Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Help Fight The NIH Budget Cuts

Many of my regular readers may know that biomedical research in the United States is largely funded by the National Institutes of Health (NIH). Please see this message from Dr. William Talman, president of the Federation of American Societies for Experimental Biology (FASEB), about proposed spending cuts to the NIH budget. Grant funding from the NIH is already hard to come by, and the proposed budget cuts will make it even harder.

Whether you are a scientist, a student, or a member of the public interested in the future of science and medicine, I join with Dr. Talman in asking you to call your congressional representatives and ask them to oppose HR1. Also, if you have a blog I’d ask you to repost Dr. Talman’s call to action so that your readers can join in.

Dear Colleague,

For months the new House leadership has been promising to cut billions in federal funding in fiscal year (FY) 2011. Later this week the House will try to make the rhetoric a reality by voting on HR 1, a “continuing resolution” (CR) that would cut NIH funding by $1.6 billion (5.2%) BELOW the current level – reducing the budget for medical research to $29.4 billion!

We must rally everyone – researchers, trainees, lab personnel – in the scientific community to protest these draconian cuts. Please go to this FASEB link for instructions on how to call your Representative’s Washington, DC office today! Urge him/her to oppose the cuts to NIH and vote against HR 1. Once you’ve made the call, let us know how it went by sending a short email to the address provided in the call instructions and forward the alert link to your colleagues. We must explain to our Representatives how cuts to NIH will have a devastating impact on their constituents!

Sincerely,

William T. Talman, MD
FASEB President

*This blog post was originally published at The Brain Confounds Everything*

A Giant Artificial Gut

What do you do when you’re one of the world’s biggest food companies and you’re looking to explore what happens after your products get chewed and swallowed? Apparently you build a large refrigerator-sized, million dollar model of a human gut, complete with valves, injection ports for enzymes, and a transparent window for visibility, of course.

Nestle, in their quest to create foods that trick your body into feeling even more satisfied after eating than you otherwise would be, has a research and development center that holds this artificial gut, tucked next to the mountains in Lausanne, Switzerland. Here they’re busy studying and trying to commercialize gastrointestinal phenomenon such as the “ileal break,” a peptidal feedback mechanism that both slows transit through the GI system and reduces food intake by triggering feelings of satiation. They hope to release products based on this science within five years.

From the Wall Street Journal:

Tracking the movement of food in a person’s gastrointestinal tract isn’t easy. So at a “digestion lab”—part of Nestle’s sprawling research and development center here—scientists use a million-dollar model of the human gut.

The machine is about the size of a large refrigerator. It has several compartments linked by valves, and it is carefully calibrated to the body’s temperature. The entire setup is controlled by a computer. The front is glass, allowing observers to watch as food travels through the system.

On a recent day, the “stomach” section at the top slowly squeezed and churned a salt solution, just like the real thing. The liquefied result then wended its way down the other tubes, representing other sections of the digestive tract. At each stage, tiny valves released the appropriate salt, bile and enzymes, which helped to digest the food.

The question still stands: What comes out the other end?

The Wall Street Journal article: Hungry? Your Stomach Really Does Have a Mind of Its Own…

*This blog post was originally published at Medgadget*

The Physical And Metaphorical Heart

Listening to NPR on Saturday morning I caught part of Scott Simon’s interview with brothers Stephen Amidon and Thomas Amidon, M.D. discussing their book “The Sublime Engine: A Biography of the Human Heart.” The interview touched on the story of the human heart in science and medicine, history, and culture: 

It turns out that the classic red heart symbol we see almost everywhere around Valentine’s Day doesn’t look much like a real human heart at all.

“Of all the theories about where that symbol comes from, my favorite is that it is a representation of a sixth century B.C. aphrodisiac from northern Africa,” says Stephen Amidon…”And I kind of like that history because it sort of suggests that early on, people sort of understood the connection between love and the heart.”

Words and how we use them were the focus of Dr. Pauline Chen’s interview by WIHI host Madge Kaplan this past Thursday, February 10th, “A Legible Prescription for Health“:

On this edition of WIHI, Dr. Chen wants to spend some time talking about language, especially the words doctors use with one another when describing patients; the unintended barriers created the more doctors and nurses don protective, infection-protecting garb; the mounting weight of patient satisfaction surveys; and more.

Back to the NPR interview on the human heart as a “sublime engine,” the authors don’t feel that as our advances in surgical techniques become commonplace that the heart will lose any of its cultural and metaphorical significance. Read more »

*This blog post was originally published at Suture for a Living*

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*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles