Category Archives: Health

Your gut tells your mind, more than you may imagine

Charles Schmidt writes: The notion that the state of our gut governs our state of mind dates back more than 100 years. Many 19th- and early 20th-century scientists believed that accumulating wastes in the colon triggered a state of “auto-intoxication,” whereby poisons emanating from the gut produced infections that were in turn linked with depression, anxiety and psychosis. Patients were treated with colonic purges and even bowel surgeries until these practices were dismissed as quackery.

The ongoing exploration of the human microbiome promises to bring the link between the gut and the brain into clearer focus. Scientists are increasingly convinced that the vast assemblage of microfauna in our intestines may have a major impact on our state of mind. The gut-brain axis seems to be bidirectional — the brain acts on gastrointestinal and immune functions that help to shape the gut’s microbial makeup, and gut microbes make neuroactive compounds, including neurotransmitters and metabolites that also act on the brain. These interactions could occur in various ways: microbial compounds communicate via the vagus nerve, which connects the brain and the digestive tract, and microbially derived metabolites interact with the immune system, which maintains its own communication with the brain. Sven Pettersson, a microbiologist at the Karolinska Institute in Stockholm, has recently shown that gut microbes help to control leakage through both the intestinal lining and the blood-brain barrier, which ordinarily protects the brain from potentially harmful agents.

Microbes may have their own evolutionary reasons for communicating with the brain. They need us to be social, says John Cryan, a neuroscientist at University College Cork in Ireland, so that they can spread through the human population. Cryan’s research shows that when bred in sterile conditions, germ-free mice lacking in intestinal microbes also lack an ability to recognize other mice with whom they interact. In other studies, disruptions of the microbiome induced mice behavior that mimics human anxiety, depression and even autism. In some cases, scientists restored more normal behavior by treating their test subjects with certain strains of benign bacteria. Nearly all the data so far are limited to mice, but Cryan believes the findings provide fertile ground for developing analogous compounds, which he calls psychobiotics, for humans. “That dietary treatments could be used as either adjunct or sole therapy for mood disorders is not beyond the realm of possibility,” he says. [Continue reading…]

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How one community is kicking the Koch brothers’ harmful black dust out of their neighborhood

Joseph Erbentraut reports: It’s not easy to take on a wealthy, multi-national corporation and win. Especially for residents of Chicago’s struggling southeast side.

But that’s exactly what’s happening on the banks of the Calumet River, where the steel plants that used to give residents of a mostly Hispanic neighborhood access to a middle-class lifestyle were replaced, nearly two years ago, with black dust called petroleum coke (“petcoke”) piled five or six stories tall.

The piles of petcoke — a byproduct of the oil refining process — belong to KCBX Terminals, owned by the conservative billionaire Koch Brothers. The piles have been roiling area residents ever since the black dust of mostly carbon and sulfur began blowing into the backyards, playgrounds and neighborhood parks. It blackens skies and leaves behind a sticky residue, raising concerns about aggravated asthma and other health issues.

A small but energetic coalition of residents have stepped up to fight the blight, holding protests and marches, educating their neighbors about the issue and pressuring elected officials. They’ve made incredible progress in a relatively short time. [Continue reading…]

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How the American opiate epidemic was started by one pharmaceutical company

Mike Mariani writes: The state of Kentucky may finally get its deliverance. After more than seven years of battling the evasive legal tactics of Purdue Pharma, 2015 may be the year that Kentucky and its attorney general, Jack Conway, are able to move forward with a civil lawsuit alleging that the drugmaker misled doctors and patients about their blockbuster pain pill OxyContin, leading to a vicious addiction epidemic across large swaths of the state.

A pernicious distinction of the first decade of the 21st century was the rise in painkiller abuse, which ultimately led to a catastrophic increase in addicts, fatal overdoses, and blighted communities. But the story of the painkiller epidemic can really be reduced to the story of one powerful, highly addictive drug and its small but ruthlessly enterprising manufacturer.

On December 12, 1995, the Food and Drug Administration approved the opioid analgesic OxyContin. It hit the market in 1996. In its first year, OxyContin accounted for $45 million in sales for its manufacturer, Stamford, Connecticut-based pharmaceutical company Purdue Pharma. By 2000 that number would balloon to $1.1 billion, an increase of well over 2,000 percent in a span of just four years. Ten years later, the profits would inflate still further, to $3.1 billion. By then the potent opioid accounted for about 30 percent of the painkiller market. What’s more, Purdue Pharma’s patent for the original OxyContin formula didn’t expire until 2013. This meant that a single private, family-owned pharmaceutical company with non-descript headquarters in the Northeast controlled nearly a third of the entire United States market for pain pills.

OxyContin’s ball-of-lightning emergence in the health care marketplace was close to unprecedented for a new painkiller in an age where synthetic opiates like Vicodin, Percocet, and Fentanyl had already been competing for decades in doctors’ offices and pharmacies for their piece of the market share of pain-relieving drugs. In retrospect, it almost didn’t make sense. Why was OxyContin so much more popular? Had it been approved for a wider range of ailments than its opioid cousins? Did doctors prefer prescribing it to their patients?

During its rise in popularity, there was a suspicious undercurrent to the drug’s spectrum of approved uses and Purdue Pharma’s relationship to the physicians that were suddenly privileging OxyContin over other meds to combat everything from back pain to arthritis to post-operative discomfort. It would take years to discover that there was much more to the story than the benign introduction of a new, highly effective painkiller. [Continue reading…]

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Angry tweets and heart disease

Tom Jacobs writes: Why does one community have higher levels of heart disease than another? Some of the reasons are obvious, such as income and education levels or local eating and exercise norms.

But as epidemiologists have long argued, other likely factors are more ephemeral. Among them: how angry or content the residents tend to feel, and whether the environment fosters a sense of social connectedness.

Measuring such things is tough, but newly published research reports telling indicators can be found in bursts of 140 characters or less. Examining data on a county-by-county basis, it finds a strong connection between two seemingly disparate factors: deaths caused by the narrowing and hardening of coronary arteries and the language residents use on their Twitter accounts. [Continue reading…]

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Did Sierra Leone’s hero doctor have to die?

Joshua Hammer writes: Dr. Sheik Humarr Khan, the head of the Kenema Government Hospital’s Ebola ward, didn’t want his head nurse moved into the main isolation unit. Called Ward A, it consisted of eight small rooms lining a dingy corridor of exposed wiring, peeling paint, and grimy cement floors. It was narrow, stiflingly hot, and crowded with as many as 30 patients. Nurses squeezed between beds, injecting antibiotics, emptying buckets of diarrhea, hosing down vomit with chlorine. Some of the sick were delirious; others catatonic, with a stony-eyed stare that usually signaled that death was imminent. All of them were hooked up to intravenous fluid bags; in a state of disorientation, some would rip the needles out of their arms, spraying their blood in all directions.

So Khan had bent the rules and moved the Ebola-stricken nurse to a private room in the observation wing, which was normally set aside for those awaiting their diagnostic test results. It was more comfortable and dignified — befitting the nurse’s status, Khan thought, as the most beloved figure at the hospital. Khan and Mbalu Fonnie had been each other’s family for much of the past decade. He called her “mom.” She thought of him as her son, and she took maternal pride in his accomplishments. A round-faced man who had been born poor in a village near Freetown, Khan had become a hero in Kenema, a backwater town of 130,000. As the head of the Lassa fever ward, he had treated more cases of hemorrhagic fever than anyone else in the world, helping thousands of patients recover their health. He attended conferences from New Orleans to Nigeria, published studies in major medical journals, and was soon headed to Harvard on sabbatical to work at the cutting edge of tropical disease research — mapping the virus genome. But now Khan was facing the greatest challenge of his life. [Continue reading…]

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How Darkness Visible shined a light

Peter Fulham writes: Twenty-five years ago, in December, 1989, Darkness Visible, William Styron’s account of his descent into the depths of clinical depression and back, appeared in Vanity Fair. The piece revealed in unsparing detail how Styron’s lifelong melancholy at once gave way to a seductive urge to end his own life. A few months later, he released the essay as a book, augmenting the article with a recollection of when the illness first took hold of him: in Paris, as he was about to accept the 1985 Prix mondial Cino Del Duca, the French literary award. By the author’s own acknowledgement, the response from readers was unprecedented. “This was just overwhelming. It was just by the thousands that the letters came in,” he told Charlie Rose. “I had not really realized that it was going to touch that kind of a nerve.”

Styron may have been startled by the outpouring of mail, but in many ways, it’s easy to understand. The academic research on mental illness at the time was relatively comprehensive, but no one to date had offered the kind of report that Styron gave to the public: a firsthand account of what it’s like to have the monstrous condition overtake you. He also exposed the inadequacy of the word itself, which is still used interchangeably to describe a case of the blues, rather than the tempestuous agony sufferers know too well.

Depression is notoriously hard to describe, but Styron managed to split the atom. “I’d feel the horror, like some poisonous fogbank, roll in upon my mind,” he wrote in one chapter. In another: “It is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair… comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze stirs this cauldron… it is entirely natural that the victim begins to think ceaselessly of oblivion.”

As someone who has fought intermittently with the same illness since college, those sentences were cathartic, just as I suspect they were for the many readers who wrote to Styron disclosing unequivocally that he had saved their lives. As brutal as depression can be, one of the main ways a person can restrain it is through solidarity. You are not alone, Styron reminded his readers, and the fog will lift. Patience is paramount. [Continue reading…]

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Cuba’s extraordinary global medical record shames the U.S. blockade

Seumas Milne writes: Four months into the internationally declared Ebola emergency that has devastated west Africa, Cuba leads the world in direct medical support to fight the epidemic. The US and Britain have sent thousands of troops and, along with other countries, promised aid – most of which has yet to materialise. But, as the World Health Organisation has insisted, what’s most urgently needed are health workers. The Caribbean island, with a population of just 11m and official per capita income of $6,000 (£3,824), answered that call before it was made. It was first on the Ebola frontline and has sent the largest contingent of doctors and nurses – 256 are already in the field, with another 200 volunteers on their way.

While western media interest has faded with the receding threat of global infection, hundreds of British health service workers have volunteered to join them. The first 30 arrived in Sierra Leone last week, while troops have been building clinics. But the Cuban doctors have been on the ground in force since October and are there for the long haul.

The need could not be greater. More than 6,000 people have already died. So shaming has the Cuban operation been that British and US politicians have felt obliged to offer congratulations. John Kerry described the contribution of the state the US has been trying to overthrow for half a century “impressive”. The first Cuban doctor to contract Ebola has been treated by British medics, and US officials promised they would “collaborate” with Cuba to fight Ebola.

But it’s not the first time that Cuba has provided the lion’s share of medical relief following a humanitarian disaster. Four years ago, after the devastating earthquake in impoverished Haiti, Cuba sent the largest medical contingent and cared for 40% of the victims. In the aftermath of the Kashmir earthquake of 2005, Cuba sent 2,400 medical workers to Pakistan and treated more than 70% of those affected; they also left behind 32 field hospitals and donated a thousand medical scholarships. [Continue reading…]

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Landmark 20-year study finds pesticides linked to depression in farmers

Modern Farmer reports: Earlier this fall, researchers from the National Institute of Health finished up a landmark 20-year study, a study that hasn’t received the amount of coverage it deserves. About 84,000 farmers and spouses of farmers were interviewed since the mid-1990s to investigate the connection between pesticides and depression, a connection that had been suggested through anecdotal evidence for far longer. We called up Dr. Freya Kamel, the lead researcher on the study, to find out what the team learned and what it all means. Spoiler: nothing good.

“There had been scattered reports in the literature that pesticides were associated with depression,” says Kamel. “We wanted to do a new study because we had more detailed data than most people have access to.” That excessive amount of data includes tens of thousands of farmers, with specific information about which pesticides they were using and whether they had sought treatment for a variety of health problems, from pesticide poisoning to depression. Farmers were surveyed multiple times throughout the 20-year period, which gives the researchers an insight into their health over time that no other study has.

Because the data is so excessive, the researchers have mined it three times so far, the most recent time in a study published just this fall. The first one was concerned with suicide, the second with depression amongst the spouses of farmers (Kamel says “pesticide applicators,” but most of the people applying pesticides are farmers), and the most recent with depression amongst the farmers themselves.

There’s a significant correlation between pesticide use and depression, that much is very clear, but not all pesticides. The two types that Kamel says reliably moved the needle on depression are organochlorine insecticides and fumigants, which increase the farmer’s risk of depression by a whopping 90% and 80%, respectively. The study lays out the seven specific pesticides, falling generally into one of those two categories, that demonstrated a categorically reliable correlation to increased risk of depression.

These types aren’t necessarily uncommon, either; one, called malathion, was used by 67% of the tens of thousands of farmers surveyed. Malathion is banned in Europe, for what that’s worth. [Continue reading…]

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The complex, varied, ever changing and context-dependent microbiome

Ed Yong writes: In the late 17th century, the Dutch naturalist Anton van Leeuwenhoek looked at his own dental plaque through a microscope and saw a world of tiny cells “very prettily a-moving.” He could not have predicted that a few centuries later, the trillions of microbes that share our lives — collectively known as the microbiome — would rank among the hottest areas of biology.

These microscopic partners help us by digesting our food, training our immune systems and crowding out other harmful microbes that could cause disease. In return, everything from the food we eat to the medicines we take can shape our microbial communities — with important implications for our health. Studies have found that changes in our microbiome accompany medical problems from obesity to diabetes to colon cancer.

As these correlations have unfurled, so has the hope that we might fix these ailments by shunting our bugs toward healthier states. The gigantic probiotics industry certainly wants you to think that, although there is little evidence that swallowing a few billion yogurt-borne bacteria has more than a small impact on the trillions in our guts. The booming genre of microbiome diet books — self-help manuals for the bacterial self — peddles a similar line, even though our knowledge of microbe-manipulating menus is still in its infancy.

This quest for a healthy microbiome has led some people to take measures that are far more extreme than simply spooning up yogurt. [Continue reading…]

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The healing power of silence

Daniel A. Gross writes: One icy night in March 2010, 100 marketing experts piled into the Sea Horse Restaurant in Helsinki, with the modest goal of making a remote and medium-sized country a world-famous tourist destination. The problem was that Finland was known as a rather quiet country, and since 2008, the Country Brand Delegation had been looking for a national brand that would make some noise.

Over drinks at the Sea Horse, the experts puzzled over the various strengths of their nation. Here was a country with exceptional teachers, an abundance of wild berries and mushrooms, and a vibrant cultural capital the size of Nashville, Tennessee. These things fell a bit short of a compelling national identity. Someone jokingly suggested that nudity could be named a national theme — it would emphasize the honesty of Finns. Someone else, less jokingly, proposed that perhaps quiet wasn’t such a bad thing. That got them thinking.

A few months later, the delegation issued a slick “Country Brand Report.” It highlighted a host of marketable themes, including Finland’s renowned educational system and school of functional design. One key theme was brand new: silence. As the report explained, modern society often seems intolerably loud and busy. “Silence is a resource,” it said. It could be marketed just like clean water or wild mushrooms. “In the future, people will be prepared to pay for the experience of silence.”

People already do. In a loud world, silence sells. Noise-canceling headphones retail for hundreds of dollars; the cost of some weeklong silent meditation courses can run into the thousands. Finland saw that it was possible to quite literally make something out of nothing.

In 2011, the Finnish Tourist Board released a series of photographs of lone figures in the wilderness, with the caption “Silence, Please.” An international “country branding” consultant, Simon Anholt, proposed the playful tagline “No talking, but action.” And a Finnish watch company, Rönkkö, launched its own new slogan: “Handmade in Finnish silence.”

“We decided, instead of saying that it’s really empty and really quiet and nobody is talking about anything here, let’s embrace it and make it a good thing,” explains Eva Kiviranta, who manages social media for VisitFinland.com.

Silence is a peculiar starting point for a marketing campaign. After all, you can’t weigh, record, or export it. You can’t eat it, collect it, or give it away. The Finland campaign raises the question of just what the tangible effects of silence really are. Science has begun to pipe up on the subject. In recent years researchers have highlighted the peculiar power of silence to calm our bodies, turn up the volume on our inner thoughts, and attune our connection to the world. Their findings begin where we might expect: with noise.

The word “noise” comes from a Latin root meaning either queasiness or pain. According to the historian Hillel Schwartz, there’s even a Mesopotamian legend in which the gods grow so angry at the clamor of earthly humans that they go on a killing spree. (City-dwellers with loud neighbors may empathize, though hopefully not too closely.)

Dislike of noise has produced some of history’s most eager advocates of silence, as Schwartz explains in his book Making Noise: From Babel to the Big Bang and Beyond. In 1859, the British nurse and social reformer Florence Nightingale wrote, “Unnecessary noise is the most cruel absence of care that can be inflicted on sick or well.” Every careless clatter or banal bit of banter, Nightingale argued, can be a source of alarm, distress, and loss of sleep for recovering patients. She even quoted a lecture that identified “sudden noises” as a cause of death among sick children. [Continue reading…]

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One in three #Gaza children already showed signs of PTSD before the latest war

The New York Times reports: Hassan al-Zeyada has spent decades counseling fellow residents of the Gaza Strip who suffer from psychological trauma. Now, as he prepares to aid his neighbors after a new round of combat and carnage, he has a challenging new patient: himself.

An Israeli airstrike demolished Dr. Zeyada’s family home on July 20, killing six close relatives, including his mother and three of his brothers.

“You try to help the people with their suffering,” the doctor said recently in his Gaza City living room lined with psychology textbooks. “It’s totally different when you have the same experience. You lose six from your family — three brothers, your mom, one of your nephews, your sister in-law. It’s really” — he paused, red-eyed — “unexpected.”

He took a mental step back, to diagnose the hallmarks of trauma in himself: He was exhibiting dissociation, speaking in the second person to distance himself from pain, as well as denial. When he heard about new shelling near where his family lived in the Bureij refugee camp, he picked up the phone to call his oldest brother there. He had forgotten that the house was already gone, his brother already dead.

Dr. Zeyada, 50, works to destigmatize mental health care for a Palestinian population exposed repeatedly to war and displacement, practicing at the Gaza Community Mental Health Program, which was led by the pioneering Palestinian psychiatrist and human-rights advocate Dr. Eyad El-Sarraj until his death from leukemia in December.

Dr. Zeyada is not the only Palestinian caregiver to become a trauma victim. In the three weeks of attacks that Israel has said are meant to root out militant rocket fire and destroy clandestine tunnels into Israel, one of Dr. Zeyada’s colleagues at the program lost a brother, and their boss, Dr. Yasser Abu Jamei, lost 26 members of his extended family, including 19 children, in a single bombing.

It is difficult — even absurd, the clinicians say at their darkest moments — to try to mend psyches in the Gaza Strip, where even in calmer times the conditions are hardly conducive to psychological health, and safety is never more than provisional under the many cease-fires that have come and gone.

People cannot flee from Gaza; Israel and Egypt keep their borders virtually sealed. Residents can flee their neighborhoods, but even United Nations schools being used as shelters in Gaza have come under deadly fire. And in downtown Gaza City, where Israel has urged people to go for safety, Israeli airstrikes have repeatedly hit apartment buildings packed with residents and refugees. One strike collapsed most of a building and killed the family of a bank employee who had fled there on Israeli instructions.

The border restrictions, stemming from an eight-year standoff between Israel and Hamas, the militant group that dominates Gaza, have steadily eroded livelihoods in Gaza, adding to a sense of powerlessness. Even during relative lulls in violence, Israeli strikes periodically kill militants — and bystanders. People who do not want Hamas and other militants to use their farm fields to fire rockets, for fear of return fire from Israel, say they cannot always stop the combatants.

The healthy processing of grief and fear works best when sufferers feel they are out of danger, Dr. Zeyada said. But that is impossible in Gaza as long as the larger conflict persists.

Sometimes, he said, he was troubled by the ethics of treating people who were likely to be traumatized again. [Continue reading…]

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Is the world making you sick?

Jill Neimark writes: In 1962, physicist and historian Thomas Kuhn proposed that science makes progress not just through the gradual accumulation and analysis of knowledge, but also through periodic revolutions in perspective. Anomalies and incongruities that may have been initially ignored drive a field into crisis, he argued, and eventually force a new scientific framework. Copernicus, Darwin, Newton, Galileo, Pasteur—all have spearheaded what Kuhn has called a “paradigm shift.”

Thomas Kuhn is Claudia Miller’s hero. An immunologist and environmental health expert at the University of Texas School of Medicine in San Antonio, and a visiting senior scientist at Harvard University, Miller lives by Kuhn’s maxim that “the scientist who embraces a new paradigm is like the man wearing inverting lenses…[he] has undergone a revolutionary transformation of vision.”

Miller has spent 30 years hammering out a theory to explain the contemporary surge in perplexing, multi-symptom illnesses — from autism to Gulf War Syndrome — which represent a Kuhnian shift in medicine. She calls her theory “TILT,” short for Toxicant Induced Loss of Tolerance.

TILT posits that a surprising range of today’s most common chronic conditions are linked to daily exposure to very low doses of synthetic chemicals that have been in mass production since World War II. These include organophosphate pesticides, flame-retardants, formaldehyde, benzene, and tens of thousands of other chemicals.

TILT, says Miller, is a two-step process. Genetically susceptible individuals get sick after a toxic exposure or series of exposures. Instead of recovering, their neurological and immune systems become “tilted.” Then, they lose tolerance to a wide range of chemicals commonly found at low doses in everyday life and develop ongoing illnesses. [Continue reading…]

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The super-abundant virus controlling your gut bacteria

The New Scientist reports: The common cold, hepatitis C… crAssphage? A new virus has been discovered that could lurk in the guts of almost three-quarters of people around the world, making it one of the most ubiquitous viruses you never knew you had.

The virus, which replicates by infecting a species of common gut bacteria, is six times more abundant than all other known gut viruses combined. Its discovery supports the idea that viruses may be the puppet masters of our intestines, regulating the teeming bacterial communities that call our gut home.

“The idea is that viruses can control the levels of bacteria in the gut, to make sure that no one type gets the upper hand,” says Bas Dutilh of Radboud University Medical Centre in Nijmegen, the Netherlands. “Viruses could maintain the biodiversity within us.”

The fact that the virus is found in so many different people, regardless of where they live or what they eat, overturns the previously held belief that each person’s viral signature is unique, says Dutilh. [Continue reading…]

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Human microbes. Who is the host?

Imagine New York City with the lights all on, but nobody home — indeed, nobody anywhere. A city fully intact and yet uninhabited. Would it still be a city, or would we refer to it as the place formerly known as New York City?

The image I’m conjuring up is not meant to represent the aftermath of some catastrophe, but rather, if we were to think of NYC as representing a human body, what that body would be like if it was stripped of its microbial life.

When the human body is described as being a host to a multitude of microbial organisms, by implication those organisms are viewed as guests. We might have some sense that we need these guests — even that we cannot survive without them — but they belong to us rather than us to them.

Why?

The “I” that stands at the center, possessed — or so it imagines — with some kind of regal authority over this domain called a person, is really a fiction.

Life in the city which is the body, continues just the same whether the monarch is awake or unconscious.

Jane Brody writes: We may think of ourselves as just human, but we’re really a mass of microorganisms housed in a human shell. Every person alive is host to about 100 trillion bacterial cells. They outnumber human cells 10 to one and account for 99.9 percent of the unique genes in the body.

Katrina Ray, a senior editor of Nature Reviews, recently suggested that the vast number of microbes in the gut could be considered a “human microbial ‘organ’” and asked, “Are we more microbe than man?”

Our collection of microbiota, known as the microbiome, is the human equivalent of an environmental ecosystem. Although the bacteria together weigh a mere three pounds, their composition determines much about how the body functions and, alas, sometimes malfunctions.

Like ecosystems the world over, the human microbiome is losing its diversity, to the potential detriment of the health of those it inhabits.

Dr. Martin J. Blaser, a specialist in infectious diseases at the New York University School of Medicine and the director of the Human Microbiome Program, has studied the role of bacteria in disease for more than three decades. His research extends well beyond infectious diseases to autoimmune conditions and other ailments that have been increasing sharply worldwide.

In his new book, “Missing Microbes,” Dr. Blaser links the declining variety within the microbiome to our increased susceptibility to serious, often chronic conditions, from allergies and celiac disease to Type 1 diabetes and obesity. He and others primarily blame antibiotics for the connection. [Continue reading…]

Want to diversify your own ecosystem?

It’s easier than you might imagine. Just start making your own kefir — a fermented milk drink. There’s very little skill required.

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Monsanto’s herbicide linked to fatal kidney disease epidemic

Jeff Ritterman, M.D. writes: For years, scientists have been trying to unravel the mystery of a chronic kidney disease epidemic that has hit Central America, India and Sri Lanka. The disease occurs in poor peasant farmers who do hard physical work in hot climes. In each instance, the farmers have been exposed to herbicides and to heavy metals. The disease is known as CKDu, for Chronic Kidney Disease of unknown etiology. The “u” differentiates this illness from other chronic kidney diseases where the cause is known. Very few Western medical practitioners are even aware of CKDu, despite the terrible toll it has taken on poor farmers from El Salvador to South Asia.

Dr. Catharina Wesseling, the regional director for the Program on Work and Health (SALTRA) in Central America, which pioneered the initial studies of the region’s unsolved outbreak, put it this way, “Nephrologists and public health professionals from wealthy countries are mostly either unfamiliar with the problem or skeptical whether it even exists.”

Dr. Wesseling was being diplomatic. At a 2011 health summit in Mexico City, the United States beat back a proposal by Central American nations that would have listed CKDu as a top priority for the Americas.

David McQueen, a US delegate from the Centers for Disease Control and Prevention who has since retired from the agency, explained the US position.

“The idea was to keep the focus on the key big risk factors that we could control and the major causes of death: heart disease, cancer and diabetes. And we felt, the position we were taking, that CKD was included.”

The United States was wrong. The delegates from Central America were correct. CKDu is a new form of illness. This kidney ailment does not stem from diabetes, hypertension or other diet-related risk factors. Unlike the kidney disease found in diabetes or hypertension, the kidney tubules are a major site of injury in CKDu, suggesting a toxic etiology. [Continue reading…]

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An ex-Trader Joe’s exec’s plan to reduce food waste and feed the hungry

The Atlantic: America’s growing income inequality has dominated the national conversation in recent months, accompanied by an avalanche of data: economists tell us the richest 1 percent of American households earn 20 percent of all income and own 40 percent of the nation’s wealth. But how do these figures translate into everyday life? For a glimpse into what has gone wrong, consider America’s food paradox: Grocery stores catering to wealthy shoppers discard billions of pounds of wholesome food because of minor cosmetic flaws while, in low-income neighborhoods across the country, 48 million Americans lack reliable access to affordable, nutritious food.

Doug Rauch, the former president of the Trader Joe’s Company, has first-hand knowledge about America’s food waste. He tells me that he has seen shocking quantities of food discarded because customers expect perfect fruit and vegetables on their supermarket shelves. “Grocery stores routinely trash produce for being the wrong shape or containing minor blemishes,” he tells me. After three decades in the grocery business, Rauch retired four years ago to devote himself to investigating and addressing the problem. The USDA estimates that 31 percent of food produced in America goes uneaten every year, amounting to a loss of $161.6 billion. “Here we are in the richest nation in the history of the world in terms of food production, yet one in six Americans is going hungry,” he says.

Rauch wants to take a stab at tackling this inefficiency in America’s food system. The solution seems obvious to him: Couldn’t we take the excesses of the wealthy and give them to the poor? This is precisely the concept behind Daily Table, a grocery store he is launching this fall in Roxbury, a low-income Boston suburb. Rauch plans to salvage food discarded by supermarkets and sell it at very low cost to consumers who would not otherwise have the means to adequately feed themselves. If this experiment works, he plans to open stores like it around the country. [Continue reading…]

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How malnutrition affects the microbiome

The Scientist reports: The gut microbiomes of young children don’t fully recover from the trauma of early-life malnourishment, even after they are treated with more-complete diets, according to a study published in Nature. A team led by Jeffrey Gordon of the Washington University in St. Louis sampled the gut microbiomes of healthy and malnourished children in Bangladesh and found that the microbiomes of children who were underfed and whose diets lacked essential nutrients looked less like those of adults and more like those of younger, healthy children.

“This is actually a real step forward in terms of having a technique to look at development of the microbiome in children,” said Josef Neu, a pediatrician at the University of Florida who studies gastrointestinal health of neonates and was not involved in the work.

The findings present a possible explanation for the commonly observed complications that malnourished children suffer even after they are treated with a standardized food regimen, including stunted growth, cognitive delays, and immune system problems. The researchers suggested that the immature gut microbiomes of malnourished children may be partially responsible for some of these long-term impairments. [Continue reading…]

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Cynicism is toxic

Cynics fool themselves by thinking they can’t be fooled.

The cynic imagines he’s guarding himself against being duped. He’s not naive, he’s worldly wise, so he’s not about to get taken in — but this psychic insulation comes at a price.

The cynic is cautious and mistrustful. Worst of all, the cynic by relying too much on his own counsel, saps the foundation of curiosity, which is the ability to be surprised.

While the ability to develop and sustain an open mind has obvious psychological value, neurologists now say that it’s also necessary for the health of the brain. Cynicism leads towards dementia.

One of the researchers in a new study suggests that the latest findings may offer insights on how to reduce the risks of dementia, yet that seems to imply that people might be less inclined to become cynical simply by knowing that its bad for their health. How are we to reduce the risks of becoming cynical in the first place?

One of the most disturbing findings of a recent Pew Research Center survey, Millenials in Adulthood, was this:

In response to a long-standing social science survey question, “Generally speaking, would you say that most people can be trusted or that you can’t be too careful in dealing with people,” just 19% of Millennials say most people can be trusted, compared with 31% of Gen Xers, 37% of Silents and 40% of Boomers.

While this trust deficit among Millennials no doubt has multiple causes, such as the socially fragmented nature of our digital world, I don’t believe that there has ever before been a generation so thoroughly trained in fear. Beneath cynicism lurks fear.

The fear may have calmed greatly since the days of post-9/11 hysteria, yet it has not gone away. It’s the background noise of American life. It might no longer be focused so strongly on terrorism, since there are plenty of other reasons to fear — some baseless, some over-stated, and some underestimated. But the aggregation of all these fears produces a pervasive mistrust of life.

ScienceDaily: People with high levels of cynical distrust may be more likely to develop dementia, according to a study published in the May 28, 2014, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Cynical distrust, which is defined as the belief that others are mainly motivated by selfish concerns, has been associated with other health problems, such as heart disease. This is the first study to look at the relationship between cynicism and dementia.

“These results add to the evidence that people’s view on life and personality may have an impact on their health,” said study author Anna-Maija Tolppanen, PhD, of the University of Eastern Finland in Kuopio. “Understanding how a personality trait like cynicism affects risk for dementia might provide us with important insights on how to reduce risks for dementia.”

For the study, 1,449 people with an average age of 71 were given tests for dementia and a questionnaire to measure their level of cynicism. The questionnaire has been shown to be reliable, and people’s scores tend to remain stable over periods of several years. People are asked how much they agree with statements such as “I think most people would lie to get ahead,” “It is safer to trust nobody” and “Most people will use somewhat unfair reasons to gain profit or an advantage rather than lose it.” Based on their scores, participants were grouped in low, moderate and high levels of cynical distrust.

A total of 622 people completed two tests for dementia, with the last one an average of eight years after the study started. During that time, 46 people were diagnosed with dementia. Once researchers adjusted for other factors that could affect dementia risk, such as high blood pressure, high cholesterol and smoking, people with high levels of cynical distrust were three times more likely to develop dementia than people with low levels of cynicism. Of the 164 people with high levels of cynicism, 14 people developed dementia, compared to nine of the 212 people with low levels of cynicism.

The study also looked at whether people with high levels of cynicism were more likely to die sooner than people with low levels of cynicism. A total of 1,146 people were included in this part of the analysis, and 361 people died during the average of 10 years of follow-up. High cynicism was initially associated with earlier death, but after researchers accounted for factors such as socioeconomic status, behaviors such as smoking and health status, there was no longer any link between cynicism and earlier death.

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