Food as medicine

Thanks to my lovely colleague Cath Bender for sending me the link to this TED talk.

United States based physician and scientist Dr Terry Wahls tells the amazing story of how she used diet to cure her MS.  She followed a logical process of research to highlight the specific nutrients necessary to maintain the health of her brain and nervous system and then built a diet abundant with these nutrients. Her recovery is incredible.

What we can all take from this is the inspiration to make the effort to include these important foods in our diet as much as possible.  It is not always easy to eat the amounts of fresh greens, brightly coloured vegetables and berries and essential fatty acids that were effective in halting and turning around the nervous system degeneration experienced by Dr Wahls.  But for anybody who is looking to prevent chronic disease these foods are here waiting to offer you their benefits, even if you start to gradually include them alongside your normal diet.  Start slow, get into good habits and build from there.

I was inspired to take these suggestions and use them to make breakfast.  This is my free range egg omelette filled with sautéed red onion and fresh sorrel, silverbeet and parsley from our garden.  I crumbled some goats cheese through the eggs, which may or may not have been in keeping with the diet, but tasted excellent.

Hunter gatherer omelette

 

How healthy is your work?

Researchers from the Western Australian Institute for Medical Research at the University of WA have found a link between sedentary work (where long periods of time are spent sitting) and an increased risk of colorectal cancer, regardless of recreational physical activity.

The study was carried out in Western Australia between 2005 and 2007 and involved men and women self-administering a questionnaire about their work history, lifestyle, diet and medication use.

Participants were asked about their lifetime occupational history and the results indicated that the participants who had spent 10 or more years working in sedentary jobs had an increased risk of distal colon and rectal cancers compared with those who had never had a sedentary job.

How many hours do you sit down each day?

If you work with a computer it is probably quite a few (I know how long I spend tapping at this machine!)

Whilst the mechanisms behind the increased risk are not yet fully understood, we can take the general message and try to include more physical activity in our day at work.

This could be as simple as getting up every 1-2 hours and having a good stretch.  This also helps avoid neck and shoulder stiffness, stretches your eyes and allows you to take some deep breaths.  A couple of bigger bursts of activity through the day can include going for a brisk walk around the block as a mid-morning break, taking the stairs when we come back in from lunch, or going to a nearby gym or yoga class for a session during the day.  You may have to come to some understanding with your boss, but in the long run you will both benefit as your increased energy and focus will help improve your productivity overall.

The abstract from the WA study can be found here:

http://aje.oxfordjournals.org/content/early/2011/03/18/aje.kwq513.abstract

Ghosts in the literature

I am all for an evidence-based approach to assessing the risks and benefits of a health-related intervention, but it seems vitally important that we remain realistic about the possibility that the evidence may not always be as clear as it seems.

A colleague alerted me to a case in the US which has highlighted the practice of publication planning, where pharmaceutical companies may employ the services of a medical education and communication company (MECC) to create and distribute the marketing message around a drug.

Documents revealed through a litigation case against pharmaceutical company Wyeth revealed that this practice extends to the ghostwriting of articles, reviews and commentaries which are placed into medical journals.  Academics are invited to put their name to these pre-written articles and can make changes as long as they do not deviate from the marketing message.

In this specific case more than 14,000 plaintiffs brought claims against Wyeth around the link between the use of menopausal hormone therapy, Prempro, and the development of breast cancer.

The documents that were revealed to be part of the marketing campaign executed by DesignWrite, an MECC, were intended to promote unproven benefits and downplay potential side effects of the drug.  As they were published in respected medical literature they would have played a role in building physician confidence in the drug.

I’m not sure how widespread this practice is, it seems bizarre that it would even be legal.   The point here is that there should be much more transparency about the true authors of any document that gains publication in a medical journal, and with this I wholly agree.

For a much more detailed account of this case please see the article on PLoS Medicine, we have them to thank for bringing this practice to light.

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000335

Does sugar make us fat?

I have just finished reading a very interesting book.  Sweet Poison: Why sugar makes us fat, by Australian David Gillespie, explores the possibility that the obesity epidemic may rest on our sugar consumption.  This challenges the long held perspective that it is fat in our diet that is primarily to blame for making us fat.

Gillespie was clinically obese and trying diet after diet with few long term results, until he cut foods and drink containing fructose out of his daily meals.  Fructose is a simple sugar that is half of the sucrose molecule and occurs naturally in many foods including fruit, honey and fruit juice and is also added to most processed foods, especially soft drinks, flavoured water and flavoured milk.  Basically any food or drink with added sugar contains fructose.  Gillespie noticed changes to his weight almost immediately and over a healthy two year period lost 40kg.

Gillespie is not a scientist but a consumer who embarked on his own research.  He has put together an easy to read but still very informative book that looks at the history of sugar consumption and the biochemical fate of excess sugar in our diet.  Fructose is unique as it seems to bypasses our inbuilt appetite control mechanisms and encourages the production of fatty acids by the liver, and thus leads directly to weight gain when eaten in excess.  The fructose in a piece of fruit is usually balanced out by the fibre in fruit which fills you up and prevents you from eating too much.  Fruit juice on the other hand has no fibre and thus you can consume much more before you feel full, leading to the consumption of a lot more fructose.  Fruit is a great source of vitamins, fibre and antioxidants, but still needs to be consumed in moderation: 1-2 pieces of fruit a day is ideal.

The overall message from this book is to trust your taste buds – if it tastes sweet then it will lead to greater energy production in your body and if this energy is not used by physical activity then you will gain weight.

I’m sure Gillespie will have been very pleased to see the study published recently in the Journal of the American Medical Association.  The study by Welsh et al (2010) explored the association between the consumption of dietary added sugars and blood lipid levels in US adults.  They found that increased dietary sugars are associated with  a variety of cardiovascular disease risk factors: low HDL cholesterol (the good type that helps clear gunk out of your arteries, high triglycerides (free fats that float around in your blood) and a high ratio of triglycerides to HDL-C.

The tides might be starting to turn in favour of the sugar makes us fat argument.

- Welsh, JA  et al. 2010 Caloric Sweetener Consumption and Dyslipidemia Among US Adults;JAMA;303(15):1490-1497

The cycles of our immune system

A few weeks ago the Science Show on ABC Radio National spoke to Brendon Coventry, associate professor surgical oncologist from the University of Adelaide, about his thoughts and research into the potential biorhythms of the immune system.  The thought is that the immune system might have a weekly cycle with times of increased immune activity and times of decreased activity.  This could mean that there are certain times in the cycle when treatments like chemotherapy might be more effective and even require a lower dose and the potential for less side effects.

This type of awareness about the patterns of our body could be the next paradigm shift that will help us develop more specific and effective treatments.  Coventry makes the point that efficacy of treatment can have a big impact on the financial cost of healthcare, and I would add, also the cost to the wellbeing of the patient undergoing this treatment.

I highly recommend having a listen to the segment:

http://www.abc.net.au/rn/scienceshow/stories/2010/2871586.htm