Be aware of evolutionary/ecological traps

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Dead bird on Midway Island in the North Pacific, 2000 miles from any other islands. The bird mistook attractive coloring of plastics that float in the ocean as food. From: https://www.youtube.com/watch?v=dtJFiIXp5Bo

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Being captured by a digital device. From: http://images.gameskinny.com/gameskinny/c9689c75994e58a03dbc5e489d346e55.jpg

How come birds on Midway Island are dying?

How come your son keeps playing computer games even after he said he would stop?

How come you ate all the French fries and the dessert even though you promised yourself to reduce your calorie intake?

How come you procrastinated and did not get up from the couch to exercise?

How come you watched pornography?

The usual answer is absence of will, self-control or self-discipline. The person is automatically blamed for making poor life choices. If you had more self-worth than you would not let yourself get obese, addicted to computer games, or watch pornography. Blaming the victim is easy, however, there are other factors that underlie the person’s covert/unconscious choices. Many of these illness producing behaviors (e.g., overeating, playing the computer games, sitting and sitting) are responses to external cues that in prehistoric times promoted survival, reproduction and health. To respond rapidly and appropriately  to those cues offered a reproductive advantages while not reacting would reduce your survival. In many cases there are no upper limits to turn off our responses to these cues because the more the person responded to those cues the more was there a reproductive advantage. Now, however, our adaptive preferences have become maladaptive because the cues that trigger the same behaviors lead to lower fitness and illness (Schlaepfer et al, 2002; Robertson et al, 2013). The cues have become evolutionary/ecological traps!

Some of the recent evolutionary/ecological traps include:

Vigilance for survival. While playing a computer games, the person rapidly responds and continuously experiences immediate rewards (e.g., successful shooting the target, points, next game level). This process activates the same  survival mechanisms that hunter used for thousands of generations. A visual or auditory stimuli represents  sources of food or danger (a game animal to hunt for food, an attack by a predator or an enemy). The visual/auditory cue captures the person’s attention and if the person reacts to that cue he would probably survive. On the other hand, if he did not react, he may not survive and reproduce. In our modern world, similar stimuli now hijack the neurological pathways that in earlier times supported survival. Over activation of these pathways is a cofactor in the development of ADHD and other disorders (Peper, 2014). For a superb discussion of  how cellphones, computers, gaming and social medial are changing our brains, read Dr. Mari Swingle’s new book, i-Minds (Swingle, 2015)

Energy for survival: Eating carbohydrate/sugary and fat foods are necessary for survival as humans constantly searched for energy sources to support life. Breast milk and almost any fruit that is sweet contain calories and supports growth. If the food was bitter it was usually harmful. For most of our evolutionary past, we would eat as much as possible because food was scarce. There was no evolutionary advantage to limit food intake as the stored calories would supply enough calories to survive during periods of famine. In our modern world, our survival mechanisms have been hijacked by advertising and the oversupply of foods which  contribute to the epidemic of obesity and diabetes.

Being a couch potato and not moving again is again survival mechanism. In a prehistoric world with limited food supply, the less movement (the fewer calories you burned), the longer you could survive. You would move when you needed to build shelter or search for food. Again in a world where shelter and food are often abundant, there is no intrinsic mechanism to initiate movement.

Sexual arousal for reproduction: Men are often captured by pornography. They can watch for hours and feel aroused. The whole porn industry is based upon hijacking our sexual drive for reproduction.

Our brain does not discriminate between actual visual and auditory stimuli, imagined or film/video images. Until the late 19th century everything we saw and heard was real. Only in the 20th century could we produce images and sounds that appeared real. These film, TV , and the ever present digital displays activate the same neurophysiological pathways as when the stimuli were actually real.  A scene on a digital screen triggers the same biological pathways and responses that for thousands of generations supported survival. If we did not respond we would not have survived.  If you have any doubt, watch a scary horror movie and check how you feel afterwards. You may feel more scared, your sleep may be disturbed, your heart rate increased, and you probably interpreted any noise around you as possible danger. Thus, cues in the environment may become evolutionary/ecological traps in the same way that birds on Midway Island in the North Pacific, 2000 miles from any other islands, mistook the attractive coloring of plastics as food. See: https://www.youtube.com/watch?v=dtJFiIXp5Bo. Should the birds be blamed because they have no self-control?

What can you do!

Recognize that modern industries for the sake of profits have hijacked our cues that had evolved to aid survival (Kemp, 2014).

Recognize that not reacting to product cues means inhibiting the intrinsic biological triggered survival responses. Yes, it is possible not react to the stimuli and demonstrate self-control; however, it is not only a problem of will. It is a problem that our cues have been hijacked and tricked for commercial profit.

Society may need to protect its own populations from commercial exploitation of evolutionary/ecological traps. A young child is automatically drawn to the visual stimuli on a smartphone and tablet which parents use to quiet the child during dinner. In this process they are activating the pre-wired biological pathways that captured attention for survival. By over activating these pathways, the brain is changing in response to this activation which increases the risk of developing ADHD, autism, and mood deregulation including anxiety, depression, and anger management, and other forms of addictive behavior (Swingle, 2015). In addition, school performance and memory retention are reduced when students take notes using their keyboard or read text from digital screens (OCallaghan, 2014). It will take the family and society to limit the availability of these cues until self-control has been developed. Similarly, the availability of cheap calories in large food portions, sugars in soft drinks and sugar and fats in snacks, need to be limited if the epidemic of obesity and diabetes is to be reversed.

It may be unreasonable to think that people can easily interrupt their biological responses to cues that have been created to increase profits. We need to take collective responsibility and limit the availability of commercially augmented evolutionary traps and cues in the same way we need to limit the plastic in the ocean so that the birds at Midway Island may be able survive. Without respecting our evolutionary past, our future may not be different from those Midway Island birds.

References

Kemp, C. (2014). Trapped!. New Scientist, 221(2960), 43-45

OCallaghan, T. (2014). Goodbye, paper: What we miss when we read on screen. New Scientist.224 (2993). 41-43.

Peper, E. (2014). Support Healthy Brain Development: Implications for Attention Deficit/Hyperactivity Disorder. Psychophysiology Today, 9(1), 4‐15.

Robertson, B. A., Rehage, J. S., & Sih, A. (2013). Ecological novelty and the emergence of evolutionary traps. Trends in ecology & evolution, 28(9), 552-560.

Swingle, M.K. (2015). i-Minds. Portland, OR: Inkwaterpress.com ISBN-13 978-1-62901-213-1

Schlaepfer, M. A., Runge, M. C., & Sherman, P. W. (2002). Ecological and evolutionary traps. Trends in Ecology & Evolution, 17(10), 474-480.


Overdiagnosed: Should I have more tests or treatments?

One Computerized tomography (CT) scan of the abdomen and pelvis will expose you to more radiation than the residents of Fukushima, Japan absorbed after the Fukushima Daiichi nuclear power plant accident in 2011. –Consumer Reports, March 2015, Vol.80 No.3, 39.

High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had a significantly lower 30-day mortality when admitted during dates of national cardiology meetings (70% survival when doctors attended meeting as compared to 60% survival when doctors did not attend the meetings). -Jena et al, 2014.

There are so many questions

I feel healthy but worry that cancer could be lurking in the background, should I do a preventative body scan?

I sometimes have slightly higher blood pressure especially when the doctor measures it. It is probably borderline, should I go on medication?

Should I have my PSA tested?

I am a healthy fifty year old, should I have a mammogram?

Should I have an annual physical?

In the quest to stay healthy or prevent disease, we are bombarded by information that preventative testing would save lives and improve health. Only in the United States and New Zealand allow direct to consumer medical advertising which tends to increase excessive drug use and medical testing (Liang & Mackey, 2011). The messages imply that medical screening and testing (e.g., body scan or stress tests) can identify early stages of a disease and implying that earlier treatment will improve quality of life and survival. Similar messages encourage basically healthy people to take drugs for borderline conditions (e.g., borderline hypertension, osteopenia, increased cholesterol levels. What is not shared is the possible risk of unnecessary medical interventions or  the harm caused by drug or treatment side effects especially when they are used for a long time period.  When unbiased research such as the Cochran Reviews are done,  even the annual physical exam appears to offer no benefits (Krogsbøll et al, 2013). Similarly,  mammograms and PSA testing  for a healthy population appears to offer no benefits and may increase risks. It is truly difficult to accept that an annual health check up is worthless or that a routine mammogram or PSA test may do more harm than good since for many years the public message has been the opposite:  to get more screening and testing. There are many reasons for this approach such as:

  1. Genuine belief, although not evidence based,  that an early intervention and more testing would reduce suffering.
  2. Financial incentives for the parties that perform testing and preventative screening or encourage increased drugs sales for borderline conditions for which the risk and benefits are not well documented.
  3. Fear of lawsuits by medical providers.  If a patient develops an illness which possibly could have been diagnosed by screening, even though the screening may not have affected the actual outcome, the health professional could be sued.

Become an informed consumer

When you have a symptom and do not feel well, see your doctor and get diagnosed, it may safe your life.  At the same time be an educated consumer and when unexpected findings are discovered and not related to your specific symptom/complaint, ask questions before agreeing to have more tests or treatments. Ask your provider some of the following questions which were initially outlined by Dr. Eugene Robins (1984):

  1. Why are you doing this test or procedure?
  2. What are the risks and what are the benefits?
  3. What are the risks of treatment and what are the benefits of treatment?
  4. How accurate is the test?
  5. How will the test results change the treatment strategy?
  6. Are there less invasive strategies that could be used? Be very careful of exposing yourself and especially children to CT scans. It is estimated that for every 1000 children who have an abdominal CT scan, one will develop cancer as a result (2015, Consumer Report, March 16).

To be able to navigate the complexities of diagnosis and to understand the risks and benefits of treatment and testing, read the recent two articles in the New York Times, Can this treatment help me? There is a statistic for that, How to Measure a Medical Treatment’s Potential for Harm and the superb book, Over-diagnosed-Making people sick in the pursuit of health,  by Drs. H. Gilbert Welch, Lisa M Schwartz, and Steven Woloshin who are professors at Darthmouth Institute for Health Policy and Clinical Practice. This book is a must read for every patient and health care provider. index

References:

(2015). Overexposed. Consumer Reports, 80(3), 37-41. http://www.consumerreports.org/cro/2015/01/when-to-skip-ct-scans-and-x-rays/index.htm

Carroll, A.E. & Frakt, A. (2015). How to Measure a Medical Treatment’s Potential for Harm. New York Times, February 2.

Frakt, A. & Carroll, A.T. (2015). Can This Treatment Help Me? There’s a Statistic for That, New York Times, January 26.

Jena, A. B., Prasad, V., Goldman, D. P., & Romley, J. (2014). Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings. JAMA internal medicine. doi:10.1001/jamainternmed.2014.6781 http://www.drperlmutter.com/wp-content/uploads/2015/01/Cardiac-outcome.pdf

Krogsbøll, L. T., Jørgensen, K. J., & Gøtzsche, P. C. (2013). General health checks in adults for reducing morbidity and mortality from disease. JAMA, 309(23), 2489-2490. http://drkney.com/pdfs/WAC_A_061913.pdf

Liang, B. A., & Mackey, T. (2011). Direct-to-consumer advertising with interactive internet media: global regulation and public health issues. JAMA, 305(8), 824-825. http://jama.jamanetwork.com/article.aspx?articleid=645713

Robins, E. D. (1984). Matter of Life & Death: Risks vs. Benefits of Medical Care. New York: W.H. Freeman and Company

Welch, H.G., Schwartz, L.M., & Woloshin, S. (2011). Over-diagnosed-Making people sick in the pursuit of health. Boston: Beacon Press.


A historical perspective of neurofeedback: Video interview by Larrry Berkelhammer of Erik Peper

Dr. Erik Peper is interviewed by Dr. Larry Berkelhammer about the research he did in the late 60s and early 70s on EEG alpha training. He describes how he learned to turn off alpha brain rhythms in one hemisphere and turn them on in the other.
Neurofeedback equipment allows researchers and clinicians to get extremely useful feedback, allowing people who are hooked up to get very good at identifying their own brain rhythms and to alter them at will. This can potentially allow us to re-train our brains. Dr. Peper talks about how the real gift of science is about being open to explore rather than to assume our beliefs are factual. Science is about curiosity, experimentation, and exploration. In studying people with cancer and other diseases it is vital that we study more than just pathology–we need to study those individuals who are the outliers, that is, those who recovered against all odds–let’s see what they did to mobilize their health.

 


Cellphone harm: Cervical spine stress and increase risk of brain cancer

It is impossible to belief that that only a few years ago there were no cell phones.

When I go home, I purposely put the phone away so that I can be present with my children.

I just wonder if the cell phone’s electromagnetic radiation could do harm?

Cell phone use is ubiquitous since information is only a key press or voice command away.  Students spend about many hours a day looking and texting on a cell phone and experience exhaustion and neck and shoulder discomfort (Peper et al, 2013).  Constant use may also have unexpected consequences:  Increased stress on the cervical spine and increased risk for brain cancer.

Increased cervical spine stress

As we look at the screen, text messages or touch the screen for more information, we almost always bend our head down to look down. This head forward position increases cervical compression and stress. The more the head bends down to look, the more the stress in the neck increases as the muscles have to work much harder that hold the head up. In a superb analysis Dr. Kennth Hansraj, Chief of Spine Surgery 0f New York Spine Surgery & Rehabilitation Medicine, showed that stress on the cervical spine increases from 10-12 lbs when the head is in its upright position to 60 lbs when looking down.

weight of headFigure 1. Stress on the cervical spine as related to posture. (From: Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277-279.)

Looking down for a short time period is no problem; however, many of us look down for extended periods. This slouched collapsed position is becoming the more dominant position. A body posture which tends to decrease energy, and increase hopeless, helpless, powerless thoughts (Wilson & Peper, 2004; Peper & Lin, 2012). The long term effects of this habitual collapsed position are not know–one can expect more neck and back problems and increase in lower energy levels.

increased risk for brain cancer and inactive sperm and lower sperm count

Cell phone use not only affect posture, the cell phone radio-frequency electromagnetic radiation by which the cell phone communicates to the tower may negatively affect biological tissue. It would not be surprising that electromagnetic radiation could be harmful; since, it is identical to the frequencies used in your microwave ovens to cook food. The recent research by Drs Michael Carlberg and Lennart Hardell of the Department of Oncology, University Hospital, Örebro, Sweden,  found that long term cell phone use is associated by an increased risk of developing malignant glioma (brain cancers) with the largest risk observed in people who used the cell phone before the age of 20. In addition, men who habitually carry the cell phone in a holster or in their pocket were more likely to have inactive or less mobile sperm as well as a lower sperm count.

What can you do:

Keep an upright posture and when using a cell phone or tablet. Every few minutes stretch, look up and reach upward with your hands to the sky.

Keep your cell phone away from your body such as putting it in your purse or outer pocket of your coat

Use your speaker phone or ear phones instead of placing the phone against your head.

Enjoy the cartoon video clip, Smartphone Ergonomics – Safe Tips – Mobile or Smart Phone Use while Driving, Traveling on the Move.

References:

Agarwal, A., Singh, A., Hamada, A., & Kesari, K. (2011). Cell phones and male infertility: a review of recent innovations in technology and consequences. International braz j urol, 37(4), 432-454. http://www.isdbweb.org/documents/file/1685_8.pdf

Carlberg, M., & Hardell, L. (2014). Decreased Survival of Glioma Patients with Astrocytoma Grade IV (Glioblastoma Multiforme) Associated with Long-Term Use of Mobile and Cordless Phones. International journal of environmental research and public health, 11(10), 10790-10805.  http://www.mdpi.com/1660-4601/11/10/10790/htm

De Iuliis, G. N., Newey, R. J., King, B. V., & Aitken, R. J. (2009). Mobile phone radiation induces reactive oxygen species production and DNA damage in human spermatozoa in vitro. PloS one, 4(7), e6446.

Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277-279.

Peper, E. & Lin, I-M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130.

Peper, E., Waderich, K., Harvey, R., & Sutter, S. (2013). The Psychophysiology of Contemporary Information Technologies Tablets and Smartphones Can Be a Pain in the Neck. In Applied Psychophysiology and Biofeedback, 38(3), 219.

Wilson, V.E. and Peper, E. (2004). The Effects of upright and slumped postures on the generation of positive and negative thoughts. Applied Psychophysiology and Biofeedback.29 (3), 189-195.


Choices: Creating meaningful days

When you woke up this morning, how did you feel? Were you looking forward to the day anticipating with joy what would occur or were you dreading the day as if once again you had to step on the treadmill of life?

how do you feel

Whenever I ask this question of college students in their junior or senior year at an urban university about 20% will answer that they are looking forward to the day. The majority answer, “Well not really”, or even “Oh shit, another day”. For many students the burden of living- working 40 hours a week to pay for rent and tuition, worrying about financial debt, and the challenge of commuting, and finding time to do the homework—feels and is overwhelming.

Asking this question about the quality—not quantity—of life is not just a question for students–it  is applicable for all of us. The more one chooses to do actively what gives fulfillment and meaning, the higher the quality of life (I do not mean eating more chocolate).

In a remarkable study by Dr. Jennifer Temel and her many colleagues, patients with metastatic non-small-cell lung cancer were given the option of early palliative care versus standard aggressive end-of-life treatment. The patients who were assigned to the early palliative care group had significantly better quality of life, fewer depressive symptoms and lived on the average three months longer than the group who received standard treatment.

Even at the end of life there may be choices. Choosing quality of life and doing what gives meaning may nurture a peaceful transition in death. This process of choice has been tenderly described in the recent New York Times essay, The best possible day. Take a moment and read this article by clicking on the link. http://www.nytimes.com/2014/10/05/opinion/sunday/the-best-possible-day.html?smid=fb-share&_r=0

Then ask yourself each day, “Am I looking forward to my day and my activities?” If the answer tends to be “No,” begin to explore new options. Ask yourself, “What would I like to do and look forward to?” First begin to dream about possible options and then begin to plan how to implement your dreams so that you are on the path to where you want to be.

It is a challenging process; however, each of us can do something that will give meaning and joy to our lives. For suggestions, see the outstanding book by Dr. Lawrence LeShan, Cancer as a Turning Point, or explore the practices in our book by Drs. Robert Gorter and Erik Peper, Fighting Cancer- A Non-Toxic Approach to Treatment.

Reference:

Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., … & Lynch, T. J. (2010). Early palliative care for patients with metastatic non–small-cell lung cancer. New England Journal of Medicine, 363(8), 733-742.

 

 

 


Cartoon ergonomics for working at the computer and laptop

I finally bought a separate keyboard and a small stand for my laptop so that the screen is at eye level and my shoulders are relaxed while typing at the keyboard. To my surprise,  my neck and shoulder tightness and pain disappeared and I am much less exhausted.

How we sit and work at the computer significantly affects our health and productivity. Ergonomics  is the science that offers guidelines on how to adjust your workspace and equipment to suit your individual needs.  It is just like choosing appropriate shoes–Ever try jogging in high heels?  The same process applies to the furniture and equipment you use when computing.

When people arrange their work setting according to  good ergonomic principles and incorporate a healthy computing work style numerous disorders (e.g., fatigue, vision discomfort,  head, neck, back, shoulder, arm or hand pain) may be prevented (Peper et al, 2004). For pragmatic tips to stay health at the computer see Erik Peper’s  Health Computer Email Tips.  Enjoy the following superb video cartoons uploaded by Stephen Walker on YouTube that summarize the basic guidelines for computer, laptop and cell phones use at work, home, or while traveling.

Adult or Child Laptop Use at Home, Work or Classroom

Healthy use of laptops anywhere.

Mobile or Smart Phone Use while Driving, Traveling or on the Move.


Evoking your healing potential: You are your placebo

Be careful what you think. You may get what you wish.

The power of the placebo and nocebo are remarkable and often overlooked in medicine. With a placebo, severe chest pain disappears with mock surgery, Parkinson’s tremors stop, knee pain is eliminated following mock arthroscopic knee surgery and even  of lymphosarcoma can be affected (Beecher, 1961; Benedeteti, 2007; Moseley et al, 2002; Kirkley et al., 2008; Klopfer, 1957; Moerman & Jonas, 2002). On the other hand, nocebo can increase pain, accelerate cancer growth, and cause death (Cannon, 1942; Klopfer, 1957; Benedeteti, 2007). These are demonstrations of the self-healing and non-healing potential intrinsic within each of us.

The placebo response (from Latin, “I shall please”) is the beneficial physiological or psychological effect that results from the administration of an otherwise ineffective or inert substance, procedure, instruction. and/or environment.  An example of placebo on neuron activity is demonstrated with  a patient who has Parkinson’s disease (see figure 1).

Fig 1.Figure 1. Recording the activity of single neurons from the brain of an awake patient suffering from Parkinson’s disease. Both the recording apparatus (a) and the electrode track (b) can be seen. In (c), the activity of a single neuron in the subthalamic nucleus can be seen before and after placebo administration (reproduced from: Benedeteti, F.(2007). The Placebo and Nocebo Effect: How the Therapist’s Words Act on the Patient’s Brain. Karger Gazette, 69)

The nocebo response (from Latin, “I will harm”) may evoke the non-healing process and reactivate symptom/disease producing process and experiences. The nocebo response can be evoked by ineffective or inert substances, procedures, instructions, and internal and external environments which by themselves have no known effects.

The placebo/nocebo response is modulated by our covert cultural, familial and personal beliefs, limitations and expectations. The placebo/nocebo effects are the actual demonstrations that the limits of our beliefs are the limits of our possibilities. This process is well described  in the recent published book, You are the Placebo: Making Your Mind Matter, by Chiropractor Joe Dispenza.

Fig 2Dr. Dispenza describes the classic studies of placebo, mental processes and possible mechanisms by which placebo effects occur and disappears and how our thoughts and expectancies create our reality.  The placebo transforms the inner beliefs and give the person the experience of improved health which transforms beliefs. In many cases we can experience improvement but are pulled back into our previous beliefs and self-images of illness by inner and outer cues which are associated with disease process.

The book describes of the covert conditioning process by which we return to our old self and may maintain illness. It is challenging to maintain new beliefs and act/think in new patterns. The internal mental chatter and doubts flood our awareness. Even the question, “How long will the improvement last?” re-evokes the associative mental conditioned disease patterns. If it is possible to interrupt and transform our thoughts moment by moment, minute by minute, hour by hour, day by day and not just for 15 minutes of practice, remarkable changes are sometimes possible. Every thought that triggers an association of the illness state needs to be interrupted and redirected. When patients somehow transform their thoughts, it may result in reversing and eliminating illnesses such as polyostotic fibrous dysphasia, Hashimot’sthyroiditis or chronic lympocytic thyroiditis, and secondary progressive multiple sclerosis.

I highly recommend this book for its outstanding description of placebo/nocebo and cognitive a model of the conditioning processes that underlie it. The book offers hope and inspiration for many patients who  accept “what is/was” and  are open to the present and future possibilities without judgement.

The book’s cases  show that it is possible to reverse chronic “incurable illnesses.” Patients and health care providers should read the book–it provides hope, empowerment, and possibility. It is an antidote to the feeling that there is nothing one can do except to live with the illness. Medicine needs to explore and study the unusual patient who has reversed the disease process and ask, “How can we understand this process and teach it to other patients.”

The major limitation of the book is the absence of data; namely, what percentage of the patients/participants who have practiced Dispenza’s techniques have actually benefited and transformed their illness? The book would be more useful if it included both successful and the many unsuccessful cases. This would help patients who do the practices and do not improve. These patients sometimes  blame themselves and failed at their self-healing—a process that increases depression and hopelessness. We need to realize that many factors affecting our health and illness are beyond our control.

Although I agree with Dr. Dspenza’s basic premise that our beliefs, acceptance of what is and being open to the present and future supports healing. This perspective is only part of the whole picture. Health and illness are multi-factorial and many factors are not within our control.

Read the book and skip chapter 8, The Quantum Mind.  This chapter attempts to describe the physics of the healing process using quantum physics.  As I did not understand quantum physics and quantum mind, I asked my colleague, James Johnston, PhD, who is an expert in quantum physics, to read it for accuracy. He confirmed my gut reaction when he said, “the quantum physics description of how energy changes is pseudo science, involving an incomplete understanding of quantum theory.”

Beecher, H.K. (1961). Surgery as Placebo. JAMA, 176(13), 1102-1107.

Benedeteti, F. (2007). The Placebo and Nocebo Effect: How the Therapist’s Words Act on the Patient’s Brain. Karger Gazette, 69.

Cannon, W. B. (1942). “Voodoo” death. American Anthropologist, 44(2), 169-181.

Dispenza, J. (2014). You are the Placebo: Making Your Mind Matter. Hay House, Inc.

Kirkley, A. et al,. (2008) A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. New England Journal of Medicine. 359:1097-1107

Klopfer, B. (1957). Psychological Variables in Human Cancer. Journal of Projective Techniques, 21, (4), 331–340.

Moerman, D.E., & Jonas, W.B. (2002). Deconstructing the Placebo Effect and Finding the Meaning Response. Annals of Internal Medicine. 136 (6), 471-476.

Moseley, J.B., et al, (2002). A controlled trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine. 347(2), 81-88.

 

 

 


What to eat? Low fat foods, high fat foods…..?

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Meat for sale (tongue and liver) at a traditional market (photo by Erik Peper).

Should I eat vegetables or meats? Should it be steaks or organ meats such as liver, heart, sweet breads? What foods contributes most to heart disease or cancer? Should I change my diet or take medications to lower my cholesterol?

Despite the many years of research the data is not clear. Many  public health dietary guidelines and recommendations were based upon flawed research, researchers’ bias and promoted by agribusiness. Starting in the 1950s there has been a significant change in the dietary habits from eating animal fats to plant based oils and fats. It is so much cheaper to produce plant based polyunsaturated salad or cooking oils (e.g. Wesson and Mazola) and hydrogenated hardened oils  (e.g. margarine and Crisco) than animal fats (e.g., butter, beef tallow, and lard).   Despite the many claims that lowering animal fat intake would reduce heart disease and possibly cancer, the claims are not supported by research data. It is true that consuming liquid plant based oils lowers the cholesterol, but with the possible exception of olive oil, polyunsaturated oils are associated with an increased cancer and death rates in large population studies (Multiple Risk Factor Intervention Trial Research Group,1982; Shaten, 1997).

slider1-2We assume that lowering cholesterol is healthy; however, it is usually a surrogate marker representing a hypothesized improvement in health. A short term apparent reduction in cholesterol levels or other illness markers may mask the long term harm. Only long term outcome studies which measure the total death rate– not just from one disease being studied but from all causes of death–provides the objective results. When looking at the results over a longer time period, there appears to be no correlation between fat intake and heart disease. In fact lowering fat intake seems to be associated with poorer long term health as described in the outstanding book, The Big Fat SurpriseWhy Butter, Meat & Cheese Belong in a Healthy Diet, by the science writer, Nina Teichol. Her superb investigative reporting describes in detail the flawed and biased research that underpinned the United States Department of Agriculture (USDA) and the American Heart Association (AHA) recommendations to reduce animal fats and use more plant based oils.

 

What should I eat now?

Diet recommendations used to be simple: Reduce animal fat intake and eat more plants. Now, there are no simple recommendations because they may depend upon your genetics (e.g., digestion of milk depends whether you are lactose tolerant or intolerant), your epigenetics (e.g., maternal malnutrition during your embryological development is a major risk for developing heart disease in later life), your physical and social activities (e.g., exercise reduces the risk for many diseases), and environment. The recent popularity of the hunter and gatherer diet, often known as the paleo diet, is challenging–it may depends on your ancestors. What hunter and gatherers ate depended upon geography and availability of food sources. The Inuit’s diet in the Arctic consisted of 90% meat/fish diet while the !Kung Bushman’ diet from the Kalahari desert in Africa consisted of less than a 15% meat/fish diet as shown in Figure 1.

paleo-diet-half-baked_3

 

Figure 1. The food content of hunter gatherers varied highly depending on geography. From:  Jabr, F. (2013). How to Really Eat Like a Hunter-Gatherer: Why the Paleo Diet Is Half-Baked. Scientific American, June 3.

Use common sense to make food choices.

  1. Eat only those foods which in the course of evolution have been identified as foods. This means eating a variety of plants based foods (fruits, tubers, leaves, stems, nuts, etc.) and more organ meats. Ask yourself what foods did your forefathers/mothers ate that supported survival and reproductive success. Carnivores usually ate the internal organs first and often would leave the muscles for scavengers.
  2. Eat like your great, great grandparents. They were not yet brainwashed by the profit incentives of agribusiness and pharmaceutical industry. For more information, read the outstanding books by Michael Pollan, The Omnivore’s Dilemma: A Natural History of Four Meals and In Defense of Food: An Eater’s Manifesto.
  3. If possible eat only organically grown/raised foods. Non organic foods usually contain low levels of pesticides, insecticides, antibiotics and hormones which increases the risk of cancer (Reuben, 2010). They may also also contain fewer nutrients such as essential minerals, vitamins, and antioxidants (Barański et al, 2014). The beneficial effects of organic foods have been challenging to demonstrate because it may take many years to show a difference.  Preliminary data strongly suggests that organic foods as compared to non organic foods increases longevity, improves fertility and enhances survival during starvation (Chhabra, Kolli, & Bauer, 2013).  For more information, see my blog, Live longer, enhance fertility and increase stress resistance: Eat Organic foods.
  4. Adapt the precautionary principle and assume that any new and artificially produced additives or chemically processed foods–most of the foods in boxes and cans in the central section of the supermarket–contain novel materials which have not been part of our historical dietary experience. These foods may be harmful over the long term and our bodies not yet know how to appropriately digest such foods such as trans fats (Kummerow, 2009).
  5. Be doubtful of dietary recommendations especially if you know of counter examples and exceptions. For example, the low fat diet recommendations could not explain the French or Swiss paradox (high butter and cheese intake and low heart disease rates). If examples exist, the popular dogma is incomplete or possibly wrong. Be skeptical about any health food claims. Ask who has funded the research, who decides whether a food can have a label that states “it is heart health” and can prevent a disease, and who would benefit if more of this food is sold.

My final comments on nutrition (source unknown).

  • The Japanese eat very little fat and suffer fewer heart attacks than us.
  • The Mexicans eat a lot of fat and suffer fewer heart attacks than us.
  • The French eat lots of butter and drink alcohol and suffer fewer heart attacks than us.
  • The Chinese drink very little red wine and suffer fewer heart attacks than us.
  • The Italians drink a lot of red wine and suffer fewer heart attacks than us.
  • The Germans drink a lot of beer and eat lots of sausages and fats and suffer fewer heart attacks than us.

Conclusion

Eat and drink what you like especially if you enjoy it with company…speaking English is apparently what kills you!

References:

Barański, M., Srednicka-Tober, D., Volakakis, N., Seal, C., Sanderson, R., Stewart, G. B., … & Leifert, C. (2014). Higher antioxidant and lower cadmium concentrations and lower incidence of pesticide residues in organically grown crops: a systematic literature review and meta-analyses. The British journal of nutrition, 1-18.  http://www.ncbi.nlm.nih.gov/pubmed/24968103
Chhabra R, Kolli S, Bauer JH (2013) Organically Grown Food Provides Health Benefits to Drosophila melanogaster. PLoS ONE 8(1): e52988. doi:10.1371/journal.pone.0052988  http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0052988

Jabr, F. (2013). How to Really Eat Like a Hunter-Gatherer: Why the Paleo Diet Is Half-Baked. Scientific American, June 3.http://www.scientificamerican.com/article/why-paleo-diet-half-baked-how-hunter-gatherer-really-eat/

Kummerow, F. A. (2009). The negative effects of hydrogenated trans fats and what to do about them. Atherosclerosis, 205(2), 458-465.http://www.atherosclerosis-journal.com/article/S0021-9150%2809%2900208-1/abstract

Multiple Risk Factor Intervention Trial Research Group. (1982). Multiple risk factor intervention trial. JAMA: The Journal of the American Medical Association, 248(12), 1465-1477. http://jama.jamanetwork.com/article.aspx?articleid=377969

Pollan, M. (2006). The Omnivore’s Dilemma: A Natural History of Four Meals. New York: Penguin Press. ISBN: 1594200823

Pollan, M. (2009). In Defense of Food: An Eater’s Manifesto. New York: Penguin Press. ISBN: 978-0143114963

Reuben, S. H. (2010). Reducing environmental cancer risk: what we can do now. DIANE Publishing. http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp08-09rpt/PCP_Report_08-09_508.pdf

Shaten, B. J., Kuller, L. H., Kjelsberg, M. O., Stamler, J., Ockene, J. K., Cutler, J. A., & Cohen, J. D. (1997). Lung cancer mortality after 16 years in MRFIT participants in intervention and usual-care groups. Annals of epidemiology, 7(2), 125-136. http://www.annalsofepidemiology.org/article/S1047-2797%2896%2900123-8/abstract

Teicholz, N. (2014). The big fat surprise-Why butter, meat & cheese belong in a healthy diet. New York: Simon & Schuster. ISBM 978-1-4516-2442-7  http://www.thebigfatsurprise.com/

 


Look up! Be aware and be open new possibilities

How is it possible that one is lonely while being connected to hundreds of Facebook friends, networked with even more LinkiedIn  colleagues,  and continuously sending and receiving Tweets and texts?  Are we so captured by the digital devices that we do not notice the actual reality around us? Watch Gary Turk’s remarkable video and then remember to look up and connect with others.


Don’t poison yourself: Avoid foods with high pesticide residues

Is it worth to pay $3.49 for the organic strawberries while the non-organics are a bargain at $2.49?

Are there foods I should avoid because they have high pesticide residues?

The United States Department of Agriculture (USDA) and the United States Environmental Protection Agency (EPA) state that pesticide residues left in or on food are safe and non-toxic and have no health consequences. I have my doubts! Human beings accumulate pesticides just like tuna fish accumulates mercury—frequent ingesting of very low levels of pesticides residue may result in long term harmful effects and these long term risks have not been assessed. Most pesticides are toxic chemicals and were developed to kill agricultural pests — living organisms. The actual risk for chronic low level exposure is probably unknown; since, the EPA pesticide residue limits are a political compromise between scientific findings and lobbying from agricultural and chemical industries (Portney, 1992).

Organic diets expose consumers to fewer pesticides associated with human disease (Forman et al, 2012).  In addition, preliminary studies have shown that GMO foods such as soy, potatoes, bananas and raisins reduces longevity, fertility and starvation tolerance in fruit flies (Chhabra et al, 2013)

Adopt the precautionary principle. As much as possible avoid the following foods that have high levels of residual pesticides as identified by the Environmental Working Group in their 2014 report.

Apples

Strawberries

Grapes

Celery

Peaches

Spinach

Sweet bell peppers

Nectarines-imported

Cucumbers

Cherry tomatoes

Snap peas-imported

Potatoes

Hot peppers

Blueberries-domestic

Lettuce

Kale/collard greens

For more details, see the Environmental Working Group report for the rankings of 48 foods listed from worst to best.

https://www.youtube.com/watch?feature=player_embedded&v=BfNQGd9BTK0

References:

Chhabra R, Kolli S, Bauer JH (2013) Organically Grown Food Provides Health Benefits to Drosophila melanogaster. PLoS ONE 8(1): e52988. doi:10.1371/journal.pone.0052988  http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0052988

Forman, J., Silverstein, J., Bhatia, J. J., Abrams, S. A., Corkins, M. R., de Ferranti, S. D., … & Wright, R. O. (2012). Organic foods: health and environmental advantages and disadvantages. Pediatrics, 130(5), e1406-e1415.

Portney, P. R. (1992). The determinants of pesticide regulation: A statistical analysis of EPA decision making. The Journal of Political Economy, 100(1), 175-197.