Another slice of cake?

I'm watching CBS 60 minutes with Dr Sanjay Gupta telling us how sugar is poisonous and speaking to a doctor who is recommending that men eat less that 150 calories worth of added sugar per day, while women eat less than 100.  The report is interesting; the effects of just s sip of soda stimulates the same part of the brain as hard drugs like cocaine, and continued consumption of sugar lead to a tolerance similar to that experienced by drug addicts. In other words, the more  you eat, the more you are driven to eat.  The chemical at the heart of this is not picky.  However we get dopamine to release from brain cells, be in sex, drugs or rock and roll or now... sugar, we are driven to need more.   OK, so we eat a lot of sugar. So what?  As long as we reduce our fats, red meats, bacon, chips etc, we are basically OK- correct?  As long as we control our weight somewhat, and lay off the chips we should be fine- right? Not even remotely.  A study being discussed on the show, took young adults and carefully controlled their diets for a period of time while monitoring their physiology and biochemistry.  They had blood drawn and were scanned throughout the study period which had them eating a non-added-sugar diet for the first few days of the study, followed by a diet with 25% of their calories in the form of sugar; still a relatively low amount of sugar by American standards (on average we consume about a third of a pound a day).  Blood samples were drawn every 30 minutes and the added- sugar consumers showed significant increases in small dense LDL cholesterol (the bad kind that clogs the arteries) within two weeks of eating the diet with 25% sugar.   For those old enough, you might remember that in the 70s the government restricted fat in the diet.
There was a short term benefit, likely due to increased awareness of dietary causes of disease and the number of people who reduced their intake of saturated fates.  However, the effect was not sustained.  Doctors not he show suggested we have replaced that fat with carbohydrates, and refined sugar in particular.  As one researcher pointed out, food without fat tastes like cardboard, so the food industry upped the sugar content to keeps palates satisfied.  Now, cardiovascular disease is back on the increase and our children may be the first generation to have a lower life expectancy that their parents.

So the sugar in our diet does as least as much harm to our cardiovascular health as fat, and maybe more. But the story doesn't end there.  Obvious effects of increased sugar are obesity, metabolic syndrome, and diabetes, and all of these diseases have peripheral effects.  Less obvious is the effect of sugar on some cancers. Because sugar stimulates increases in insulin, it also catalyzed the growth of certain types of cancers.  Almost a third of common human cancers contain insulin receptors that circulating sugar latches onto and triggers the tumor cells to take up the glucose to use for cell growth.  Basically the tumor cells highjack our blood sugar and uses it to feed itself and grow.  Exactly whether the sugars in the blood cause the tumor to begin or just nudge it along once it has become established makes no difference.  Sugar is good news for cancer, and bad news for us.

There is much more to the sugar story that I'll save for other blogs but as we think about how to balance our diets, it's worth thinking about the role of the food industry in our food choices.  Since I still have the TV on, I'm catching a few ads I haven't seen before.  In one, Con Agra is encouraging us to buy their products and is promising one meal for a hungry child for ever specially marked package we buy.  This sounds incredible and I am sure there is good will behind the gesture. Certainly, there are too many hungry kids in America today. However, the foods that Con Agra is asking us to buy includes Snack Paks, frozen chicken nuggets, Chef Boyardee and others, all of which are high in sugar.  We buy and eat a package of processed food that will go a little way towards poisoning us (some might think that's too strong a word but based on what I have read and hear, I don't think so) and in return Con Agra will feed a child.  Does this make anyone wonder exactly how they will be feeing that child?

And finally, as I complete this blog, I just saw a fantastic commercial on the TV with a diverse group of vibrant people stripping open their coats and cardigans to unveil bright red shirts with 'I'm unique', I'm A Vailable, I'm a dreamer....etc, as they run, walk, dance, around some city. It seemed like such a positive commercial, celebrating all that is good in the world- courage, difference, creativity.  Imagine my disappointment when I realized what the ad was for.   Dr Pepper.  Ugh.

Health advances-not so fast

A section of New York Magazine, June 16th 2008, begins with the words, ‘medicine advances at astonishing speeds’. It’s a profound statement but is it accurate? Of course it depends on what you mean by astonishing speed, but I think medicine progresses quite slowly considering the rate at which we accumulate new insights into disease and it’s potential treatments. We hypothesis and test at an alarming rate, but it can take an interminably long time for a new medicine to reach the pharmacy, or for a medical paradigm to shift. Take the Human Genome Project for example. This was a 13-year old project coordinated by the National Institutes of Health and the US dept of energy. Multiple countries participated as did the Wellcome Trust, a premier UK research foundation. Much was made of the effort which identified most of the 12-25,000 genes estimated to make up the human genome, and determined the sequence of the 3 billion chemical base bases that make up human DNA. (ref: www.ornl.gov/sci/techresources/Human_Genome/home.shtml). As it neared completion, widespread anticipation grew among the general public about the slew of medicines that would surely follow the last gene identified. We are now 5 years on and there is little to show for it in terms of medical breakthroughs. The NIH itself admits that the analyses of the data will continue for many years. The most obvious outcome to date is the availability of a relatively cheap way to get a genetic profile for those that are brave enough. Even this though, is not a definitive depiction of the future for those that take the test. Genes are rarely deterministic, depending on environmental conditions to trigger and support their directives to vulnerable cells and systems. Some companies that administer the tests also supply the putative nutritional safeguards that go along with each potential risk, playing on the fears of the patient and pocketing the rewards as a result. Not that genetic testing is bad; rather that it needs to be kept in perspective. Knowing your genetic risk can be a good thing if the risk is well characterized and there are things you can do to off-set the disease. For most genetic risks, that is not the case. Human physiology in health and disease is fascinating and complicated and inherently unique. Understanding the interactions of genes with each other and the environment in which they operate requires lengthy research and analysis. We should learn to set our expectations. Accumulation of observations is indeed fabulously fast. But translation to, and acceptance of, real benefit will always be, by comparison, painstakingly slow.

Welcome to the Future Health Trends Blog

Our health environment is changing as information becomes more available about diseases, treatments and the effects of our own body's characteristics on the effects of both.  There is so much information out there, in fact, that we can get bogged down answering even the simplest of questions when we turn to the internet, the TV or media.  The problem with the ubiquity of information is that not all information is relevant to each one of us, and the trick is to understand what is meaningful in our own context, and what is not.

Science and technology has been quite reductionist for a while. For several centuries in fact.  Now, however, we are recognizing that the power of science and technology can only be increased by integrating with the arts and the humanities. It is at the intersections of art and science that true discoveries are often made. This blog is intended to explore the future of health and medicine from the perspective that integrative approaches to health and wellness are better than linear, discipline based approaches.  We will also report on key developments that stand to improve access and effectiveness of diagnostics and treatments based on the understanding of individual physiological, psychological and socioeconomic characteristics.