rules that underlie both language and music, such as the rules of syntax in sentences, and the rules of harmony in music.

The study involved 64 adults and the researchers used a technique called event-related potentials, in which they measured the brain's electrical activity using electrodes placed on the scalp.

The subjects listened to 180 snippets of melodies. Half of the melodies were segments from tunes that most participants would know, such as "Three Blind Mice" and "Twinkle, Twinkle Little Star." The other half included novel tunes composed by one of the researchers. Three versions of each well-known and novel melody were created: melodies containing an in-key deviant note that could only be detected if the melody was familiar, and therefore memorized; melodies that contained an out-of-key deviant note that violated rules of harmony; the original melodies that acted as the “controls”

They found that violations of rules and memory in music corresponded to the two patterns of brain waves seen in previous studies of rule and memory violations in language. In-key violations of familiar melodies led to a brain-wave pattern similar to one called an "N400" that has previously been found with violations of words. One example that the authors gave: :I'll have my coffee with milk and concrete.” Out-of-key violations of both familiar and novel melodies generated electrical activity over the frontal lobe similar to the patterns previously found for violations of rules in both language and music. Out-of-key violations of familiar melodies also led to an N400-like pattern of brain activity, as expected because these are violations of memory as well as rules.

This research opens up new ways of thinking about the relationships between language and music, and may have implications for speech and language therapy.

“When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest.”
--Henry David Thoreau (American Essayist and Philosopher, 1817-1862)

“There is nothing better than music as a means for uplifting the soul.”
--Hazrat Inayat Khan (Founder of the Sufi Order of the West, 1882-1927)

“There are more love songs than anything else. If songs could make you do something we'd all love one another.”
--Frank Zappa (American Composer, Guitarist, Satirist and Song Writer, 1940-1993)

“Since music is a language with some meaning at least for the immense majority of mankind, although only a tiny minority of people are capable of formulating a meaning in it, and since it is the only language with the contradictory attributes of being at once intelligible and untranslatable, the musical creator is a being comparable to the gods, and music itself the supreme mystery of the science of man, a mystery that all the various disciplines come up against and which holds the key to their progress.”
--Claude Lévi-Strauss (Belgian-born French Social Anthropologist, 1908-)

Brain Mapping and ADHD

It is amazing how many people remain resistant to the idea that Attention Deficit Hyperactivity Disorder (ADHD) is a genuine problem. It is likely becoming more common as we live in a progressively more demanding world in which our inner resources can easily become overwhelmed. It is a “real” problem since if it is severe it can cause suffering and second, ADHD can also be associated with a range of other difficulties. There is also more and more evidence that it is associated with robust disturbances in the structure and functioning of the brain.

There is an important study published in Human Brain Mapping that reveals an association between ADHD and a decrease in cortical volume, surface area and folding throughout the brain. Researchers from the Kennedy Krieger Institute in Baltimore, Maryland, found that children with ADHD has decreased total brain volume and decreased volume throughout the cerebral cortex. What is new is that the reduction in cortical volume seems to be the result of decreased folding in the cortex. This in turn suggests that folding – a process that starts around the 14th-16th weeks of pregnancy and continues into infancy - is the key structural brain feature associated with ADHD.

The investigators examined 21 children with ADHD aged 8-12 years, and a control group of 35 unaffected children matched for age and gender. The children with ADHD had more than 7 percent reduction in total cerebral volume compared with the control group.

One of the design problems in human beings is that the brain is encased in a hard skull that moves little. So once the brain has grown to fill the skull, the only way to increase the surface area of the brain is for the cortex to become more folded. The whole process of cortical folding is crucial to increasing the structural and functional capacity of the brain.

This is of great interest, particularly in light of the study just published in the Proceedings of the National Academies of Sciences that indicates that the brain of people with ADHD can catch up later. That study did not look at brain folding, so it will be interesting to see exactly how the brain can catch up, and how we might be able to give it a helping hand.

Nutrigenetics: A Peak Into the Future

At any given time only about ten percent of you genes are thought to be active. They are switched on and off in response to all kinds of internal and environmental changes. This is particularly true in the metabolic pathways, where gene activation is an essential part of the normal response to dietary changes. We also know that many of us have genetic reasons for varying in our nutritional requirements.

Anybody who has looked into diet and nutrition knows that there is no one approach that works for everyone, and the Holy Grail of weight management is to be able to identify which diet will work for whom.

This goal has just come a little closer with the publication of a report from researchers in Greece, London and Colorado that has been published in the Nutrition Journal.

The paper, “Improved weight management using genetic information to personalize a calorie controlled diet” is available for free download.” The study population consisted of 50 patients who had failed to lose weight. They were offered a nutrigenetic test screening 24 variants in 19 genes involved in metabolism. 43 patients attending the same clinic were selected for comparison using algorithms to match age, sex, frequency of clinical visits and BMI at initial clinic visit. The second group of 43 patients did not receive a nutrigenetic test. BMI reduction at 100 and over 300 days and blood fasting glucose were measured.

The results are very promising. After 300 days of follow-up individuals in the nutrigenetic group were more likely to have maintained some weight loss (73%) than those in the comparison group (32%). Average BMI reduction in the nutrigenetic group was 1.93 kg/m2 (5.6% loss) vs. an average BMI gain of 0.51 kg/m2 (2.2% gain). Among patients with a starting blood fasting glucose of >100 mg/dL, 57% (17/30) of the nutrigenetic group but only 25% (4/16) of the non-tested group had levels reduced to <100 mg/dL after >90 days of weight management therapy.

The paper concludes by saying that the addition of nutrigenetically tailored diets resulted in better compliance, longer-term BMI reduction and improvements in blood glucose levels.

This is a small “proof of concept” study, and the effects are not enormous, but there is easily enough here already to vigorously pursue this genetic approach.

A New Lie Detector?

I am sure that this is a story that is going to be picked up and re-worked by those excellent writers over at Law and Order.

An academic at the University of Sheffield has used groundbreaking technology to investigate the potential innocence of a woman convicted of poisoning a child in her care.

Professor Sean Spence, who is a pioneer in the use of functional Magnetic Resonance Imaging (fMRI) to detect lies, carried out the experiments on the woman who, despite protesting her innocence, was sentenced to four years in prison. His results have now been published for the first time in the journal European Psychiatry.

Sean examined the woman’s brain activity as she alternately confirmed her account of events and that of her accusers. The tests demonstrated that when she agreed with her accusers´ account of events she activated extensive regions of her frontal lobes and also took significantly longer to respond: these findings have previously been found to be consistent with false or untrue statements.

Although the technology has previously been claimed to be 90% accurate, which is far superior to “lie detector" – polygraph – tests, its use has also been open to debate. Lie detection tests are already used regularly in parts of the United States justice system, as well as by businesses. But as far as I know, these are the first brain scanning tests of their kind, carried out on a real-life case, reported in the world literature.

Professor Spence said:

"This research provides a fresh opportunity for the British legal system as it has the potential to reduce the number of miscarriages of justice. However, it is important to note that, at the moment, this research doesn’t prove that this woman is innocent. Instead, what it clearly demonstrates is that her brain responds as if she were innocent."

"If proved to be accurate, and these findings replicated, this technology could be used alongside other factors to address questions of guilt versus innocence."

Blondes Makes Us Dumb??

No, this isn’t just a cheap excuse to display a picture of Pamela Anderson.

I just received this from a regular reader:

"Dear Dr Petty,

Have you seen this article Times Online?

“WHEN men meet fair-haired women they really do have a “blonde moment”. Scientists have found that their mental performance drops, apparently because they believe they are dealing with someone less intelligent.

Researchers discovered what might be called the “bimbo delusion” by studying men’s ability to complete general knowledge tests after exposure to different women. The academics found that men’s scores fell after they were shown pictures of blondes.

Further analysis convinced the team that, rather than simply being distracted by the flaxen hair, those who performed poorly had been unconsciously driven by social stereotypes to “think blonde”.

“This proves that people confronted with stereotypes generally behave in line with them,” said Thierry Meyer, joint author of the study and professor of social psychology at the University of Paris X-Nanterre. “In this case blondes have the potential to make people act in a dumber way, because they mimic the unconscious stereotype of the dumb blonde.”

Do you have any comment to make about the research??"

The answer is that I have seen this article all over the Internet, with all kinds of sage comments.

The trouble is that I have not yet been able to read and critique the research. As far as I know, neither the hard copy nor electronic versions are available yet, so I cannot evaluate the report.

This highlights one of the problems of the Internet: news travels across it like the wind, yet a lot of material is passed on without analysis. So the story is fun to read, but until we can see and analyze the data, we cannot comment.

As soon as I get a copy I shall see if I have anything to add to the firestorm of commentary!

Talking with Your Hands

In recent years there has been a small but growing literature that seems to support an idea going back to Roman times: certain specific movements may facilitate learning and a number of positive mental states.

Now, according to research from the University of Chicago that is reported in this month’s issue of Journal of Experimental Psychology: General gesturing can help children to learn new and correct mathematical problem-solving strategies. And the learning sticks: if they are taught new material later, children taught to gesture are more likely to succeed on math problems.

The investigators conducted two studies of 176 children in late third and early fourth grade, all of whom had been making mistakes in solving math problems. The children were randomly assigned the students to three groups:

1. Told to gesture
2. Told not to gesture
3. Not told to do either

In the studies' baseline phase, students had to solve six age appropriate math problems on a chalkboard and explain to an experimenter how they solved each one. The researchers coded the children's videotaped efforts, analyzing gestures and utterances that conveyed problem-solving strategies.

Compared with the children who were not told to do anything, those who were told to move their hands when explaining how they had solved a problem were four times as likely to manually express correct new ways to solve problems. They still did not give the right answer, but their gestures revealed an implicit knowledge of mathematical ideas. As one example, if the problem needed for the sides to be equal, children might sweep their palm first under a problem's left side and then under its right side. So they had implicit knowledge. Their problem was in turning explicit knowledge into correct answers. The second study showed that gesturing prepared them to benefit from subsequent instruction. Children told to gesture solved 1.5 times more problems correctly compared with the children who had been told not to gesture.

The authors conclude,

"Telling children to gesture encourages them to convey previously unexpressed, implicit ideas, which in turn makes them receptive to instruction that leads to learning."

Gesturing appears to help children to produce new problem-solving strategies, which in turn gets them ready to learn. The authors speculate that gesturing may help kids notice aspects of the math problems that may be more easily grasped through gestural representation

The findings extend previous research that body movement not only helps people to express things they may not be able to verbally articulate, but actually to think better. At the same time, gesturing offers a potentially powerful new way to augment the teaching of math. Strategies for math problems have focused on externalizing working memory, such as writing things down in certain ways. However, children often find it hard to recall and use those strategies. Gesturing may be more accessible, and help break through the roadblock.

This makes sense: we are hardwired to learn motor actions. That was an important skill long before the first person learned the basics of arithmetic. It is quite well known in educational circles that when it comes to learning, “doing” is 2-3 times more efficient than “listening.” But even “doing” is nowhere near as good as questioning, being questioned and then teaching.

(The entire article is available for free download here.)

“He who wishes to teach us a truth should not tell it to us, but simply suggest it with a brief gesture, a gesture which starts an ideal trajectory in the air along which we glide until we find ourselves at the feet of the new.”
--José Ortega y Gasset (Spanish Philosopher, 1883-1956)

Mature Plasticity in the Human Brain

The more we look, the more we understand that the human brain retains a remarkable ability to learn and re-fashion itself well into old age. The old idea that young brains are flexible, but that age causes us to become “hard-wired” and inflexible is not correct.

This has been confirmed in some new research that has just been published in the journal Neuron by investigators from Johns Hopkins who have shown that adult neurons are not glued in place as rigidly as had been thought.

The investigators led by David Linden used a new technique known as two-photon microscopy that allowed them to living neurons at work in the intact brain. The researchers injected fluorescent dye into the brains of mice to illuminate a subset of neurons and then viewed these neurons through a window in the skull of living, anesthetized mice.

They examined neurons that extend axons to the cerebellum, a region of the brain involved in coordinating motor and sensory information. These axons have a primary trunk that runs upward and several smaller branches that sprout out to the sides.

While the main trunk was firmly connected to other target neurons in the cerebellum, the side branches were mobile: Linden describes them like this:

"The side branches swayed like kite tails in the wind."

Over the course of a few hours, individual side branches would highly dynamic behavior, elongating, retracting and morphing. These side branches also failed to make conventional synaptic connections with adjacent neurons. The motion of the side branches was arrested stalled by a drug that produced strong electrical currents in the axons.

Why the brain would want such motile, non-connected branches remains a mystery.

They may provide a second mechanism for conveying information beyond traditional synapses. Alternatively they may be involved in nerve regeneration.

Whatever the final answer, it is clear that the adult brain remains a remarkably plastic, fluid and flexible structure.

Excellent news for all of us!

“That which is flexible and flowing will prosper and grow. That which is rigid and blocked will wither and die.”
--Tao D Ching

“When a noble life has prepared old age, it is not decay that it reveals, but the first days of immortality.”
--Muriel Spark (Scottish Writer, 1918-)

"You will stay young as long as you learn, form new habits and don’t mind being contradicted.”
--Marie, Baronin von Ebner-Eschenbach (a.k.a. Baroness Marie von Ebner-Eschenbach, Austrian Writer, 1830-1916)

Attention Deficit Disorder and the Growing Brain

An extremely important article by researchers from the National Institute of Mental Health has just been published in the Proceedings of the National Academies of Sciences. It suggests that children with Attention Deficit Hyperactivity Disorder (ADHD) have brains that develop more slowly than those of children without ADHD. However in most cases they still follow a normal pattern of development.

In a study of 450 children, 225 of whom had ADHD, the researchers found that the cerebral cortex of children with ADHD developed about three years more slowly.

The primary measure that they used was the peak thickness of the brain, which is normally taken to be a sign of maturity. Half of the children with ADHD reached peak thickness when they were an average of 10.5 years old, compared with 7.5 years among children without ADHD.

Even if the brain is developing more slowly, the fact that it appears to grow normally is reassuring, and may explain why a substantial proportion of children with ADHD do grow out of it as they get older. Though it still leaves us with several questions:

• Why does the delay occur at all?
• Why do so many people NOT grow out of it, and have persistent symptoms in adulthood?
• Is the brain really “catching up?” The brains of people without ADHD also continue to develop and grow

The National Institute of Mental Health has also published a nice press release that includes a video of brain maturation. You can find it here.

Blood Pressure and the Seasons

High blood pressure may be more difficult to control in winter, according to research reported to the American Heart Association, at its meeting in Orlando last week.

A five-year study by a team from the United States found Department of Veterans Affairs analyzed data on 443,632 veterans treated for hypertension at 15 VA hospitals in cities throughout the US found that blood pressures during the summer were on average 7.76% lower than during the winter. The researchers found the same pattern emerged from each hospital they studied, regardless of whether it was based in a warm or cold climate, in locations that ranged from Anchorage, Alaska to San Juan, Puerto Rico.

This is an intriguing finding, and there are a load of potential explanations for it:
A more active summer lifestyle may be the key
It is also possible that people might eat more salty foods in winter, and salt is strongly linked to raised blood pressure
There may also be a link with sunlight. Which can trigger a number of metabolic changes

But I also need to sound a note of caution: blood pressure changes all the time throughout the day. Although the study was all done correctly, it is important to realize that many subtle variations in blood pressure could be lurking within the data.

Nonetheless, people should be aware of the possibility that their blood pressure may be harder to control in the winter, and to be more vigilant at this time.

“For everything there is a season, And a time for every matter under heaven: A time to be born, and a time to die; A time to plant, and a time to pluck up what is planted; A time to kill, and a time to heal; A time to break down, and a time to build up; A time to weep, and a time to laugh; A time to mourn, and a time to dance; A time to throw away stones, and a time to gather stones together; A time to embrace, And a time to refrain from embracing; A time to seek, and a time to lose; A time to keep, and a time to throw away; A time to tear, and a time to sew; A time to keep silence, and a time to speak; A time to love, and a time to hate, A time for war, and a time for peace.”
--The Bible, Ecclesiastes, 3:1-8

“Each new season grows from the leftovers from the past. That is the essence of change, and change is the basic law.”
--Hal Borland (American Writer, 1900-1978)

“Live in each season as it passes; breathe the air, drink the drink, taste the fruit, and resign yourself to the influences of each. Let them be your only diet drink and botanical medicines.”
--Henry David Thoreau (American Essayist and Philosopher, 1817-1862)

Emotional Eating

A new study from Miriam Hospital's Weight Control and Diabetes Research Center in Providence, Rhode Island, has just been published in the journal Obesity. The research suggests that dieters who tend to eat in response to external factors like parties and celebrations, have fewer problems with their weight loss than those who eat in response to internal factors such as emotions. The study also found that emotional eating was associated with weight regain in people who had successfully lost weight

The researchers analyzed individual's responses to questions in a well-known research tool called the Eating Inventory which is designed to assess three aspects of eating behavior:

1. Cognitive restraint
2. Hunger
3. Disinhibition

The main focus was on the third item, since some previous research has suggested that disinhibition as a whole is an accurate predictor of weight loss.

The disinhibition scale evaluates impulsive eating in response to emotional, cognitive, or social cues.

There were two groups in the study. The first consisted of 286 overweight men and women who were currently participating in a behavioral weight loss program. The second group included 3,345 members of the National Weight Control Registry (NWCR), an ongoing study of adults who have lost at least 30 pounds and kept it off for at least one year. 

The investigators found that the components within the disinhibition scale could be grouped into two distinct factors: external and internal disinhibition.

An example of external disinhibition would be the person who overeats when they are with someone who is also overeating, or the person who just overeats at a party, picnic or celebration.

The person with internal disinhibition eats in response to thoughts and feelings such as loneliness, upset or anxiety.

In both groups internal disinhibition was a significant predictor of weight over time. For participants in the weight loss program, the higher the level of internal disinhibition, the less weight an individual lost over time. The same was true for maintainers in the NWCR: Internal disinhibition predicted weight regain over the first year of registry membership.

Before starting a weight management program it is very helpful to know which group you are in. It provides us with a quick and easy method of tailoring the program to the individual, and tells us where to put our efforts.

More Genes Involved in Obesity

I am impressed by the progress being made by some of my former colleagues who are busily unraveling the complex genetics of obesity.

In a paper in the journal Science a group of British scientists including Chris Ponting of the Medical Research Council Functional Genetics Unit in Oxford and Stephen O'Rahilly’s group at the  University of Cambridge, has made a second breakthrough in twelve months in understanding how a gene triggers weight gain in some individuals. In May we looked at the first piece of work on the gene called “FTO.”

At that time we learned that variations in the FTO gene influence people's risk of becoming obese. This particular gene was of great interest because the genetic variant in FTO that predisposes to obesity is very common in the population.

About half the British population carries a copy of the variant and they are on average 3-4 pounds heaver than those who do not have it. The 16 per cent of the population who carry two copies of the variant and are on average 6-7 pounds heavier. We also learned that carriers of the variant have an increased risk of diabetes. However the function of FTO was completely unknown.

The new paper shows that the FTO gene codes for an enzyme - 2-Oxoglutarate-Dependent Nucleic Acid Demethylase - that can act directly on DNA. This strongly suggests that FTO might have a role in controlling how and when genes are turned on and off.

The investigators also found that FTO is highly expressed in the hypothalamic region of the brain, which has important roles in the control of hunger and satiety. In certain areas of the hypothalamus, the levels of FTO are influenced by feeding and fasting.

This is a remarkable finding. That a gene involved in obesity and diabetes has a direct effect on DNA in specific regions of the brain is very exciting. It suggests that the gene is involved in influencing how well the brain senses hunger and fullness. Small molecules derived from metabolism can modulate the activity of FTO, so we can see a direct link form food to metabolism to DNA in the brain.

The findings raise all kinds of treatment possibilities and also confirm something that I have been teaching for three decades: weight control does not start with a diet. It starts between the ears. Until you have been shown how to re-program your brain, thoughts and emotions, your chance of successfully controlling your weight is, ahem, slim.

The Looming Crisis of Alzheimer’s

For those of us who lobby for resources, it is no overstatement to say that Alzheimer's disease has reached crisis proportions in the United States.

As we are getting older, the incidence, prevalence and mortality of Alzheimer’s disease are all rising.

The 2007 Alzheimer's Disease Facts and Figures report by the Alzheimer's Association makes sobering reading. Here are some of the headline facts:

• Alzheimer's disease is the most common cause of dementia
• At the present rate, one in 85 people will have the disease in 40 years
• There are now more than 5 million people suffering from Alzheimer's disease, and the report projects an increase of 16 million cases by 2050 unless preventive measures are taken and/or science is able to come up with a prevention or cure
• One person is now diagnosed with dementia every seven seconds
• One in every four American families is affected by dementia
• The incidence of dementia is one in 1,000 before age 65 and one in 20 after age 65.
• More than $100 billion is spent per year on dementia, which is about 10 percent of all healthcare expenditures

As we have discussed before, the symptoms of dementia may be delayed for 3 to 5 years through healthy lifestyles and behavior modification, and there are many new treatment approaches in the pipeline.

The huge issue is that statistic about one in four families being affected by the disease. And it is a disease: it is not part of normal aging.

Caregivers can suffer terribly.

The Alzheimer’s Association also has some information for those who care for people with Alzheimer’s.

There is also some food information here concerning caregiver stress.

I would also like to direct you to some of the things that I have written here about the wellness of caregivers.

And for everyone, don’t wait until you are thirsty before you dig that well. Work on building you personal resilience and follow the simple lifestyle guidelines that may significantly reduce your risk of developing Alzheimer’s disease.

Career Contentment Radio

Later today I have the privilege of speaking to Jeff Garton and Cathy Yin on Career Contentment Radio, which is broadcast by Business Voice America.

We are going to be talking about one of my favorite topics: Building Resilience.

This program goes out live at Noon Pacific, which is 3PM Eastern, and is rebroadcast at Midnight Pacific time.  It will then be available on demand and podcast ready.

I have already sent out e-card invitations with the links to people on my list. If you did not get one, please let me know.

Later today I shall also be posting a report on "Building Resilience" on my main website with more free resources for you to use.

Close Your Eyes and I’ll…

Every young neuroscience student learns about a classic experiment that was published in 1956 by Raul Hernandez-Peon, in which he had an electrode in the acoustic nerve of a cat, while a metronome was ticking. Every tick caused a pulse of electricity in the nerve. But as soon as the cat saw or smelled a mouse, the electrical activity plummeted: now all of his attention was on lunch, and his brain damped down the unnecessary ticking of the metronome. Something similar happens with the “Cocktail Party Phenomenon:” our ability to focus our listening attention on a single talker and ignoring other conversations that are going on.

A study by researchers from Wake Forest University Baptist Medical Center and the University of North Carolina was presented at the Society for Neuroscience conference in San Diego this week, suggesting that our brains can turn down our ability to see, so that we are better able to listen and focus on music and complex sounds.

The research used functional Magnetic Resonance Imaging in 20 non-musicians and 20 musical conductors aged 28-40, and found that both groups diverted brain activity away from visual areas during listening tasks. The activity fell in the visual regions areas as it rose in auditory ones. But during harder tasks the changes were less marked for conductors than for non-musicians.

While being scanned the subjects were asked to listen to two different musical tones played a few thousandths of a second apart and identify which was played first. The task was made harder for the professional musicians than for the non-musicians, to allow for the differences in their background.

As the task was made progressively more difficult, the non-musicians carried on diverting more and more activity away from the visual parts of the brain to the auditory, as they struggled to concentrate on the music. However, the conductors did not suppress their brains, suggesting that their years of training had given them an advantage in the way that their brains were organized and functioning. They are less likely to be distracted and are highly tuned to musical sounds.

This is like closing your eyes to listen to music and the advantage of the trained musicians is similar to the advantage that we see in the brain of the chess master compared with the amateur. Years of study and practice enable the chess player to move without much conscious thought.

It shows how well we are able to divert activity from one part of the brain to another as needed. It is that ability to be flexible and to recruit more brain when we need it that lies at the heart of the neurocognitive revolution that is changing the way that we think about the brain and mind.

Genes, Breastfeeding and IQ

Studies on intelligence and breastfeeding have come up with conflicting results. The major question has been whether the results have been skewed because more educated or more affluent mothers were more likely to breastfeed.

A new study by colleagues in London, New Zealand and here in the United States has just been published in the Proceedings of the National Academies of Sciences and indicates that a single gene influences whether breastfeeding improves a child's intelligence.

The gene in which the researchers were interested is a fatty acid delta desaturase – FADS2 – that is involved in the genetic control of fatty acid pathways. Children with one version of the FADS2 gene scored seven points higher in IQ tests if they were breastfed, but breastfeeding had no effect on the IQ of children with a different version of the gene.

Researchers at the Institute of Psychiatry, Kings College London, used data from two previous studies of breast-fed infants in Britain and New Zealand that had involved more than 3,000 children. IQ was measured at various points between the ages of five and 13 years in the studies. The only thing that we do not know is exactly how long the children were breastfed.

This is yet another study to show us why the nature/nurture debate needs a radical re-think. Nutrition and genetics act together. People have been arguing about the roots of intelligence for at least a hundred years, and this research shows nature working via nurture to create better outcomes.

Around 90% of people carry the version of the gene that was associated with better IQ scores in breastfed children. We do not know if there are any ethnic differences in those numbers, but there may be.

And that seven point difference in IQ? It s not going to determine how well someone is going to do in life, but in school it might be enough to put the child in the top third of the class.

Unhealthy America

The Milken Institute has released an impressive study that shows the heavy economic burden chronic disease places on our nation. “An Unhealthy America: The Economic Burden of Chronic Disease” shows the current treatment costs of seven chronic diseases - cancers, diabetes, heart disease, hypertension, stroke, mental disorders and pulmonary conditions – as well as the economic impacts of lost workdays and lower employee productivity. It gives a breakdown across all 50 states and the nation as a whole. The study finds that the annual economic impact on the U.S. economy of the most common chronic diseases is more than $1 trillion, and projects that the figures could reach nearly $6 trillion by the middle of the century.

Though some of the blame for this burden can be blamed on stress and environmental factors, much more of it is a direct consequence of our lifestyle choices interacting with our genes. Most of us are failing to renew, refresh and replenish ourselves, and it is important to recognize that whenever we start debating the costs of health care in the United States.

Integrated Health is based on tailored systems to help people care for themselves by going way beyond diet and exercise, and addressing the psychological, social, cultural, subtle and spiritual components of health and wellness. Healing, Meaning and Purpose is a detailed roadmap for creating the life that you deserve, and we are going to be rolling out a new series of teleseminars and workshops in the New Year.

The Dangers of Health Screening

We have talked before about the problems of interpreting blood and other tests. Yet in this land of defensive medicine, most wise physicians have to do an awful lot of screening that is not always in the patient’s best interests.

Here is a recent article from Forbes that looks at seven health screens about which we should, perhaps, think twice:

1. Total body scans
2. PSA screen for prostate cancer
3. CT scan for lung cancer
4. PlacTest to evaluate your chance of a heart attack or stroke
5. Coronary calcium scans
6. CA125 tests for ovarian cancer
7. Vitamin D testing

Controversial stuff, and I can think of a number of other tests about which I have a great many reservations.

The problem is that every advocacy group has a slightly different set of recommendations on screenings. Doctors and patients are getting conflicting and confusing messages about which tests to use.

The second issue is false positives. Even recommended tests yield many false readings. According to research compiled by the United States Agency for Healthcare Research and Quality,  the percentage of false-positive mammograms is between 7% and 8% for women aged 40 to 59 who took the test. The figure drops to around 4% for women 60 to 79, presumably because the chances of getting breast cancer rise as women age. The conclusion is that if every woman between 40 and 59 in the U.S. had a mammogram, a few million would be fretting unnecessarily over a wrong result.

My life’s work has centered on wellness and the prevention of illness, so I would never want to abandon screening. We just need to be very aware of the pros and cons of any tests that we do.

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.

Resting Racehorses

Your humble reporter lives on a horse farm, and many of our equine friends compete on a regular basis, so we are always interested in anything to keep them fit, healthy and happy.

I was interested to see a report of some research done in Finland. The main carbohydrate store in muscle is called glycogen, and Seppo Hyyppä, from MTT Agrifood Research Finland, looked at the way in which muscle glycogen stores are rebuilt after exercise. This is an important question, and not only for horses: glycogen is the most important nutrient during exercise and if glycogen stores are depleted the horse breaks down the protein in its own muscles to provide energy. So if the horse is chronically over-exercised it can hurt him.

The two most important factors in rebuilding muscle glycogen were:

• Sufficient recovery time between intense training periods, and
• Hydration

Giving horses an isotonic glucose-electrolyte rehydration solution soon after exercise helps to overcome dehydration significantly better than providing them with plain water.

The research also showed that weighing the horse before and after exercise gave a reasonably accurate estimate of the rate at which glycogen was being replenished. If you don’t have a set of weighing scales handy, you can measure the horse’s chest circumference.

The research also confirmed what every horse owner knows: you can tell a lot by looking at a horse: his general alertness and, for example, suppleness and appetite, indicate that he is in good condition.

“A canter is the cure for every evil.”
--Benjamin Disraeli, 1st Earl of Beaconsfield (English Statesman, Novelist and, in 1868 and from 1874-1880, British Prime Minister, 1804-1881)

“A man on a horse is spiritually as well as physically bigger than a man on foot.”
--John Steinbeck (American Writer and, in 1962, Winner of the Nobel Prize in Literature, 1902-1968)

Fat and Cancer

It is not every day that a medical story hits the front page of USA Today, but today one has, and for a very good reason.

The World Cancer Research Fund (WCRF) has just published a report that we have been eagerly awaiting for several years. It is the most comprehensive analysis ever published on the link between cancer and diet, weight and physical activity. Researches at nine academic institutions across the world looked for every relevant study published since records began in the 1960s. They initially found half a million, and in the end 7,000 of them were judged to be the most relevant and robust for inclusion in the report.

It includes 10 recommendations from a panel of 21 world-renowned scientists that represent the most definitive and authoritative advice that has ever been available on how the general public can prevent cancer. UNICEF and the World Health Organization were among the official observers of the report's process.

A key finding is that maintaining a healthy weight (a BMI of 20-25) is one of the most important things you can do to prevent cancer. The number of types of cancer where there is "convincing" evidence that body fat is a cause has risen from one to six since the last WCRF report was published in 1997, including colorectal cancer and post-menopausal breast cancer.

Prof Sir Michael Marmot, who was Chair of the Panel, said that,

“We are recommending that people aim to be as lean as possible within the healthy range, and that they avoid weight gain throughout adulthood.

"This might sound difficult, but this is what the science is telling us more clearly than ever before. The fact is that putting on weight can increase your cancer risk, even if you are still within the healthy range.

"So the best advice for cancer prevention is to avoid weight gain, and if you are already overweight then you should aim to lose weight."

Other findings in the report include:

There is "convincing" evidence that processed meats, including ham and bacon, increase the risk of colorectal cancer. People who consume them are advised to do so sparingly.

The evidence that red meat is a cause of colorectal cancer is stronger than ever before. People should not eat any more than 18 ounces (500g) of red meat a week.

This figure is for cooked meat, and is the equivalent of between 15-30 ounces (700-750g) of non-cooked meat.

Here is something that is almost a first, at least for a cancer report. It has made a breastfeeding recommendation: mothers are advised to breastfeed exclusively for six months and to continue with complementary breastfeeding after that. This is because of "convincing" evidence that breastfeeding protects the mother against breast cancer and "probable" evidence that it protects the child against obesity later in life.

Dietary supplements are not recommended for cancer prevention. The evidence that alcohol is a cause of cancer is stronger now than ever before.

Professor Martin Wiseman, Project Director of the Report, said:

"This report is a real milestone in the fight against cancer, because its recommendations represent the most definitive advice on preventing cancer that has ever been available anywhere in the world.

"When individual studies are published, it is impossible for the public to put them into context and know how seriously they should be taking the findings. But the great thing about this report is that it does this job for them.

"If people follow our recommendations, they can be confident they are following the best advice possible based on all the scientific research done up to this point. These recommendations are not based on one study but are based on 7,000." 

In the United Kingdom, plans are afoot to establish a Cancer Reform Strategy. Professor Mike Richards, the British Government's Clinical Director for Cancer, had this to say:

“The WCRF report is the most authoritative and exhaustive review done thus far on the prevention of cancer through food, nutrition and physical activity.

"For those of us wanting to lower our risk of developing cancer, the Report provides practical lifestyle recommendations. The Report also provides public health goals. Both will form an important element for the forthcoming Cancer Reform Strategy."

These are the main recommendations:

• Limit red meat
• Limit alcohol
• Avoid bacon, ham, and other processed meats
• No sugary drinks
• No weight gain after 21
• Exercise every day
• Breastfeed children

Have you seen those infomercials where someone tells you that there is some conspiracy by shadowy people who don’t want you to know the truth about diet, exercise and cancer?  Next time remember this research. If some expensive supplement or the juice of an exotic berry from the Himalayas could really reduce the risk of cancer, these studies should have noticed something by now.

Nutrition and Female Fertility

Whoever said that “you are what you eat” was not wrong. The composition of our diets can affect everything from our moods to our risk of getting some types of cancer.

Now it looks as if nutrition may also be an essential part of helping at least one type of infertility.

There are literally hundreds of causes of infertility, but one of the more common ones in women is a problem with ovulation. A rapidly growing cause of ovulatory problems is the polycystic ovarian syndrome, which is itself associated with insulin resistance.

New research from Harvard School of Public Health is published today in the prestigious journal Obstetrics & Gynecology which suggests that women who followed a combination of five or more lifestyle factors, including changing specific aspects of their diets, had more than 80 percent less relative risk of infertility due to ovulatory disorders when compared with women on more unhealthy diets.

The investigators followed a group of 17,544 married women who were participating in the Nurses' Health Study II, which is based at the Brigham and Women's Hospital in Boston. The researchers created a scoring system on dietary and lifestyle factors that previous studies have found to predict ovulatory disorder infertility. Among those factors were:

• The ratio of mono-unsaturated to trans fats in diet
• Consumption of animal or vegetable protein consumption
• Carbohydrates consumption, which included both dietary fiber the glycemic index of foods
• Dairy consumption: both low- and high-fat
• Iron consumption
• Multivitamin use
• Body mass index
• Level of physical activity

The researchers then assigned a "fertility diet" score of one to five points. The higher the score, the lower the risk of infertility associated with ovulatory disorders.

The women with the highest fertility diet scores ate:

• Less trans fat
• Less sugar from simple carbohydrates
• More vegetable than animal protein
• More fiber and iron
• More multivitamins
• More high-fat dairy products and less low-fat dairy products

The more fertile women also had a lower BMI and exercised for longer periods of time each day.

This relationship between a higher "fertility diet" score and lesser risk for infertility was similar for different subgroups of women. It seemed to hold in many different age groups, and whether or not a woman had been pregnant in the past.

The effect size is impressive: women following five or more low-risk dietary and lifestyle habits have a six fold reduction in ovulatory infertility risk compared with women following none of them.

There are two surprises here. It has been believed that heavier – though not obese – women tended to be more fertile. That is not what this study found. Second,  the higher fertility rates of women who consume high-fat dairy products and less low-fat dairy products may seem counter-intuitive. But well-nourished women would be expected to have a higher chance of being fertile.

The take home message is this: if a woman is having problems with ovulation, sensible dietary choices and a moderate amount of physical activity may make a large difference in her chance of becoming fertile.

This all makes sense. From an evolutionary perspective it could be dangerous to bear a child while ingesting foods, chemical or toxins that could harm a baby, or could compromise the health of a pregnant mother.

"Nutrition can be compared with a chain in which all essential items are separate links. We know what happens if one link of a chain is weak or is missing. The whole chain falls apart.”
--Patrick Wright (American Director of the Institute for Research on Food-related Disease)

“Health requires healthy food.”
--Roger Williams (Indian-born American Chemist who did pioneering work on the Vitamin B Complex, 1893-1988)

The Mile High Club

Your humble reporter just saw this on the BBC website:

“Airline bans A380 mile-high club

Singapore Airlines has taken the unusual step of publicly asking passengers on its new Airbus A380 plane not to engage in any sexual activities.

The potential problem has arisen because the first class area of its giant super-jumbo contains 12 private suites complete with double beds.

Singapore, which is the first airline to start flying the A380, said the suites were not soundproofed.

It said it did not want anyone to offend other travelers or crew.

Singapore added that while the suites were private, they were also not completely sealed.

"All we ask of customers, wherever they are on our aircraft, is to observe standards that don't cause offense to other customers and crew," the airline said in a statement.”

Does this mean that Singapore Airlines is going to do something with Virgin?


Richard Branson: Care to comment????!

Breathing Problems During Sleep and the Heart

We have talked about the importance of heart rate variability (HRV), which reflects the activity of many critical bodily functions. HRV is the result of a subtle interplay between the heart and the nervous system, and abnormalities in HRV may be an early warning of severe illness and even of death.

There are many reasons why peoples’ breathing can become disturbed during the night, and it is essential to be sure that we are treating the right thing.

In obstructive sleep apnea (OSA) the body stops breathing during sleep. The most common reason for OSA is swelling of the tissues at the back of the throat that then block the airway.

In central sleep apnea (CSA) is a breathing decreases or stops during sleep. It may occur as a result of a problem in the sleep centers in the brain, and/or the nerves supplying the heart. It usually follows a cycle, with people breathing normally for a while and then slowing or stopping altogether.

Continuous positive airway pressure (CPAP) that provides a steady stream of pressurized air is often the best treatment for sleep apnea.

There is a close relationship between breathing and the heart, and new research from the Alfred Hospital and Monash University in Melbourne, Australia has looked at a sleep-related breathing disorder that is common in heart failure, and increases HRV.

The researchers looked at the breathing patterns of 21 patients with heart failure who had sleep-related breathing disorder.

They found that as people transitioned from stable breathing to a sleep-related breathing disorder, there was an associated increase in HRV.

On the other hand, people with central sleep apnea (CSA) and obstructive sleep apnea (OSA) produce different patterns of HRV, suggesting that they each involve different mechanisms in the heart and the brain.

This may sound esoteric, but it is not.

Breathing problems during sleep are common and so is heart failure. Unfortunately heart failure carries a high mortality rate, and it is very valuable to have simple tests to guide us to give the correct treatment.

Simply measuring HRV during sleep will give us an idea about whether or not a person with heart failure is stable, or if we need to change treatments before he or she starts getting symptoms.

“All the energy that is used in the creation of every cell in the universe is on that breath that you are breathing in.”
--George King (English Spiritual Teacher, Writer and Founder of the Aetherius Society, 1919-1997)

“For breath is life, and if you breathe well you will live long on earth.”
--Sanskrit Proverb

“There is one human activity which is continuous, rhythmic, natural, easy, and pleasant. It is breathing. We may take advantage of its existence by combining it with a simple exercise to bring about a kind of meditation which will possess all these four mentioned attributes. The exercise is merely to repeat one word silently on the inhalation and another word on the exhalation. The two words must be such that they join together to make a suitable spiritual phrase or name. Here is one useful example: "God Is.”
--Paul Brunton (a.k.a. Raphael Hurst, English Philosopher, Traveler, Spiritual Teacher and Author, 1898-1981)

“You know that our breathing is the inhaling and exhaling of air.  The organ that serves for this is the lungs that lie round the heart, so that the air passing through them thereby envelops the heart.  Thus breathing is a natural way to the heart.  And so, having collected your mind within you, lead it into the channel of breathing through which air reaches the heart and, together with this inhaled air, force your mind to descend into the heart and to remain there.”
-- Nicephorus the Solitary (Calabrian Christian Mystic and Monk on Mount Athos, c.1250-1300)

Minocycline and Neurological Disease

We recently talked about the fascinating new data on the use of the antibiotic minocycline for treating stroke. The reason is that minocycline is also an anti-inflammatory and it also prevents “apoptosis” or programmed cell death. It has been found to be neuroprotective in animal models of stroke, traumatic brain injury and neurodegenerative disorders. Minocycline also prolongs survival and reduces the loss of motor neurons in transgenic mouse models of amyotrophic lateral sclerosis (ALS), a.k.a. motor neuron disease, a.k.a. Lou Gehrig's disease.

But as with any new research, we always have to go back and re-check and replicate everything. How many times have you heard a news item about some major breakthrough, and then you never again hear anything about it?

An article in today’s issue of the Lancet has indicated that minocycline may be harmful to people with ALS. This is important and will have implications for several clinical trials that are either planned or in progress for trying minocycline in people with dementia, stroke, Huntington's disease and multiple sclerosis.

The United States Western ALS Study Group based at Columbia University in New York, undertook a randomized phase III trial to test the efficacy of minocycline as a treatment for ALS in 412 patients. Patients who took minocycline deteriorated at a 25% faster rate compared with people on placebo.

Therefore the authors suggest that trials of minocycline in other neurological diseases should be reassessed. It is possible that minocycline might be detrimental in patients with other neurological diseases as well.

There is also an editorial comment by Mike Swash, who was once one of my teachers. He talks about the importance of early diagnosis in ALS:

"Clinicians and patients alike would prefer ALS therapy to be tested as early as possible, but there are unresolved difficulties with accurate early diagnosis, particularly the absence of a specific diagnostic test. Might some of the compounds that have failed in clinical trials show benefit if tested at disease onset in human beings?" He concludes that the time has come for new approaches to trial design: "The aim must be to design informative, short, inexpensive, and sensitive phase I/II studies before large phase III studies are attempted".

This is another one of those examples where a medicine introduced for one indication may have many others. In contrast to an antibiotic being used to treat neurological problems, there has recently also been a great deal of interest in the antibiotic potential of some medicines used to treat depression and psychosis.

There is a mountain of new information on this topic, which promises to revolutionize many of our concepts of health and disease. I shall keep you posted as more material is published.

Integrated Medicine with Heart Surgery

The movement to treat the whole person is a lot more developed in Europe than tit is in the United States. So it is always gratifying to see research on integrated medicine on this side of the pond. Even if there are critics who call anything holistic “woo woo,” the fact is that patients like the approach, and there is a developing research base.

A new study from the Mayo Clinic indicates that massage therapy decreases pain levels for patients after heart surgery. During a five-month period in 2005, 58 patients undergoing surgery participated in a pilot study to examine the effect of massage on pain after surgery. Of the 30 who received massage, the mean pain scores were less than 1 on a scale of 1 to 10, with 10 as the most painful.

Before the massage therapy, these patients rated their pain at an average of 3 on a 10-point scale. In the control group of 28, pain levels remained the same over the same period, according to findings published in the current issue of Complementary Therapies in Clinical Practice. 

As a result of the pilot study, Mayo now has a full-time massage therapist available for patients after heart surgery, and a larger, randomized study is under way.

The reason for the study was that patients often report that tension, stress, pain and anxiety get in the way of their recovery after cardiac surgery. Therefore apart from massage, the researchers are also exploring the use of stress management, music therapy and guided imagery as adjuncts to the best of modern medicine.

This makes good sense, and I shall keep you posted as more information is published.

Rewiring the Dyslexic Brain

Dyslexia can be a real difficulty for many children, although for many it has been a gift: they have succeeded very well in life by mobilizing other psychological and neurological resources. Sir Richard Branson, the founder of Virgin Enterprises, Thomas Edison and Albert Einstein are all said to have had dyslexia.

There are many types of dyslexia, but in the most common - developmental dyslexia – children confuse letters and syllables when they read.

It now appears that some children with dyslexia struggle to read because their brains are not correctly wired to process fast-changing sounds, according to a study published this month in the journal Restorative Neurology and Neuroscience.   

However sound training using computer exercises was able to rewire children's brains, correcting the sound processing problem and improving reading.

More than 30 years ago Paula Tallal of Rutgers University proposed that children with dyslexia might have an underlying problem processing sound, but it has never been tested using brain imaging. The researchers used functional MRI imaging (fMRI) to examine how the brains of twenty two 9- to 12-year old children with developmental dyslexia, and normal readers, responded to sounds, both before and after using educational software called Fast ForWord Language.

The first test involved measuring how the children's brains responded to either fast-changing or slow-changing sounds that resembled speech. The fast-changing sounds altered in pitch or other acoustic qualities quickly. In just tens of milliseconds, as occurs in normal speech. The slow-changing sounds changed over only hundreds of milliseconds.

In normal readers, 11 brain areas became more active when the children listened to fast changing, compared to slow changing, sounds. In dyslexic children, the fast-changing sounds did not stimulate high levels of activity in these regions of the brain. Instead, dyslexic children processed the fast-changing sounds as if they were slow changing. They used the same regions of the brain but at lower intensity.

We know that infants must correctly process fast-changing sounds as they learn language. They use sound processing to create a sound map of their native language. If they are unable to analyze fast-changing sounds, their sound map may become confused. The idea is that they run into trouble when they first see printed letters because the children's brains now try to match their internal sound map to letters that they see on the page. Linking normal letters to confused sounds may lead to syllable-confused reading.

But the brains of the children with dyslexia changed after completing exercises in a computer program known as

The Fast ForWord Language program does not involve reading at all, but only listening to sounds, starting with simple, changing noises, like chirps that swooped up in pitch. The children then have to respond with a clicker when the chirp's pitch goes up or down. At first the sounds are played slowly, but they gradually speed up, becoming more challenging for dyslexic children. The exercises are then repeated with increasingly complex sounds: syllables, words, and finally, sentences.

The fMRI study showed that these repetitive exercises appeared to rewire the dyslexic children's brains: after eight weeks of daily sessions - about 60 hours in total - their brains responded more like the brains of typical readers when they were processing fast-changing sounds, and at the same time their reading improved.

It is still early days for this research, and we do not yet know whether the improvements in reading and in the brain will be sustained.

This research may make it possible to identify children at risk of dyslexia even before they start learning to read. It is also possible that other approaches to learning sounds, such as learning to sing or play an instrument may be effective, since most of us learn music with gradual, repetitive, and intense listening and move up to faster changing sounds.

Decision Making and Internal Balance

Many of us run into problems when we try to make decisions. In a special section in the October 26 issue of the journal Science, Martin Paulus who is a professor in the Department of Psychiatry at the University of California in San Diego, has marshaled a growing body of evidence that human decision-making is inextricably linked to an individuals' need to maintain a homeostatic balance.

He goes on to suggest that psychiatrists may need to approach the treatment of psychiatric patients from a new direction: by understanding that such individuals' behavior and decision-making are based on an attempt to reach an inner equilibrium, in the same way that we try to being our temperature or blood pressure back to a set point. And if the thermostat is broken we may see mental illness and substance abuse.

This makes good sense: in the past decision-making process as a considered series of options and values, but that is not what we see in the clinic. People with addictions and some mental illnesses keep making bad choices, despite being intelligent and insightful.

Recent neuroimaging research shows strong support for the homeostatic nature of decision-making:
The insula is involved in processing interoceptive information: the body's internal state or sense of balance
Damage to the insula stops addiction to cigarettes
Some of the same brain structures implicated in the urge to take drugs are involved in other biological urges

The question addressed in part by this paper are whether changes in decision-making behavior and associated brain functions are a result of pre-existing characteristics - which may predispose individuals to use drugs - or occur as a consequence of long-term use. 

This is certainly an interesting idea, and we shall have to see how it fits as we collect further data.

“The quality of a decision is like the well-timed swoop of a falcon which enables it to strike and destroy its victim.”
--Sun Tzu (Chinese Military Strategist and Author of the “Art of War”, c.400-c.430 B.C.E.)

“The risk of a wrong decision is preferable to the terror of indecision.”
--Maimonides (a.k.a. Rabbi Moses ben Maimon, Spanish-born Jewish Philosopher and Physician, 1135-1204)

“All you have to decide is what to do with the time that is given you.”
--J.R.R. Tolkien (South African-born English Writer, Linguist, Oxford Don and a Member of C.S. Lewis’ Literary Group, “The Inklings,” 1892-1973)

“Decisions are doorway to change and change starts from a moment of decision. One decision can change your life forever!”
--Tony Robbins (American Motivational Speaker and Writer, 1960-)

“Nothing is more difficult, and therefore more precious, than to be able to decide.”
--Napoleon Bonaparte (Corsican-born French Military Strategist, General and, from 1804-1814, Emperor of the French, 1769-1821)

He That Enjoys His Portion

Having grown up at a time and in a culture where it was expected that everyone would finish every morsel of food on his plate, it was quite a shock to come to the United States and to be confronted by mountains of food. During my first few months I dutifully consumed everything on my plate and soon noticed the effect on my waistline. But it brought home to me the power of social and cultural factors in eating.

Though each of us is responsible for how much we eat, research suggests that cultural and social norms can make it hard for us to choose appropriate portion sizes. The November 2007 issue of Harvard Women's Health Watch has published an interesting article about the way in which misperceptions about portions can affect calorie intake.

A first point is that many of us tend to treat portions as equivalent to nutritional servings. A serving is a specific quantity of food designated on the basis of nutritional need. However, a portion--the amount you actually get on your plate, in the package, or at the counter--is often much larger. Many of us do not always read the Nutrition Facts label, and may find ourselves eating two or three servings' worth. Studies suggest that we might be satisfied with smaller portions if larger ones were not so easily available. Other research has shown that the more plentiful the food, the more we eat. I know form my own experience that both of those are true.

The Harvard Women's Health Watch offers some advice for “keeping portions in proportion:”

• Train your eye: Measure out servings - not portions - of the food you commonly eat so you know what a single serving looks like
• Change your tableware: Use a smaller bowl or a mug for cereal and a smaller plate at dinner
• Control portions at home: To discourage second helpings, serve food in the kitchen and take it to the table on plates
• Eat at regular intervals throughout the day: Do not wait until you are hungry, since you are then more likely to overindulge at the next meal
• Control portions while eating out: Avoid buffets and salad bars. Instead of a dinner, order a low-fat appetizer and a large salad with dressing on the side

These are all simple and straightforward pieces of advice that will be familiar to anyone working in the weight and metabolism field.

On another occasion I shall give you a few more of my own tips, including “Perimeter shopping”

Folic Acid: Too Much of a Good Thing?

If you believe everything that your read in the media or hear on those infomercials, you would think that you should spend all day munching pounds of fruits and vegetables while taking megadoses supplements chasers.

While that may sound good in theory, in practice things are not so simple and this approach may actually do you harm.

A good example has just come to light in a report from the Institute of Food Research in the United Kingdom that has just been published in the British Journal of Nutrition.

We have talked before about the potential value of fortifying food with folic acid. Apart from reducing the risk of neural tube defects in babies, it may also reduce the risk of depression.

The new report suggests that fortifying flour with folic acid may lead to a range of health problems.

Folic acid is a synthetic form of folate, a B vitamin found in a wide variety of foods including liver and leafy green vegetables. Folates are metabolized in the intestine, whereas folic acid is metabolized in the liver. The liver is an easily saturated system, and at doses of half the amount being proposed for fortification that could lead to significant unmetabolized folic acid entering the blood stream.

This excess folic acid could cause a number of problems:
It may interfere with some treatments for leukemia and arthritis
Women being treated for ectopic pregnancies
Men with a family history of colon cancer
People with blocked arteries being treated with a stent 
In women undergoing in-vitro fertilization, it may increase the likelihood of conceiving multiple embryos
Unmetabolized folic acid accelerates cognitive decline in the elderly with low levels of vitamin B12 (If they have normal levels of B12, folic acid may slow brain aging)
While dietary folates have a protective effect against some cancers, folic acid supplementation may increase the incidence of colon cancer
Folic acid may increase the incidence of breast cancer in postmenopausal women, though other studies have shown the opposite

The trouble is that it could take 10-20 years for any potential harmful effects of unmetabolized folic acid to become apparent.

The latest study follows a letter to the Food Standards Agency from Sir Liam Donaldson, the Chief Medical Officer of England, requesting further expert consideration of two recent studies linking folic acid to bowel cancer before the government gives the final go-ahead for mandatory fortification of food with folic acid. However the Food Standards Agency has stuck to its position that fortification is safe. Mandatory fortification has already been introduced in the US, where it has been required since 1998, Canada and Chile, where it has cut neural tube defect rates by up to half.

Professor Nicholas Wald, director of the Wolfson Institute of Preventive Medicine, said:

“Fortification would prevent many cases of spina bifida and would also benefit the health of the country as a whole. Further delay in this public health measure will result in hundreds more babies being disabled by this serious disorder, or pregnancies being needlessly terminated due to a neural tube defect."

When it comes to analyzing risks and benefits, one of the most important things is to realize that more is not necessarily better, and that folate and folic acid are not the same thing at all.

Second is the point that we discussed before: some people have the right genes to be able to metabolize folic acid with impunity, while others may get a range of problems from taking it.

Optimism and the Brain

Humans have a wonderful ability to expect positive events in the future, even when there is no shred of evidence to support them. One of the key components of resilience is optimism. Though there is data to show that there is a genetic contribution to optimism, it is also a psychological attribute that can flow from life experiences as well as attitude that can be developed. Though the motivational coaches who tell us that putting on a happy face will make you happy and optimistic are probably overstating the truth! A lack of optimism is often a sign of clinical depression so learning more about it, is not just an academic exercise.

New research just published in the journal Nature indicates that there are two regions of the brain linked to optimism.

The team from New York University and University College, London, says that the act of imagining a positive future event, for example winning an award or receiving a large sum of money, activates two brain areas: the amygdala and the rostral anterior cingulated cortex (rACC). The finding ties in with earlier studies that suggested that these brain regions malfunction in depression. (1,2)

The investigators first measured how optimistic 15 volunteers were using a standard questionnaire. They were then scanned using functional magnetic resonance imaging (fMRI) while reflecting on one of a number of potential scenarios.

In one part of the trial, subjects followed specific instructions to recall a negative event in the past, such a funeral that they had attended in the past five years. In another experiment they had to imagine what it would be like to be involved in a car crash in the near future. At other points in the study subjects had to reflect on positive events such as winning an award in the past or receiving a large sum of money in the future.

Reflecting on both past and future events activated the amygdala and the rACC regions of the brain. However, positive events, and particularly those imagined in the future, generated a significantly larger response in these regions than reflecting on negative events.

When imagining happy events, the more pessimistic subjects in the trial had less activation of these brain areas than their optimistic counterparts when imagining happy events.

For some time now, many researchers have assumed that the amygdala and rACC are only involved in negative thoughts and negative reactions, but this research indicates that they have an important role in signaling cheerful thoughts. And, what is more, these are also regions of the brain that have been implicated in depression. Previous research has suggested that patients with depression have decreased nerve signaling and fewer cells in the rACC and amygdala.

Is this why people with depression find it so hard to generate positive thoughts?

This is important work that will likely have a great many practical applications.

“Children are born optimists and we slowly educate them out of their heresy.”
--Louise Imogen Guiney (American-born English Poet, 1861-1920)

“Although the world is full of suffering, it is full also of the overcoming of it.”
--Helen Keller (American Blind and Deaf Swedenborgian Philosopher, 1880-1968)

“No man is so old as not to think he can live one year more.”
--Marcus Tullius Cicero (Roman Political Figure and Orator, c.106-43 B.C.E.)

"The way to become happy
Is to think

And to feel

That the very best is yet to come.”
--Sri Chinmoy (a.k.a. Chinmoy Kumar Ghose, Indian Philosopher and Spiritual Teacher, 1931-2007)

The Neurology of Fibromyalgia

Fibromyalgia can be a particularly nasty illness, not least because people who suffer from it have often been misdiagnosed and occasionally even accused of malingering. But the pain can be very real and very severe. There are some very good reasons for believing that it is a neurological problem involving regions of the brain and spinal cord that are involved in modulating pain.

A new study from the University of Bath and Royal National Hospital for Rheumatic Diseases in England has raised some intriguing possibilities for treatment. A year ago, researchers from the same institution reported that there is a reorganization of the sensory regions of the brain n people with chronic pain.

In this new study, researchers asked patients to look at a reflection of one arm while moving their other arm in a different direction that was hidden behind a mirror positioned in front of them at a right angle. So one limb was obscured from view behind the mirror while they could clearly see the other limb and its reflection.

This simple experiment created a mismatch between what the brain sees from sensory input and what it feels through the motor system that controls movement.

Of the 29 fibromyalgia patients involved in the study, 26 reported feeling a transient increase in pain, temperature change or heaviness in their hidden limb - all symptoms of a flare up of their condition.

This suggests that a mismatch between sensory and motor neurons could be at the root of the fibromyalgia.

This study adds to the growing body of evidence that many of the symptoms of fibromyalgia may be triggered or perpetuated by a sensory-motor conflict.

That opens up all kinds of new possibilities for treatment.

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)

Sleep Deprivation and Emotional Instability

Most of the time we are in control of our moods, rather than our moods being in control of us. One of the main things that we learn as we get older is not simply to damp down our emotional reactions, but to make them “contextually relevant:” we produce the right emotional response for the right situation. Yet we also know that there are exceptions: times when our emotions over-run any attempts at our control.

Second, we all know that sleep deprivation can be a Bad Thing. It is known to impair a range of mental and physical activities, including immune function, metabolic control and many cognitive processes, including learning and memory.

It has long been suspected that sleep deprivation can have significant effect on mood. Many of us feel irritable and distractible if we haven’t slept enough, and you may have had the experience of being up all night and feeling a little bit “high” in the morning. It has also been known for centuries that mood disorders are very commonly associated with sleep disturbances, and sleep disturbance is often the first sign that someone with mood problems is running into trouble. So mood and sleep must be linked in some way.

Despite these common observations, there has never been that much empirical evidence for the impact of sleep deprivation on mood, and in particular the effects of sleep deprivation on the brain.

An important new study by researchers from Harvard Medical School and the University of California at Berkeley has just been published in the journal Current Biology, and it is beginning to fill in some of the gaps in our knowledge.

The amygdala is known to be involved in processing of emotionally salient information, particularly unpleasant or aversive stimuli. In mature individuals, the emotional centers of the brain are usually controlled and modulated by an array of connected systems, mainly in the frontal regions of the brain. One particularly important part of the frontal lobes that is involved in controlling the amygdala is the medial-prefrontal cortex (MPFC). Under normal conditions the MPFC is supposed to exert an inhibitory, top-down control of the amygdala, so that we only generate appropriate emotional responses.

The scientists worked with 35 volunteers who were deprived of sleep for 35 hours. Blood flow can be used to deduce which specific regions of the brain are active. The researchers used functional magnetic resonance imaging (fMRI) to examine the blood flow – and therefore activity - in the brains of the volunteers in real time, both during and after sleep deprivation.

After going without sleep, the participants were asked to look at images that were designed to trigger angry or sad emotional responses. The investigators discovered that the amygdala showed 60% higher reactions to the images compared with people who are not sleep-deprived.

This is an extraordinarily large effect and implies that sleep deprivation knocks out the normal control mechanisms in the frontal lobes so that the sleep-deprived brain reverts to a more primitive pattern of activity. As a result we become unable to put emotional experiences into context and produce controlled, appropriate responses.

If we needed any more reasons to get a good night’s sleep, this one is very powerful. It also re-iterates something very important: if you or a loved one have had problems with mood, anger or anxiety, it is essential to watch your sleep pattern. Any change may be a harbinger or trouble, and is an excellent early warning that you or they need a hand to make sure that things stay on an even keel.

"Your brain shall be your servant instead of your master, you will rule it instead of allowing it to rule you.”
--Charles E. Popplestone (American Author of Every Man a Winner, 1936)

“Control your emotions or they will control you”
--Chinese Proverb

“For the uncontrolled there is no wisdom, nor for the uncontrolled is there the power of concentration; and for him without concentration there is no peace. And for the unpeaceful, how can there be happiness?”
--Bhagavad Gita (Ancient and Sacred Sanskrit Poem Incorporated into the Mahabharata)

“He who controls others may be powerful, but he who has mastered himself is mightier still.”
--Lao Tzu (Obscure Chinese Philosopher, Founder of Taoism and Alleged Author of the Tao-Te Ching, c. 604-c. 531 B.C.E.)

“ . . . let every man be swift to hear, slow to speak, slow to wrath.”
--The Bible, James 1:19

“When angry, count ten before you speak; if very angry, a hundred.”
--Thomas Jefferson (American Writer, Philosopher, Politician and, from 1801-1809, 3rd President of the United States, 1743-1826)

The Neurology of Eating

Any attempt at weight management that fails to address the whole person is doomed to failure.

It is not enough to diet and exercise, and whatever the truth of manifesting, you cannot think yourself thin. Success demands an approach that integrates every system of your body, mind, social and subtle systems. For many people there is even an important role for integrating their spirituality into a plan for healthy living.

So we need to learn as much as we can about each component. Some fascinating new research has added some important pieces to the puzzle.

Writing in the journal Nature a group of scientists from University College London and King's College London used peptide YY (PYY), a naturally occurring hormone that regulates appetite, to investigate which areas of the brain are involved in controlling food intake.

PYY is released into the bloodstream from the intestine after we eat something. In animals PYY signals the appetite control centers in the hypothalamus and brainstem that food has been eaten. Injections of this hormone have been shown to decrease food intake both in healthy volunteers and in people with obesity.

The hypothalamus and brainstem are ancient regions of the brain involved I te most basic functions. But humans have complex, highly developed brains, and the question was to discover how PYY regulates eating in humans.

The study involved eight normal weight men in a double blind placebo-controlled study. After 14 hours without food the subjects were given an intravenous infusion of either PYY or placebo for 100 minutes. During all this their brains were scanned continuously using functional Magnetic Resonance Imaging (fMRI). Thirty minutes later they were offered an unlimited meal. Each subject was tested twice one week apart, once with PYY and once with the placebo. PYY infusion reduced food consumption in all 8 subjects and on average caused a 25% reduction in the calories eaten.

Now it gets interesting. The fMRI scans showed that PYY not only targets the primitive parts of our brain that control feeding but it also acts in the corticolimbic brain regions that are involved in the rewarding and pleasurable aspects of eating.

The greatest change in brain activity in response to PYY was within the orbitofrontal cortex (OFC), a region that acts as an integrative center in the brain and is also implicated in reward processing. The change in OFC activity predicted how much food the volunteers subsequently ate. The greater the activation, the less people.

When we are hungry, brain activity within the hypothalamus predicts how much food we should eat. However an infusion of PYY tricks the brain into thinking that it has eaten, and switches on the circuits that control eating. The activity in the orbitofrontal cortex now predicts how much people will eat in the future.

If you have not eaten for a long time, you get full very quickly. It is not that your stomach has shrunk; it is that the production of hormones like PYY has been turned down. When you eat, they are over-produced and switch off more eating. When someone has gastric bypass surgery, their levels of PYY go up and stay up. 

An important aspect of weight management is to retrain and reprogram the mind and body.

This research helps to show us how the approach works.

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

The Evolving Obesity Pandemic

Here is something that is not too much of a shock. At least it isn’t until you look at the numbers.

People are getting heavier throughout the world, with the possible exception of south and east Asia. These are the conclusions of a one-day global “snapshot:” a single day in 2006 when doctors and nurses in 63 countries across five continents - not even including the United States – found that between half and two-thirds of men and women in were overweight or obese.

The study is being published in the journal Circulation and included 168,159 people. The initial results were published http://eurheartjsupp.oxfordjournals.org/cgi/content/abstract/8/suppl_B/B26 last year in the European Heart Journal, but this new report puts more “flesh” on the original report.

The International Day for the Evaluation of Obesity (IDEA) study looked at two measures of fatness - waist circumference and body mass index or BMI.

A BMI (weight in kg divided by square of height in meters) of 18.5 to 25 is considered healthy. A BMI over 25 is considered overweight and greater than 30 is obese. I shall have something to say about BMI in a moment.

In Eastern Asia 7% were obese, compared with:

• 36% of people in Canada
• 38% of women in Middle Eastern countries
• 40% in South Africa

Canada and South Africa led in the percentage of overweight people, with an average BMI of 29 among both men and women in Canada and 29 among South African women.

In Northern Europe men had an average BMI of 27 and women 26. In other words they were just into the overweight “category.” In southern Europe, the average BMI was 28. In Australia BMI for men was 28 and 27.5 for women. In Latin America the average BMI was just under 28.

Waist circumference was also high - 56% of men and 71% of women carried too much weight around their middle.

The overall frequency of heart disease was 16% in men and 13% in women. In Eastern European men, many of whom still smoke, the rates of heart disease, 27%, and women, 24%. By comparison in Canada the rate of heart disease in women was 8%, and in men 16%.

The rates of diabetes varied across regions. Overall, 13% of men and 11% of women were diagnosed with diabetes.

This means that the rest of the world is catching up with the United States, long considered the country with the worst weight problem.

An estimated two-thirds of Americans are overweight and a third of these are obese. In the US, the lifetime risk of developing diabetes, is also high - 33% for men and 38% for women.

In studies like these, a BMI over 25 is considered to be overweight and greater than 30 is obese. I have commented before about the limitations of using BMI, but it remains a way of getting an overall picture of what is happening in the body.

The findings are deeply worrying.

It is well known that increasing weight, particularly the amount of fat carried inside the abdomen – not the “lovers’ handles!” - increase the risk of coronary artery disease, Type II diabetes and other diseases including some cancers. That point about the “intra-abdominal” fat I all important. For years we have been told that even small increases in weight can do us harm, but that is not completely accurate. It is where the fat is deposited, not only how much we have. It is only when people become extremely obese all over that the risks of many diseases begin to climb.

The moral of the story?

Watch you the size of your abdomen, and stay tuned as I give you more advice about the Whole Person ways to control you weight.

Emotion and Cancer Survival

There is some research coming out in the December issue of the journal Cancer from some researchers at the University of Pennsylvania School of Medicine and other colleagues. The results surprised me, particular since I know some of the authors, and they are first rate investigators.

For over thirty years, most research studies have claimed to find an association between emotions, attitudes and beliefs, and the chance of survival form several types of cancer. Entire psychological wellness and psychotherapy programs have been designed around that premise.

The study suggests that emotional wellbeing has no effect on the chances of surviving head and neck cancer. People with negative emotions had the same survival rate as people with positive emotions.

Patients from two Radiation Therapy Oncology Group clinical trials completed a quality of life questionnaire known as the Functional Assessment of Cancer Therapy-General (FACT-G) at the start of the trials. So these assessments were added on to studies of different cancer treatments. One trial was looking at what is known as “dose fractionation strategies” and the other was looking at combined chemotherapy and radiation treatments.

The FACT-G questionnaire included a collection of items called the Emotional Wellbeing Scale. This was assessed against overall survival.

There were 1,093 at the start of the trials, of whom 646 died during the period of the study. One of the reasons for trusting the data is that this large sample together with the consistency in the treatment the patients received have made this study one of the most statistically robust ever conducted.

Emotional state did not predict survival, and the results did not change when the researchers took into account possible effects such as interactions between emotional wellbeing and the methods of the study, gender, the primary site of the cancer, or the stage of the cancer.

There are several important points:

• The study only included head and neck cancer patients. These are often very traumatic cancers, but they do not usually involve the endocrine system. Some of the best data on emotions and survival come from studies of breast cancer, which often involves disturbances of hormones that may themselves have an impact on mood and survival. And mood can have a big impact on hormones
• The patients in the study had to keep coming to appointments, and to follow instructions, so they may not be representative of all people with head and neck cancer

But the most important thing is this: before critics jump off the deep end, let’s be very clear.

The study is not saying that having an optimistic or positive emotional outlook does not bring benefits to cancer patients. All it is saying is there is no evidence that it prolongs life.

Psychotherapy, art therapy, bibliotherapy and many others can all provide a great many emotional and social benefits.

They may not add anything to the years that a persons lives, but they may add greatly to the life in those years.

Chocolate, Comfort Foods and Depression

Most people have done a bit of comfort eating from time to time: candies and chocolates are usually the favorites. That’s not a coincidence. Not only do they taste good, but chocolate also contains chemicals that may improve mood, and sugar can have an indirect impact on the uptake of specific amino acids into the brain, where they go on to form the chemical neurotransmitters involved in inter-cellular communication and learning.

On the more serious side, some types of mood disorders, particularly seasonal affective disorder, premenstrual syndrome and the so-called “atypical depression” are often associated with quite sever cravings for chocolate.

So I was very interested to see a paper from colleagues in Australia in this month’s issue of the British Journal of Psychiatry.

Gordon Parker and Joanna Crawford examined links between chocolate craving in people who are depressed and both personality style and atypical depressive symptoms, with a web-based questionnaire completed by nearly 3000 individuals reporting clinical depression.

People accessing a mood disorder consumer information website (http://www.blackdoginstitute.org.au) were invited to participate in an online survey of lifetime treatments for a depressive episode, together with some interesting evaluation tools.

Half of the respondents said that they craved chocolate, and the number was slightly higher in women. They said that they felt that chocolate helped with depression, anxiety and irritability. The ones who said that chocolate helped were more likely to score higher on a “neuroticism” scale, particularly irritability and rejection sensitivity.

Five years ago the same team found that atypical depression was associated with a personality that was especially sensitive to rejection, and also tended to be linked with several symptoms - including food cravings – that tie in with behaviors aimed to try and make us feel better and to maintain internal balance.

The results suggest that people with certain personality styles derive personal benefit from comfort eating. Some research has linked carbohydrate craving to the opioid system in the brain, and it is possible that munching on chocolate may be an example of genuine self-medication. People eat to chocolate to calm down their ability to feel emotional distress.

The trouble is, of course, that although chocolate is yummy and may even be therapeutic, too much can be a bad thing. Weight problems are common in people with chronic depression, especially the “atypical” type.



“Chocolate causes certain endocrine glands to secrete hormones that affect your feelings and behavior by making you happy. Therefore, it counteracts depression, in turn reducing the stress of depression. Your stress-free life helps you maintain a youthful disposition, both physically and mentally. So, eat lots of chocolate!”
--Elaine Sherman (American Culinary Expert, Teacher and Writer, 1938-2001)

"Look, there’s no metaphysics on earth like chocolates.”
--Fernando Pessoa (Portuguese Poet, 1888-1935)

Height and Quality of Life

It’s difficult to guess it from that mug shot over on the left, but your humble reporter is six foot four, or, for our more metrically inclined friends, 193 centimeters. Believe it or not, on my mother’s side of the family, that would have made me one of the shortest. Over the years I have heard all the arguments about boys getting their height form their mothers, height being correlated with various maladies, and the old chestnut about tall people being more successful. Something that clearly escaped Alexander the Great, Napoleon Bonaparte and Adolph Hitler.

Nonetheless, some interesting correlations between height and psychological measures have begun to emerge in recent years.

Regular readers may recall the work from the West of England that has found some association between growth hormone and intelligence.

A new study in the journal Clinical Endocrinology indicates that your height in adult life significantly affects your quality of life, with shorter people reporting worse physical and mental health than people of “average” height. Shorter people judge their state of health to be significantly lower than their “normal” height peers do. I put quotes around words like “average” and “normal, since they have particular scientific rather than personal connotations.

The data for this study came from 14,416 people enrolled in the 2003 Health Survey for England, carried out by the UK Department of Health. In this survey, participants filled out a health-related quality of life (HRQoL) questionnaire and a nurse measured their height. A person's health-related quality of life refers to their perceived physical and mental health over time rather than a measure of his or her actual health.

People in the shortest height category (men shorter than 162 cm {5 foot four inches} and women shorter than 151 cm {4foot eleven inches}) reported they experience significantly lower HRQoL than people of “normal” height. The effect size is more pronounced the shorter a person is. This means that a small increase in height has a much larger positive effect on a short person than it does on a person of “normal” height.

One of the reasons for doing this study, which was supported by Novo Nordisk, is that there are some uncommon problems such as growth hormone deficiency or Turner syndrome in which people have short stature. The argument is that if their height causes psychological distress, there is a greater justification for treatment with growth hormone, which can increase their final adult height by approximately 4-10 cm (1.5 to 4 inches) depending on the underlying cause.

There is also another point. Some people already have a shorter stature, and most are perfectly well adapted. But it is important to be aware that some may be suffering in silence, and it is so important to ensure that they get the help that they need.

We cannot cure everything problem in the world, but we should be able to treat anything.

Finding Your Ancestors

I think that most of us have at least a little bit of curiosity about our ancestry. Growing up in Europe, most people have quite a good idea where they came from. It is very different in the “New World.”

People here often have deeply personal reasons for wanting to know their ancestry. Some hope to validate genealogical records or fill in gaps in family histories. Others are searching for a connection to specific groups or places in Eurasia or Africa. Many African Americans hope to trace ancestral links lost during the slave trade. Other hope to obtaining Native American tribal affiliation or to challenge tribal membership decisions.

Hence the proliferation of services offering genetic analyses to individuals. And it has become big business.

A quick search on Google just found least two dozen companies who market genetic ancestry tests to help people discover the origins of their ancestors. The tests typically cost between $100 and $900, and in the United States alone it is said that more than 460,000 people have purchased the tests during the past six years.

But there have been lingering doubts about the value and accuracy of the tests.

In "The Science and Business of Genetic Ancestry Testing," which appears in the today’s issue of the journal Science Deborah Bolnick, assistant professor of anthropology at The University of Texas at Austin and 13 researchers from universities across the country call upon the scientific community to educate the public about the limitations of the tests, and also urge consumers to approach the tests with caution.

The writers argue that the assumptions and limitations of the tests make them less informative than many people realize. Secondly, the rapid commercialization of the tests may have led to misleading practices that reinforce misconceptions.

They make several important points:

• Most tests trace only a few of your ancestors
• Most only test a small portion of your DNA
• Tests are not likely to identify all of the groups or locations around the world where a test-taker's relatives are found
• When we do genetic research we spend a great deal of time checking and re-checking the accuracy of the tests. But commercial tests may report false negatives or false positives
• Limited sample databases mean test results are subject to misinterpretation
• There is no clear connection between DNA and racial/ethnic identity: the similarities between the races are far greater than the differences
• Tests cannot determine exactly where ancestors lived or what ethnic identity they held

There is also an excellent feature story, entitled "Deep Roots," that may interest you.

Caveat emptor!

An Extraordinary Memoir

Regular readers will know that I am very interested in helping people with posttraumatic stress disorder (PTSD), and you will find a number of articles here.

The problem is growing as more people are returning from the conflicts overseas. But it is also important to return to another point: the difference between categorical and dimensional diagnosis. Few problems fit into neat little boxes. Instead they tend to lie on spectra. At one end you have people who have never had a day’s trouble in their lives, at the other you will find people who have been incapacitated by the most terrible things that have happened to them.

And in between is a huge number of people who do not fit any diagnostic criteria, but nonetheless suffer from many of the signs and symptoms of illness. How many people suffer from some of the symptoms of PTSD because they found a dead relative? Or had an important relationship that went terribly wrong?

They do not, of course, have diagnosable PTSD, but it can sometimes be helpful to reframe their suffering as a reaction to trauma.

I have just reviewed a book on the Amazon website that I hope is read very widely.

The book is called The Dancer Returns: From Victim to Victory, by Susan Lee Titus.

It tells an extraordinary true story about a young businesswoman who is brutally assaulted. She suffered from such severe PTSD that she actually needed to be admitted to hospital for a short time.

She transcends the terrible experience, and she is herself transformed by compassion and forgiveness. She moves on to teach dance to incarcerated women, each of whom carries her own scars.

The book is short but profoundly moving and can be life-changing.

If you have any interest in PTSD in all its manifestations, and also if you are interested in alternative ways of living with and transcending distress, I strongly recommend the book.

Dopamine, Drugs and Diabetes

We recently talked about the increasing evidence that insulin has many extremely important roles in the brain.

New research by investigators at the Center for Molecular Neuroscience and the Institute of Imaging Science at Vanderbilt University Medical Center researchers, working with colleagues in Texas, has found that insulin levels affect the brain's dopamine systems. These systems are involved in motivation, reward, salience, movement and emotional processing. Disturbances in dopamine pathways have been implicated in substance abuse, as well as schizophrenia, bipolar disorder and attention deficit hyperactivity disorder (ADHD). Drugs that interfere with the dopamine pathways may produce Parkinsonism as well as elevations of the hormone prolactin.

The psychostimulant drugs amphetamine and cocaine, as well as related medications for ADHD, block the reuptake of the neurotransmitter dopamine by dopamine transporters (DATs) thereby increasing the level of dopamine signaling. Some of these compounds also cause a massive surge of dopamine through DATs, resulting in high levels of synaptic dopamine that alter attention, increases motor activity and plays an important role in the addictive properties of psychostimulants.

The reason for examining a possible relationship between dopamine and insulin goes back to the 1970s, when it was reported that amphetamine had no effect on diabetic animals and in the 1980s it was shown that diabetic rats did not show the usual stereotyped behaviors when given amphetamine. There were also odd reports about disturbances in the enzyme dopamine-beta-hydroxylase in experimental diabetes and changes in dopamine D1 receptors in the brains of rats with induced diabetes.

These observations lead to this new research into a possible link between insulin signaling and amphetamine action.

They used a standard a rat model of type 1 diabetes in which insulin levels are massively depleted, and then assessed the function of the dopaminergic pathway in the striatum, an area of the brain rich in dopamine.

In the absence of insulin, amphetamine-induced dopamine signaling was disrupted: dopamine release in the striatum was severely impaired and expression of DAT on the surface of the nerve terminal was significantly reduced.

The lack of the DAT protein on the plasma membrane prevents the amphetamine-induced increase in extracellular dopamine, and in turn, amphetamine fails to activate the dopamine pathways that stimulate reward, attention and movement.

The researchers then gave insulin into the brains of the diabetic animals and found that the system returns to normal, indicating that the lack of insulin in the striatum directly affected amphetamine action.

They also developed a probe for brain DAT activity using functional magnetic resonance imaging (fMRI). In normal, healthy rats with plenty of insulin, amphetamine increased neural activity in the striatum. But in diabetic animals, activity in the striatum was suppressed.

So there is a powerful interplay between dopamine neurotransmitter systems and insulin signaling mechanisms. The results are some of the first to link insulin levels and dopamine function in the brain and hold several implications for human health and disease.

We need to have another look at the effect of diabetes on the brain. We have known that people with diabetes are at increased risk of cognitive impairment and depression, and we had assumed that it was because of hypoglycemia and vascular disease. Those assumptions may have been wrong.

The findings may also be important for diseases with altered dopamine signaling, such as schizophrenia and ADHD. Insulin may have something to do with the underlying brain disturbances in ADHD. Then control of insulin levels and neuronal responses to the hormone may help determine the efficacy of psychostimulants in people with ADHD.

Every now and then you see people on psychostimulant medications who need huge doses. Perhaps their problem lies with insulin rather than dopamine.

Stretching and Exercise

I think that most of us have been told that it is really important to stretch before we hit the gym, and do it again after we have finished. It is said to improve performance as well as reducing the risk of injury and post-exercise stiffness. It is one of those things that has just entered mass consciousness.

However a new study using the Cochrane database shows that stretching before or after exercise has little or no effect on muscle soreness between half a day and three days later.

Two researchers identified 10 relevant trials, each of which involved between 10 and 30 people. Nine of the studies had been carried out in laboratory situations and people stretched for everything from 40 seconds to 10 minutes.

The investigators used a 100-point scale to assess stiffness after exercise. The results showed that the effects of stretching were extremely small. Stretching reduced soreness by less than 1 point on the 100-point scale. The size of the effect was similar if stretching was performed before or after activity. 

The authors point out that there is still a need to see whether stretching can have an effect on people in the community who have reduced levels of flexibility.

“A great man can bend and stretch.”
--Chinese proverb

“The simple exercise of stretching helps to counter the congestions, compressions, and adhesions which obstruct the flow of the vital force through the spinal column with its sixty-two branching nerves and thus to regain energy. This truth of the need of spine-loosening movement is instinctively known by every dog and cat, every lion and tiger, for they apply it immediately after awakening from sleep. The back, the legs, and even paws are bent and stretched and even rolled by them in this natural exercise.”
--Paul Brunton (a.k.a. Raphael Hurst, English Philosopher, Traveler, Spiritual Teacher and Author, 1898-1981)

“Dachshunds are ideal dogs for small children, as they are already stretched and pulled to such a length that the child cannot do much harm one way or the other.”
--Robert Benchley (American Writer, Actor and Critic, 1899-1945)

Relationships, Conflict and Heart Disease

Robust, dynamic and balanced relationships can be the source of untold support and happiness in our lives. They can also provide us with the scaffolding on which to structure and maintain the health and meaning of our existence.

On the other hand, precisely because positive relationships can be such powerful forces for good, toxic, fractured and unbalanced interactions can create physical, emotional, social and spiritual havoc. Most of the evidence about the physical impact of negative relationships has concerned heart disease and disturbances of the immune system.

An article in this week’s issue of the Archives of Internal Medicine continues to flesh out the interaction between dysfunctional relationships and heart disease, suggesting that If you are in stuck in a close relationship with many negative characteristics, for instance conflict, you may well have a raised risk of heart disease, compared with somebody whose close relationship is more positive overall.

Roberto De Vogli and his colleagues from University College, London, looked at 9,011 British civil servants who filled in a questionnaire about negative aspects of their close relationships during two periods: 1989-1990 and 1985-1988. The main focus was on couples and participants also outlined how much regular emotional and practical support they received from their partners. They were followed up twelve years later to find out whether they had had a fatal or non-fatal coronary event, including chest pain of cardiac origin or a full-blown heart attack.

Of 8,499 people who were followed up and had provided enough information at the start of the study, quite a high number - 589 - had sustained a coronary heart disease event, although none of them had obvious coronary heart disease at the beginning of the study. The analysis took account of multiple potentially confounding risk factors including socioeconomic status and health habits. When they had all been stripped away, the researchers found that there was a 1.34 higher risk of coronary heart disease events among those who experienced a high level of negativity in their close relationships. This link was found in both men and women and in each social class. It could not be explained by depression or negative personality traits: it seemed to be the negative relationships itself that was to blame.

We already know that negative marital interactions are associated with depression, often in combination with reduced self-esteem and higher levels of anger. These are all emotions that can have both acute and chronic effects on the coronary arteries, through alterations in the normal balance of the autonomic nervous system, neuroendocrine changes, disturbances in coagulation and inflammatory and immune responses.

Many people are sensitive to any kind of negative interactions in the people around them, but the effects are particularly toxic if they involve the people closest to us. They are more likely to elicit strong emotions such as worry and anxiety that are the most likely to induce effects on our bodies.

Staying in a chronic negative relationship may be more than just masochistic.

It could kill you.

“Tenderness emerges from the fact that the two persons, longing, as all individuals do, to overcome the separateness and isolation to which we are all heir because we are individuals, can participate in a relationship that, for the moment, is not of two isolated selves but a union.”
--Rollo May (American Existential Psychologist, 1909-1994)

“Whenever you're in conflict with someone, there is one factor that can make the difference between damaging your relationship and deepening it. That factor is attitude.”
--Timothy Bentley (Canadian Family Therapist)

“Today the network of relationships linking the human race to itself and to the rest of the biosphere is so complex that all aspects affect all others to an extraordinary degree. Someone should be studying the whole system, however crudely that has to be done, because no gluing together of partial studies of a complex nonlinear system can give a good idea of the behavior of the whole.”
--Murray Gell-Mann American Physicist Noted for his Concept of Strangeness and the Discovery of Quarks, and, in 1969, Winner of the Nobel prize in Physics, 1929-

“We shield our heart with an armor woven out of very old habits of pushing away pain and grasping at pleasure. When we begin to breathe in the pain instead of pushing it away, we begin to open our hearts to what’s unwanted. When we relate directly in this way to the unwanted areas of our lives, the airless room of ego begins to be ventilated.”
--Pema Chodron (Formerly Deirdre Blomfield-Brown, American Buddhist Nun, 1936-)