Tag Archives: health

December 2016 in Review

3 most frightening stories

  • The climate situation is not good. Concerns about food continue to surface, including from Bjorn Lomborg.
  • The water resources situation is not good. Asia may be headed for serious water shortages. 100 million trees have died in California during the current drought there. Drought and fire in the U.S. Southeast are an increasing problem and the region is unprepared.
  • The geopolitical situation is not good. If Russia did hack the U.S. election, it wouldn’t be the first election they have hacked. The wars in Afghanistan and Iraq are not over, and the rest of the greater Middle East is increasingly a mess.

3 most hopeful stories

3 most interesting stories

  • Scientists can synthesize proteins that could be incorporated in silicon-based life.
  • According to Bill Gates, “new genome technologies are at the cusp of affecting us all in profound ways”. But an article in Nature says we should not be too hopeful about living much past 100.
  • Maybe fish are not as stupid as we thought.

do the rich deserve more health care?

This New York Times opinion article is an economist making the somewhat offensive argument that maybe poor people should not be offered the same access to newer more expensive health care technology as rich people. I say offensive because that is the gut reaction. But part of the article’s point is that newer, higher-tech and more expensive don’t automatically mean a big benefit in terms of outcome and effectiveness. If they do improve outcomes, it is often just by a little bit compared to the lower-tech alternative, and at a much higher price. So it is an argument that a small increase in health is not worth a high price, or at least people should be helped to understand that tradeoff and then decide for themselves. It’s the economist’s basic argument that we live in a universe with finite resources available and we have to decide how to allocate them, and a large number of people making small decisions in a relatively free market will do that efficiently, if not necessarily fairly. Fairness is not really an economic argument, after all.

Consider, for example, treating prostate cancer with proton-beam therapy. It’s more expensive than alternatives like intensity-modulated radiation therapy, but isn’t proven to be any better. If given the choice, many people — especially those with lower incomes — might rather buy health insurance plans that exclude high-cost, low-value treatments.

The trouble is that insurers rarely sell those sorts of plans. Even insurers that try to exclude a particularly expensive and unproven technology from coverage are often rebuffed by legislatures and the courts.

This one-size-fits-all approach to insurance coverage disproportionately hurts low-income people, many of whom might reasonably prefer to devote their scarce dollars to housing or their children’s education. To some extent, subsidies and other monetary adjustments can mitigate this problem. Medicare and Medicaid, for example, are financed in large part out of federal income taxes. And within the Affordable Care Act marketplaces, lower-income people receive subsidies that cover some of their costs.

One way to handle this, which is not suggested in this article, is for the government to provide a minimum level of cost-effective treatment to all citizens, plus catastrophic coverage for the really big stuff like heart attacks and car accidents. The private health insurance market could still exist to cover everything in between, which you could argue is the stuff people want but don’t necessarily need. Which is the proper domain of economics. Distinguishing between high value treatments that prolong and improve the quality of life, and shiny new technologies that we might want but don’t necessarily all need, may become more and more important as technology continues to accelerate.

vaccine for the common cold

According to Inhabitat, there may soon be an effective vaccine for the common cold.

Could the common cold soon be a thing of the past? Scientists have created a breakthrough nasal spray that could block the virus as it tries to enter through the nose, where more than 90% of pathogens get in. The vaccine is called SynGEM, and it treats Respiratory Syncytial Virus (RSV), one of three viruses that cause 80% of common colds.

Zuckerberg vs. disease

Mark Zuckerberg and his wife have decided to set a modest goal of curing all disease.

Facebook co-founder Mark Zuckerberg and his wife, Priscilla Chan, on Wednesday announced a $3 billion effort to accelerate scientific research with the wildly ambitious goal of “curing all disease in our children’s lifetime.”

The many components of the initiative include creating universal technology “tools” based on both traditional science and engineering on which all researchers can build, including a map of all cell types, a way to continuously monitor blood for early signs of illness, and a chip that can diagnose all diseases (or at least many of them). The money will also help fund what they referred to as 10 to 15 “virtual institutes” that will bring together investigators from around the world to focus on individual diseases or other goals — an idea that has the potential to upend biomedical science…

anti-aging pill

This MIT professor thinks he has discovered an anti-aging pill.

The product contains a chemical precursor to nicotinamide adenine dinucleotide, or NAD, a compound that cells use to carry out metabolic reactions like releasing energy from glucose. The compound is believed cause some effects similar to a diet that is severely short on calories—a proven way to make a mouse live longer…

Scientists have shown they can reliably extend the life of laboratory mice by feeding them less, a process known as “caloric restriction.” That process seems to be mediated by biological molecules called sirtuins. NAD is important because it’s a chemical that sirtuins need to do their work and is also involved in other aspects of a cell’s metabolism. In worms, mice, and people, NAD levels fall with age, says Guarente, so the idea is to increase levels of the molecule.

“NAD replacement is one of the most exciting things happening in the biology of aging,” says Nir Barzilai, director of the Institute for Aging Research at the Albert Einstein College of Medicine in New York, who has coauthored scientific papers with Guarente but is not involved in Elysium. “The frustration in our field is that we have shown we can target aging, but the FDA does not [recognize it] as an indication.”

 

the bottom line on fat

I’ve been confused by the seemingly conflicting studies and guidelines on saturated fat that have been released the past few years. This study from Harvard School of Public Health makes a pretty strong case that it really does make sense to replace saturated fat with unsaturated fat.

When it comes to saturated fat, what you replace it with matters. People who replaced saturated fat in their diets with unsaturated fats—especially polyunsaturated fats—had a far lower risk of death from any cause, as well as death due to cardiovascular disease, cancer, neurodegenerative disease, and respiratory disease. Those who replaced saturated fat with carbohydrates only slightly lowered mortality risk. This is most likely because carbohydrates in typical American diets are high in refined starch and sugar, which have a similar influence on mortality risk as saturated fats…

The recent widespread confusion about the health effects of specific types of dietary fat is in part caused by a misleading 2014 Annals of Internal Medicine paper, which concluded there is no evidence supporting the longstanding recommendation to limit saturated fat consumption and replace it with unsaturated fats. The authors of this paper employed a meta-analysis (a statistical analysis that summarizes data from many different studies), and therefore could not look at specific macronutrient comparisons with saturated fat. In addition, this paper also had errors in data extraction, omitted important studies, and only examined coronary heart disease.

In addition, a recently published BMJ paper based on 1960’s data from the Minnesota Coronary Experiment suggested that replacing saturated fat with vegetable oils rich in linoleic acid was not protective against death from coronary heart disease or all causes, which appeared to challenge current guidelines and added further confusion. However, this study was of very short duration, extremely low in follow-up rate, and the intervention likely reduced intake of important omega-3 polyunsaturated fatty acids. The extreme intervention diet was also never consumed by any appreciable number of Americans and likely confounded by intake of trans fat.

Finally, a new systematic review and meta-analysis looking at the association of butter consumption (a concentrated source of saturated fat) with chronic disease and all-cause mortality resulted in headlines touting “butter is back,” even though the findings were predominantly neutral, and the authors pointed out that unsaturated fats were found to be a better choice than butter.

teenagers and green environments

This article says that teenagers in green environments are less aggressive, even after controlling for socioeconomic factors.

The researchers describe several “possible pathways” that could explain their results. Easy access to the natural world may reduce maternal stress, which can lead to children acting out. It can encourage physical activity, reduce air pollution levels, and “act as a buffer for ambient noise.”

In addition, they write, green space in urban areas has been shown to preserve “the microbial biodiversity needed to drive immunoregulation, and to optimize brain health.”

everyday chemicals and the developing brain

This is a disturbing article about the effects of common chemicals on childrens’ developing brains. I don’t get too alarmed when I hear this stuff from hte anti-vaccine and anti-GMO crowd, but this article is signed by dozens of scientists who study the brain.

Children in America today are at an unacceptably high risk of developing neurodevelopmental disorders that affect the brain and nervous system including autism, attention deficit hyperactivity disorder, intellectual disabilities, and other learning and behavioral disabilities. These are complex disorders with multiple causes—genetic, social, and environmental. The contribution of toxic chemicals to these disorders can be prevented…These include chemicals that are used extensively in consumer products and that have become widespread in the environment. Some are chemicals to which children and pregnant women are regularly exposed, and they are detected in the bodies of virtually all Americans in national surveys conducted by the U.S. Centers for Disease Control and Prevention. The vast majority of chemicals in industrial and consumer products undergo almost no testing for developmental neurotoxicity or other health effects.

To me, there is a difference between chemicals used in industry and agriculture, and chemicals found in everyday household products. We should be looking for truly safe and nontoxic substitutes for all of them, but the latter are particularly important both because the public is exposed to them directly, and because in some cases they are just not necessary. When I read the label on a bottle of shampoo I can’t help wondering if the chemical soup that is in there is really necessary to cleanse my hair, and even if were, cleansing my hair is not a matter of life and death.

“the new war on cancer”

I remember that one of the (few) things that caught my attention in the last State of the Union address was talk of a new research plan to cure cancer. This article in The Week talks about what that is.

recently, researchers have had very encouraging results with a new approach called immunotherapy. Some patients in advanced stages of the disease, who previously would have been deemed terminal, have undergone rapid and complete recoveries. Hoping to build on that progress, President Obama in January announced a $1 billion “moonshot” to cure cancer, putting Vice President Joe Biden — whose son Beau died of brain cancer last year — in charge of “mission control.” …

Another promising new frontier is genetic analysis, which splits each type of cancer into dozens of subtypes, so that specific chemotherapy drugs can be tailored to each cancer. Experts also now hope they can use the breakthrough gene-editing technique called CRISPR to correct mutations in cancer cells, or perhaps “edit” out mutation-prone genes that people inherit…

In August 2015, former President Jimmy Carter announced he had been diagnosed with advanced melanoma, a type of skin cancer that had spread to his liver and brain. “I’m perfectly at ease with whatever comes,” said Carter, then 90. Four months later, Carter announced he was cancer-free. Along with radiation, Carter had been put on pembrolizumab (brand name Keytruda), a checkpoint inhibitor that stops cancer cells from blocking the immune system’s response. Soon after, Carter’s scans showed no evidence of the original cancer lesions on his brain, or any new lesions. Given that cancer can often reappear years down the line, oncologists prefer to talk in terms of “years of remission” rather than “cure” — but like Carter, some cancer patients on Keytruda have seen their disease disappear completely. Not surprisingly, says melanoma specialist Dr. Patrick Ott, Carter’s miraculous recovery has prompted patients across the country to demand, “I want what Jimmy Carter had.” Doctors caution that in clinical trials, Keytruda shrank the tumors in only 24 percent of patients, and that it only works on certain types of cancer.