December 21st, 2012 by admin in Opinion, Research
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I hate scientific studies that don’t investigate the assumptions on which they’re based. They do harm. The findings slither around and get into the heads of people who treat people for the issues the research purports to understand. And the misconceptions become protocol. Here’s one example:
The Journal of Epidemiology and Community Health published an article declaring a connection between childlessness and increased risk of death and mental illness.
Among the findings:
- Having a child cut the risk of early death, particularly among women.
- The early death rate from circulatory disease, cancers, and accidents among childless women was four times as high as that among those who gave birth to their own child, and 50% lower among women who adopted.
- Similarly, rates of death were around twice as high among men who did not become parents, either biologically or through adoption.
- The prevalence of mental illness in couples who adopted kids was around half that of other parents.
What the study states but doesn’t investigate is that for their research they used: “population-based health and social registers, we conducted a follow-up study of 21 276 childless couples in in vitro fertility treatment.”
Do you hear the sound of “WHAT!??!” beginning to reverberate?
Might it be that couples who have been living in the infertility system for months, maybe years and have had their original life script expectations erased, have had doctors and drugs and timetables invade their intimate time, have spent gobs of money, and have had repeated cycles of devastating disappointment may be in a very different state than couples who have CHOSEN not to have children?
And let me state my assumption up front. Choosing not to have children is not dysfunctional. It’s not a psychological condition. It’s not an ethical/moral lapse. It’s not a sign of immaturity or selfishness. It’s a legitimate choice.
It may be that the researchers’ findings do apply to couples who undergo infertility treatment in order to have a child.
But there is harm in assuming that all couples who don’t have children are at higher risk for death and mental illness.
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This post originally appeared at Barbara’s blog, In Sickness As In Health.
December 17th, 2012 by admin in Quackery Exposed
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Miracles are pretty rare events. Except on television’s “Dr. Oz Show,” where they appear with astonishing frequency. Oz of course doesn’t claim to raise the dead or part the Red Sea, but he does raise people’s hopes of parting with their flab. And he’s certainly not shy about flinging the word “miracle” about. But it seems miracles fade as quickly as they appear. Raspberry ketones, acai berries and African mango, once hyped as amazing “fat busters,” have already given way to newer wonders.
Granted, Dr. Oz, or more likely his producers, do not pull miracles out of an empty hat. They generally manage to toss in a smattering of stunted facts that they then nurture into some pretty tall tales. Like the ones about chlorogenic acid or Garcinia cambogia causing effortless weight loss. The former piqued the public’s interest when the great Oz introduced green coffee bean extract as the next diet sensation. Actually “chlorogenic acid” is not a single compound, but rather a family of closely related compounds found in green plants, which perhaps surprisingly, contain no chlorine atoms. The name derives from the Greek “chloro” for pale green and “genic” means “give rise to.” (The element chlorine is a pale green gas, hence its name.)
An “unprecedented” breakthrough, Dr, Oz curiously announced, apparently having forgotten all about his previous weight-control miracles. This time the “staggering” results originate from a study of green coffee bean extract by Dr. Joe Vinson, a respected chemist at the University of Scranton who has a long-standing interest in antioxidants, such as chlorogenic acid. Aware of the fact that chlorogenic acid had been shown to influence glucose and fat metabolism in mice, Vinson speculated that it might have some effect on humans as well. Since chlorogenic acid content is reduced by roasting, a green bean extracts was chosen for the study.
In cooperation with colleagues in India who had access to volunteers, Dr. Vinson designed a trial whereby overweight subjects were given, in random order, for periods of six weeks each, either a daily dose of 1,050 mg of green coffee bean extract, a lower dosage of 700 mg, or a placebo. Between each six-week phase there was a two-week “washout” period during which the participants took no supplements. There was no dietary intervention; the average daily calorie intake was about 2,400. Participants burned roughly 400 calories a day with exercise. On average there was a loss of about a third of a kilogram per week. Interesting, but hardly “staggering.” And there are caveats galore.
The study involved only eight men and eight women, which amounts to a statistically weak sample. Diet was self-reported, a notoriously unreliable method. The subjects were not really blinded since the high dose regimen involved three pills, the lower dose only two. A perusal of the results also shows some curious features. For example, in the group that took placebo for the first six weeks, there was an 8 kilogram weight loss during the placebo and washout phase, but almost no further loss during the high dose and low dose phases. By the time, though, that critics reacted to Oz’s glowing account, overweight people were already panting their way to the health food store to pick up some green coffee bean extract that might or might not contain the amount of chlorogenic acid declared on the label. As for Dr. Oz, he had already moved on to his next “revolutionary” product, Garcinia cambogia, unabashedly describing it as the “Holy Grail” of weight loss.
We were actually treated to the Grail in action. Sort of. Dr. Oz, with guest Dr. Julie Chen, performed a demonstration using a plastic contraption with a balloon inside that was supposed to represent the liver. A white liquid, supposedly a sugar solution, was poured in, causing the balloon, representing a fat cell, to swell. Then a valve was closed, and as more liquid was introduced, it went into a different chamber, marked “energy.” The message was that the valve represents Garcinia extract, which prevents the buildup of fat in fat cells. While playing with balloons and a plastic liver may make for entertaining television, it makes for pretty skimpy science.
Contrary to Dr. Oz’s introduction that “you are hearing it here first,” there is nothing new about Garcinia. There’s no breakthrough, no fresh research, no “revolutionary” discovery. In the weight control field, Garcinia cambogia is old hat. Extracts of the rind of this small pumpkin-shaped Asian fruit have long been used in “natural weight loss supplements” Why? Because in theory, they could have an effect.
The rind of the fruit, sometimes called a tamarind, is rich in hydroxycitric acid (HCA), a substance with biological activity that can be related to weight loss. Laboratory experiments indicate that HCA can interfere with an enzyme that plays a role in converting excess sugar into fat, as well as with enzymes that break down complex carbohydrates to simple sugars that are readily absorbed. Furthermore, there are suggestions that Garcinia extract stimulates serotonin release which can lead to appetite suppression.
Laboratory results that point toward possible weight loss don’t mean much until they are confirmed by proper human trials. And there have been some. Fifteen years ago a randomized trial involving 135 subjects who took either a placebo or a Garcinia extract equivalent to 1500 mg of HCA a day for three months, showed no difference in weight loss between the groups. A more recent trial involving 86 overweight people taking either two grams of extract or placebo for ten weeks echoed those results. In-between these two major studies there were several others, some of which did show a weight loss of about one kilogram over a couple of months, but these either had few subjects or lacked a control group. Basically, it is clear that if there is any weight loss attributed to Garcinia cambogia, it is virtually insignificant. But there may be something else attributed to the supplement, namely kidney problems. Although incidence is rare, even one is an excess when the chance of a benefit is so small. So Garcinia cambogia, like green coffee bean extract, can hardly be called a miracle. But it seems Dr. Oz puts his facts on a diet when it comes to fattening up his television ratings.
joe.schwarcz@mcgill.ca
Joe Schwarcz is director of McGill University’s Office for Science & Society (mcgill.ca/oss). He hosts The Dr. Joe Show on CJAD Radio 800 AM every Sunday from 3 to 4 p.m.
December 4th, 2012 by admin in Health Tips, Humor, Research
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In my last post I told you that I would reveal the one thing you can do to have a significant, positive and lasting effect on your brain health as you get older. See if you can spot it in the following list:
a) Learn to dance Gangnam style
b) Join a choir
c) Catch a wave
d) Pump some iron
Ok, that was a trick question. All of these answers are somewhat correct, but I was looking for the “most” correct answer (flashbacks to undergrad, anyone?): Pump some iron.
I realize I sound like a broken record – I’ve already written about how aerobic exercise can promote healthy aging here and here, and I’ve even already written about resistance training, or lifting weights, here.
So why am I at it again? Because it’s important!
I’m fresh out of the 2012 Aging and Society Conference, where researchers came together to discuss what works and what doesn’t when it comes to healthy aging. It turns out everyone pretty much agrees that exercise is hands down the most effective intervention to keep your brain cells happy into old(er) age. All sorts of different types of exercise, ranging from simply walking to attending resistance training classes, are associated with different types of improvements in cognition, memory, and even brain size.
Of course, there are different levels of effort involved with different types of exercise, or even when talking about a single form of exercise. When my friend Jess asks me to go for a walk, she means a power walk: it usually involves going up hills, sweating like a pig (even though pigs, ironically, don’t sweat much), and barely having enough breath for girl talk (though somehow we always seem to find it). When my friend Al and I go for a walk, what he means is a “mosey”: we stop to look at the view, pet the dog, chit chat with strangers, and have more than enough breath for lengthy discussions about life, work, and the possibility of alien lifeforms. When it comes to brain health, whether you’re walking or pumping iron, a little sweating and effort can go a long way. For example, resistance training has been proven to be most effective when the load, or how much weight you are working with, increases over time. So kick the intensity up a notch: there will still be plenty of time for chit chat around a post-exercise, antioxidant-rich mug of matcha (my new obsession – stay tuned).
Now that the obvious has been (re)stated, I want to take this opportunity to discuss the idea that perhaps lifestyle interventions such as exercise could be prescribed by your doctor. We know that exercise can improve cognition in aging but also conditions like depression. Should physicians prescribe lifestyle changes? Or are diet, exercise, and other lifestyle activities choices we should make ourselves? How would you feel if your doctor prescribed you exercise instead of pills? Would you be more motivated to exercise if the prescription came from your doctor instead of from your friendly Internet science blogger? Your thoughts in the comments!
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Dr. Julie Robillard is a neuroscientist, neuroethicist and science writer. You can find her blog at scientificchick.com.
November 26th, 2012 by admin in Quackery Exposed, True Stories
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What did the jockey who never lost a race whisper into the horse’s ear? “Roses are red, violets are blue, Horses that lose are made into glue!” OK, so it’s a groaner. But until the advent of polyvinyl acetate (PVA) and other synthetic glues in the twentieth century, the destiny of aging horses was indeed the glue factory. The collagen extracted from their hides, connective tissues and hooves made for an ideal wood adhesive. Our word “collagen” for the group of proteins found in these tissues actually derives from the Greek “kolla” for “glue.”
Not all aging horses were dispatched to the glue factory after their plow-pulling days came to an end. Some farmers found they could squeeze a little more profit out of the animals by assigning them another duty. They would become leech collectors! The elderly horses were driven into swampy waters only to emerge coated with the little bloodsucking worms. It seems the creatures found horses to be a particularly tasty treat! Since for many people suffering from various ailments, the little parasites were just what the doctor ordered, the harvesting of leeches made for a lucrative business.
Leeches have actually been used in medicine since they were first introduced around 1500 BC by the Indian sage Sushruta, one of the founders of the Hindu system of traditional medicine known as “Ayurveda.” That translates from the Sanskrit as “knowledge of life.” Sushruta recommended that leeches be used for skin diseases and for various musculoskeletal pains. Ancient Egyptian doctors extended the indications, treating headaches, ear infections and even hemorrhoids in this peculiar fashion. Galen, the famous Roman physician, used leeches to balance the four “humors,” namely blood, phlegm, black bile and yellow bile. Swollen, red skin, for example, was thought to be due to too much blood in the body and the answer was to have leeches slurp the excess.
Curiously, despite having no evidence for efficacy, bloodletting, either with leeches or by making an incision with a “lancet,” became part of standard medical practice for more than 2500 years! Monks, priests and barbers got into the act along with physicians. In 1799 George Washington had more than half his blood drained in ten hours, certainly hastening his demise.
Many British doctors preferred leeches, especially in areas around the mouth, ears and eyes where lancing was a tricky procedure. They even learned how to encourage a leech to bite by stimulating its appetite with sugar or alcohol. But the creatures were in short supply, and had to be imported by the millions from France, Germany, Poland and Australia where they were often caught in nets using liver as bait. Sometimes poor children earned a little extra money by wading into infested waters to emerge, like the horses, with leeches attached to their legs. A gentle tug or a pass with a flame then relaxed the bloodsucker’s grip before much damage ensued. Good thing, because leeches can be pretty nasty once they latch on. Remember Humphrey Bogart flailing about in African Queen while trying to rid himself of the little vampires?
The lack of leeches caused some physicians to explore recycling techniques. Usually a single leech becomes satiated after filling up on about 15 milliliters of blood and then falls off. But then if it is plunked into salt water, it will disgorge the blood and is soon ready for another round. A German physician even developed a technique to encourage continued sucking by making an incision in the leech’s abdomen allowing for the ingested blood to drain out as fast as it came in. It seems the leech wasn’t much bothered by this affront to its belly and would go on sucking for hours. Amazingly, leeches were sometimes used internally. To treat swollen tonsils, a leech with a silk thread passed through its body would be lowered down the throat and withdrawn when it had finished its meal. Sometimes the creatures were even introduced into the vagina to treat various “female complaints.” The literature is vague about how this was done but one account suggests that the technique required a clever nurse.
While bloodletting as a general treatment for ailments has been drained out of the modern medicine chest, there is still work for leeches. That’s because their saliva is a complex chemical mix of pain killers and anticoagulants. Hirudin, for example, is the protein that keeps the blood flowing steadily after the initial bite is made, and is so effective that the blood will not coagulate for quite some time even after the leech falls off. Indeed, these bloodsucking aquatic worms have received approval from the U.S. Food and Drug Agency as a “medical device.”
Surgeons have been known to use leeches after reattaching ears, eyelids or fingers that have been severed, as well as after skin grafts. This has to do with the fact that arteries are easy to reconnect but veins are not. Eventually new capillaries do form to reconnect veins, but in the meantime the finger or ear fills with blood which then clots and causes problems with circulation. A leech will drain the excess blood at just the right rate and can prevent blood clot formation by injecting hirudin. This is such a potent anticoagulant that it holds hope for dissolving blood clots after a heart attack or stroke. Unfortunately hirudin is too difficult to extract from leeches but can potentially be produced through genetic engineering techniques.
Where do physicians get leeches today? No need for horses. They can order them directly from the French firm Ricarimpex. One would think that after helping to save a finger or an ear the useful little critters would be rewarded. But their destiny is death in a bucket of bleach. Not any better than ending up in a glue factory.
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Joe Schwarcz, Ph.D., is the Director of McGill University’s Office for Science and Society and teaches a variety of courses in McGill’s Chemistry Department and in the Faculty of Medicine with emphasis on health issues, including aspects of “Alternative Medicine”. He is well known for his informative and entertaining public lectures on topics ranging from the chemistry of love to the science of aging. Using stage magic to make scientific points is one of his specialties.
November 15th, 2012 by admin in Health Tips
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Can we “train” our brains to be brighter, sharper, faster?
A while back I wrote a post about a big study looking at “brain training”. The researchers wanted to know whether training programs that look like video games (like Brain Age andLumosity) could significantly improve brain performance on various tests. The results, in a nutshell, showed that while participants improved on the tasks they trained on (e.g., if the game involved ranking balls from smallest to biggest, the participants got *really* good at ranking balls from smallest to biggest), the improvement didn’t carry over to general brain function.Turns out ranking ball sizes doesn’t help you remember where you left your keys this morning.
Two years later, what’s the word?
I’m going to shift a little from how I normally do things (review a single article) and tell you about findings I learned about at the recent Aging and Society conference. At the conference, several researchers talked about brain training in the context of aging. We know that as we get older our cognitive abilities decline – we forget names and words, misplace our shopping lists, and process information a little bit more slowly. Wouldn’t it be fantastic if we could just spend ten minutes a day playing games on our iPad and successfully counter this decline? Of course it would be fantastic. Not just for us, but also for the companies who are trying very hard to convince us to buy their products to improve our cognition.
The problem is that skills are specific. If you want to become a fabulous jazz pianist, you have to play the piano (preferably jazz songs, too). If you want to become a star ballet dancer, you have to practice ballet. If you want to become a better mountain biker, you have to mountain bike – road biking will improve your leg strength and fitness, but ultimately it won’t make you a better mountain biker. So why should things be any different for brain skills?
As it turns out, they aren’t. Two years later, nearly all the research conducted in the field of brain training is turning up the same results: people only get better at the tasks they trained on – the improvement doesn’t cross over to more general skills, different skills, or everyday life. In one study, a researcher compared a commercially available brain training program with what she called an “active control” – a group that simply played regular video games like Tetris. She found that the group who spent time on the commercially available brain training program actually saw some aspects of their cognition decline compared with the control group. Bummer.
Now don’t throw out your Brain Age game yet – everyone at the conference agreed that engaging your brain in training programs is better than not doing anything. And most of the researchers felt that while the programs don’t work now, it’s not to say they’ll never work. We are increasingly more knowledgeable about how the brain works, what happens when we get old, and what different training tasks do. So it’s quite possible that sometime in the near-ish future (don’t ask me when) we could see the advent of brain training programs that do have a significant and lasting impact on cognition.
Until then, there is one thing you can do to have a significant and lasting impact on your brain health… And I’ll tell you in the next post.
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Dr. Julie Robillard is a neuroscientist, neuroethicist and science writer. You can find her blog at scientificchick.com.
