Wednesday, February 23, 2011
Reducing Fat Leads to Obesity
Wednesday, February 9, 2011
Nature's Role in Disease, Bigger Than We Thought
Continual fear and danger of violent death; and the life of man, solitary, poor, nasty, brutish, and short”
http://www.ajcn.org/content/early/2011/02/02/ajcn.110.001909.abstract
The popular wisdom, return to nature advocates, and our educational system do not appreciate, as Hobbes did, how brutal and difficult life was a few hundred generations ago. Primitive societies(see my article from 7/6/10), have a violent death rate of 6%, 50% childhood mortality, are prone to prolonged periods of famine, and carry a huge burden of acute and chronic infectious disease.
The articles referenced today discusses how human physiology evolved to cope with some of these challenges. In periods of famine, low blood sugar may result in death of the unborn child. The tendency for diabetes may therefore be a substantial advantage for the pregnant woman. Chronic tuberculosis, endemic in many societies, results in loss of body mass and wasting. The tendency to store fat might keep individuals alive long enough to reproduce. A hyper-stimulated immune system would keep chronic bone and tooth infections from spreading throughout the body.
Of course,modern society, addressing famine and infections has caused these survival mechanism to backfire. Elevated sugar levels lead to diabetes, tendencies to store fat leads to obesity, and hyper-stimulated immune systems lead to asthma or rheumatoid arthritis. Thousands of generations of evolution, with strong genetic and physiologic imperatives, are constantly working against the efforts of healthcare providers. Understanding these processes may eventually contribute to treatments, but in the meantime we are left with what we have.
It is important to remember that defects in one environment might be beneficial in another. Sociopaths, who lack feelings for others, thrive in times or war. Those prone to diabetes or obesity will do better following some upcoming climate/nuclear/zombie apocalypse. Human diversity encompasses more than ethnicity. We must remember that evolution works for the survival of the species, not for the individual. Nature is efficient, but is also heartless and doesn't care much for the good intentions of Obamacare.
Tuesday, January 25, 2011
Rising Costs Cut to the Heart of Obamacare
A lie may take care of the present, but it has no future.
~Author Unknown
http://www.businessweek.com/lifestyle/content/healthday/649165.html
Both of my grandfather's died of heart problems that could be easily treated today. One needed a coronary artery stent, and the other needed a valve procedure. Using modern techniques, a total of about two hours of procedure time could have kept them alive for many years. In many ways, such advances represent the best of modern medicine. However for the supporters of Obamacare, or anyone attempting to address our healthcare crisis, progress in the fight against heart disease is one of our greatest problems.
New therapies to combat heart disease have not decreased it's incidence. Unlike polio or tuberculosis, modern drugs or invasive techniques do not eliminate the disease, but only slow its progression or lessen its impact. More people than ever have heart disease because of obesity, sedentary lifestyles, diabetes, and the rising age of our population. Breakthroughs in the treatment of this and other chronic diseases, including cancer, diabetes and arthritis, are one of the key contributors to increasing medical costs. As the referenced report today concludes, the diagnostic procedures, drug therapies, angiograms and surgeries needed to treat these patients will triple in cost by 2030, and this report does not even consider new treatments such as stem cell therapy.
Although this news may cheer catheter manufacturers and cardiology residents, it should strike fear into the hearts of healthcare reformers and Congressional supporters of Obamacare. The fanciful cost projections used to support the passage of the bill do not acknowledge these increasing expenses. Disease rates are assumed to be constant, and procedures are assumed to get cheaper, not increase three-fold. Supporters of the legislation relied on unproven or useless prevention programs to pretend that disease incidences would decrease in order to meet delusional cost projections. Substituting good intentions and hand waving for science may satisfy political pressure groups, but it cannot replace reality. Even if such a comprehensive prevention program to cut the incidence of heart disease could be developed, it remains to be seen how long it would take to be effective.
If we are to have any hope of solving our healthcare problems we must stop lying to ourselves. Even the most simple and laudable of reforms goals, such as universal coverage and coverage of preexisting conditions have huge price tags. Studies like the one above only reinforce the need to confront the very hard choices our leaders have chosen to ignore or demagogue. We deserve better.
Friday, January 14, 2011
Steps Toward Solving Our Healthcare Crisis, Literally
Two miles a day keeps the doctor away
(with apologies to Ben Franklin)
http://www.medicalnewstoday.com/articles/213681.php
I have become discouraged about the impact of obesity and the resultant diabetes epidemic that threatens to overwhelm the American healthcare system. In a prior post I suggested that bariatric surgery was the only workable solution to this long term crisis(12/2/10). The paper referenced today suggests a far more benign, inexpensive and natural way to combat this impending epidemic, the simple act of walking.
The study out of Australia directly correlates diabetic risk with steps taken per day. The more steps taken, the lower the diabetes risk. 3000 steps(about two miles) a day significantly lowers the incidence of type 2 diabetes, with more steps further giving even more benefit.
The result is surprisingly simple, yet makes real sense. Diabetes is related both to the amount of insulin produced, and how your body uses that insulin. Exercise has long been known to improve the bodies response to insulin. What this study confirms is that walking alone is sufficient to obtain the benefits of exercise.
This investigation dovetails well with many other studies about the negative impacts of a sedentary lifestyle. It appears our body is designed to walk, and sitting in front of computer screen or TV may be the genesis of many of our healthcare woes. The impact is independent of calories consumed, and may explain much about why healthcare in America is both more expensive and less effective than other countries where people walk more.
This study may also contain the key to solving our healthcare crisis. Walking represents a free, efficacious and accessible therapy for obesity and diabetes. Walking does not require expensive programs, highly trained personnel, or a new government bureaucracy. Pedometers can be inexpensively used to monitor progress. Incentive based programs tying health insurance costs to distance walked, make both medical and economic sense.
I have been spending many hours attempting to understand the Pelosian level complexity of the rules governing electronic medical record adaption. Obamacare mandates all providers institute these expensive and unproven systems which at best will have limited impact upon the health of Americans. How about a simple law requiring people to walk 20 miles a week in order to buy health insurance. That law might actually work.
Sunday, January 25, 2009
Which diet is best?
The Facts:
· People in this study followed the Atkins diet, Slim-fast plan, Weight Watchers pure points programme or Rosemary Conley’s ‘Eat yourself slim diet and fitness plan’.
· If you are trying to lose weight the type of diet has little impact on the outcome.
· The average weight loss for everyone was about 6 kg over 6 months.
Shaun's comment: Everyone knows about the “epidemic of obesity” occurring in Western countries but no-one knows the best solution. There are numerous diets out there including low-fat diets, low-carbohydrate diets and natural diets which try to mimic how our ancestors ate. This study, published in the prestigious British Medical Journal, showed that four of the most famous diets all had great results over a 6-month period. We look forward to seeing more results from this important study.
Study Reference:
http://dx.doi.org/10.1136/bmj.38833.411204.80