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Three R’s Of Health And Wellness

I’d like to talk about how rodents, relationships, and riding relate to overall health and wellness.

This idea comes from a nicely-written New York Times piece entitled, “Does Loneliness Reduce the Benefits of Exercise?” Here, Gretchen Reynolds reviews a few intriguing studies about how relationships may affect exercise, stress hormone levels, and intelligence. The combo caught my eye.

Anyone who pays attention to wellness knows that exercise produces more flexible arteries, more durable hearts, and leaner body shapes. These benefits are obvious, and honestly, sometimes a bit tiresome to write about.

To me, a far more interesting — and lesser known — benefit of regular exercise is that it might make us smarter. Here’s where the rodents come into the story.

As was summarized in the New York Times piece, when researchers allowed rats and mice access to running wheels they observed (a) that they all ran, and (b) those rats that did run scored better on rodent IQ tests, and actually grew more brain cells. This is a striking finding because nerve cells — unlike blood, GI and skin cells, which turnover rapidly — grow very slowly, if at all.

But that’s not the entire story. The Princeton researchers wanted to know whether the rat’s social relationships could have measurable biologic effects.

It turns out that rodents — like humans — are quite social. So social, in fact, that in these trials the brain-growing effect of exercise was blunted when rodents lived alone. Compared to rats and mice that lived in groups, those that were kept in isolation failed to grow new nerve cells in response to exercise. And importantly, isolated rats produced higher levels of stress hormones than those who lived in groups, even though both groups ran the same distance. Read more »

*This blog post was originally published at Dr John M*

Mind-Over-Matter In Medicine

[Recently] I came upon a Jan 24 op-ed, “A Fighting Spirit Won’t Change Your Life” by Richard Sloan, Ph.D., of Columbia University’s psychiatry department. Somehow I’d missed this worthwhile piece on the sometimes-trendy notion of mind-over-matter in healing and medicine.

Sloan opens with aftermath of the Tucson shootings:

…Representative Giffords’s husband describes her as a “fighter,” and no doubt she is one. Whether her recovery has anything to do with a fighting spirit, however, is another matter entirely.

He jumps quickly through a history of the mind cure movement in America: From Phineas Quimby’s concept of illness as a product of mistaken beliefs — to William James and “New Thought” ideas — to Norman Vincent Peale’s 1952 “Power of Positive Thinking“ – to more current takes on the matter. These ideas, while popular, are not reality-based.

In his words:

But there’s no evidence to back up the idea that an upbeat attitude can prevent any illness or help someone recover from one more readily. On the contrary, a recently completed study* of nearly 60,000 people in Finland and Sweden who were followed for almost 30 years found no significant association between personality traits and the likelihood of developing or surviving cancer. Cancer doesn’t care if we’re good or bad, virtuous or vicious, compassionate or inconsiderate. Neither does heart disease or AIDS or any other illness or injury.

*Am. J. Epidemiol. (2010) 172 (4): 377–385.

The New York Times printed several letters in response, most of which point to pseudo-evidence on the matter. All the more reason to bolster public education in the U.S. — people won’t be persuaded by charismatic, wishful thinking about healthcare.

It happens I’m a fan of Joan Didion’s. I was so taken by the “Year of Magical Thinking,” in fact, that I read it twice. Irrational responses — and hope — are normal human responses to illness, disappointment, and personal loss. But they’re not science. It’s important to keep it straight.

*This blog post was originally published at Medical Lessons*

At-Home Psychotherapy For The Super Bowl FAN (Football Attention Neurosis)

So it’s Super Bowl Sunday and the fans are psychiatric patients waiting to happen — the beer and the beer and the beer, and maybe the fights will break out, and they’ll all end up in therapy. Oh, the angst and the panic, and the pre-game anxiety, and the post-game euphoria or depression.

New York Times reporter Benedict Carey talks about treatment options in his article, ”A Home Treatment Kit for Super Bowl Suffering.” Mr. Carey suggests:

Breathing exercises are highly recommended and become increasingly important as the football contest nears the fourth quarter, when events on the field are likely to prompt strong physiological reactions, like a pounding heart, hyperventilation, even dizziness. These internal cues, as they’re called, can escalate the feeling of panic, a self-reinforcing cycle resulting in groans and cries that can be frightening to small children, pets and sometimes neighbors.

In the final minutes of the game, be forewarned: Many patients will move beyond the reach of therapy. Their faces may change, their breathing appear to stop. Researchers have not determined whether this state is closer to Buddhist meditation or to the experience of freefall from an airplane. All that is known is that, once in it, patients will fall back on primal coping methods, behaviors learned in childhood within the cultural context of their family.

Like emitting screams. Or leaping in an animated way, as if the floor were on fire. Or falling on their back and moving their arms and legs like an overturned beetle, in celebratory fashion.

This post is dedicated to my husband and son.

*This blog post was originally published at Shrink Rap*

Abortion Doesn’t Cause Mental Illness

Here’s yet another study showing that abortion does NOT lead to future psychiatric problems. From The New York Times:

The New England Journal of Medicine has taken on one of the pillar arguments in the abortion debate, asking whether having the procedure increases a woman’s risk of mental-health problems and concluding that it doesn’t. In fact, researchers found, having a baby brings a far higher risk.

The study, by Danish scientists (and financed in part by the Susan Thompson Buffett Foundation, which supports research on abortion rights), is the most extensive of its kind to date. It studied 365,550 Danish women who had an abortion or gave birth for the first time between 1995 and 2007. Of those, 84,620 terminated their pregnancies and 280,930 gave birth.

In the year after an abortion, 15.2 out of 1,000 sought psychiatric help (defined as admission to a hospital or clinic), which was essentially the same as the rate of that group (14.6 per 1,000) in the nine months before the abortion. In contrast, among women who went on to give birth, the rate at which they sought treatment increased to 6.7 per 1,000 after delivery from 3.9 per 1,000 before.

Why do first-time mothers have a lower overall rate of mental illness both before and after pregnancy than those who choose termination? The researchers suggest that those who have abortions are more likely to have emotional problems in the first place. Compared with the group who give birth, those who have abortions are also statistically more likely to be struggling economically, and to have a higher rate of unintended pregnancies.

And why do first-time mothers seem to nearly double their risk in the year after giving birth? That is likely to have something to do with the hormonal changes, decreased sleep, and increased stress of parenting, which women who terminate do not experience.

Can we please talk about something else? Like maybe how to help these young women with the issues and unmet contraceptive needs that led to unplanned pregnancy in the first place?

*This blog post was originally published at The Blog That Ate Manhattan*

Stress In Life: Respond Differently And Live Longer?

“This job is killing me” is not a statement of jest. It is a desperate plea of outright sincerity.

Stress, anxiety, depression — all have been associated with an increased risk of cardiovascular disease and mortality. But can interventions to help people cope with stress positively affect longevity and decrease risk of dying? The results of a new study in the Archives of Internal Medicine would imply the answer is an encouraging “yes.”

Constructively dealing with stress is easier said than done, but it would seem logical that if we can reduce our psychological and social stressors we might live longer and delay the inevitable wear and tear on our vessels. This study proved that one such intervention, cognitive behavioral therapy (CBT) for patients who suffered a first heart attack, lowered the risk of fatal and nonfatal recurrent cardiovascular disease events by 41 percent over eight years. Nonfatal heart attacks were almost cut in half. Excitement may be dampened by the fact that all-cause mortality did not statistically differ between the intervention and control groups, but did trend towards an improvement in the eight years of follow up.

Definitely less suffering. Maybe less deaths.

The authors state that psychosocial stressors have been shown to account for an astounding 30 percent of the attributable risk of having a heart attack. Chronic stressors include low socioeconomic status, low social support, marital problems, and work distress. Emotional factors also correlated with cardiovascular disease include major depression, hostility, anger, and anxiety. Read more »

*This blog post was originally published at The Examining Room of Dr. Charles*

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