Health

Personalized Life Extension Conference 2012

Posted by Peter on April 8, 2012
Posted in: Health. Tagged: , .

The Personalized Life Extension Conference 2012 presented lots of ideas, with occasionally some science to back them up.

A lot of the advice backed up by the best science won’t be followed. In spite of the title of Brian Delaney’s Calorie Restriction talk, he didn’t have a solution to the problem of feeling hungry. When Max Peto reminded us of the dangers of sitting, the percentage of people who remained seated only dropped from maybe 97 to 95. There were vendors pushing food that had higher than optimal sugar content, and I think at least one pusher had some success.

I’ve been cutting back drastically on my vitamin/supplement consumption, and Stephen Spindler’s talk (arguing that most apparently good results in other animals were due to supplements inducing calorie restriction) has me thinking about cutting back farther to just fish oil and vitamin D.

The telomere guys still haven’t come up with a good theory for why evolution didn’t do the apparently easy thing and make some telomerase available to non stem cells, so I’m still assuming there’s some tradeoff such as cancer.

The most interesting talk was by David Asprey, describing an “upgraded paleo” diet – high fat, with careful attention to the quality of the fat. He has more ideas than he has time to communicate them.

Unfortunately he seems too busy throwing out new opinions to document the evidence behind them (or maybe the evidence is hiding somewhere on his poorly organized website). But in most cases he has a plausible paleo-like theory, and I’m generally confident they’d be little worse than a placebo, so I’m trying some of them.

At the moment that involves consuming more of some paleo-like foods that I’d already been starting to add to my diet. Grass-fed (Kerrygold) butter is possibly the most important, and coconut products are also rather high on the list. The butter tastes better than my dim recollection of butter from malnourished grain-fed cows. Coconut milk works well as a substitute for milk in dishes such as chowder and cream of onion soup.

Josh Whiton had an intriguing idea about trying to get the benefits of calorie restriction via a very low protein diet once or twice a week (with a paleo-like diet the rest of the time).

Protein

Posted by Peter on December 7, 2011
Posted in: Health. Tagged: .

A protein rich diet may make us more alert and help us lose weight.

The reaction of Hypothalamic orexin/hypocretin neurons to amino acids (especially nonessential amino acids) appears to be a mechanism for this effect.

Poultry products appear to be one of the better ways to get nonessential amino acids.

I’ve been trying to increase the protein in my diet for the past four months (in response to weaker evidence than I’ve linked to here), and have found that animal sources have been the easiest way to do that (I’ve mainly increased my egg and meat consumption). I think I’ve found it slightly easier to avoid gaining weight. I think I’ve also been more alert, but I don’t think the increase in alertness coincided too closely with the increase in protein consumption.

Assorted Links

Posted by Peter on February 2, 2011
Posted in: Health, The Human Mind. Tagged: .

Trans-fats in commonly sold plant oils

Posted by Peter on January 20, 2011
Posted in: Health. Tagged: .

There seem to be serious risks in some food oils that are commonly considered healthy. This report says:

hexane processing strips the remaining nutrients from the oil, and turns a significant quantity of polyunsaturated fats into inflammatory, artery-clogging trans fats!

Hexane processing is apparently common for Canola oil, soybean oil, and other plant-based oils (but not olive oil). Trans-fat levels have been measured at 0.56 to 4.2 percent in commercial oils.

Since FDA-regulated labels are only accurate to about 0.5 grams, and oils are often labeled for 14g serving sizes, a 1 or 2 percent trans-fat content would apparently show up as zero. I suspect those levels are more harmful than most additives that the FDA has banned from foods.

The bottled Canola oil I buy from Trader Joe’s says it’s expeller pressed – no solvents used, so I’m still guessing it’s healthy, but I’ll try harder to avoid processed foods containing plant oils. (There a lot of misleading arguments against Canola oil that should be ignored).

Doctors and Smart Drugs

Posted by Peter on December 23, 2010
Posted in: Health, The Human Mind.

Doctors are more willing to prescribe Viagra than cognitive enhancement drugs.

Why?

The report wonders whether it’s due to conservative tendencies among doctors. But Viagra and Modafinil both became available in the U.S. in 1998. Conservatism doesn’t explain why doctors are slower to accept Modafinil than Viagra. Although maybe combined with more patients asking for Viagra it would be plausible.

Concern over side effects might explain why doctors are less comfortable with Ritalin, but not why three different cognitive enhancing drugs all produced similar comfort levels – about half that of Viagra. And I see no signs that Modafinil is much riskier than Viagra.

Could it be concern that Viagra has an equalizing effect (making people more normal), whereas cognitive enhancers make people who can afford them smarter than the less fortunate? Partly – doctors were more willing to prescribe cognitive enhancers for older patients than younger ones. But the cross-drug comparisons were done for a case where “the patient was a 40-year-old reporting symptoms consistent with the label indications for the respective drug”. I’m pretty sure the label indications describe a patient who is functioning well below normal.

The obvious conclusion part of what’s happening is that doctors believe sex produces larger benefits than cognitive enhancement. If we ignore potentially important externalities such as sexually transmitted diseases versus improved science/technology (would doctors admit to doing that?), I could make a decent case for sex being more valuable. There’s no shortage of evidence that sex makes people happy, whereas there seems to be little or no correlation between cognitive ability and happiness.

(HT YourBrainonDrugs.net).

Counterclockwise

Posted by Peter on December 15, 2010
Posted in: Book Reviews, Health, The Human Mind. Tagged: , .

Book review: Counterclockwise: Mindful Health and the Power of Possibility, by Ellen J. Langer.

This book presents ideas about how attitudes and beliefs can alter our health and physical abilities.

The book’s name comes from a 1979 study that the author performed that made nursing home residents act and look younger by putting them in an environment that reminded them of earlier days and by treating them as capable of doing more than most expected they could do.

One odd comment she makes is the there were no known measures of aging other than chronological age at the time of the 1979 study. She goes on to imply that little has changed since then – but it took me little effort to find info about a 1991 book Biomarkers which made a serious attempt at filling this void.

She disputes claims such as those popularized by Atul Gawande that teaching doctors to act more like machines (following checklists) will improve medical practice. She’s concerned that reducing the diversity of medical opinions will reduce our ability to benefit from getting a second opinion that could detect a mistake in the original diagnosis, and cites evidence that North Carolina residents have an unusually high tendency to seek second opinions, and also have signs of better health. But this only tells me that with little use of checklists, getting a second opinion is valuable. That doesn’t say much about whether adopting a culture of using checklists is better than adopting a culture of seeking second opinions. The North Carolina evidence doesn’t suggest a large enough health benefit to provide much competition with the evidence for checklists.

One surprising report is that cultures with positive views of aging seem to produce older people who have better memory than other cultures. It’s not clear what the causal mechanism is, but with the evidence coming from groups as different as mainland Chinese and deaf Americans, it seems likely that the beliefs cause the better memory rather than the better memory causing the beliefs.

Two interesting quotes from the book:

certainty is a cruel mindset

to tell us we’re “terminal” may be a self-fulfilling prophecy. There are no records of how often doctors have been correct or not after making this prediction.

The bacterial part of our bodies

Posted by Peter on November 3, 2010
Posted in: Health.

Some quotes from Bacteria ‘R’ Us:

the vast majority — estimated by many scientists at 90 percent — of the cells in what you think of as your body are actually bacteria

researchers describe bacteria that communicate in sophisticated ways, take concerted action, influence human physiology, alter human thinking and work together to bioengineer the environment. These findings may foreshadow new medical procedures that encourage bacterial participation in human health.

Many researchers are coming to view such diseases as manifestations of imbalance in the ecology of the microbes inhabiting the human body. If further evidence bears this out, medicine is about to undergo a profound paradigm shift, and medical treatment could regularly involve kindness to microbes.

bacteria “have to have a reason to hurt you.” Surgery is just such a reason.

bacteria that have antibiotic-resistance genes advertise the fact, attracting other bacteria shopping for those genes; the latter then emit pheromones to signal their willingness to close the deal. These phenomena, Herbert Levine’s group argues, reveal a capacity for language long considered unique to humans.

Doctor/Hospital ratings

Posted by Peter on October 14, 2010
Posted in: Health, U.S. Politics.

Despite strong opposition, a little progress is being made at informing consumers about medical quality and prices.

Healthcare Blue Book has some info about normal prices for standard procedures.

Healthgrades has some information about which hospitals produce the best outcomes (although more of the site seems devoted to patient ratings of doctors, which probably don’t make much distinction between rudeness and killing the patient).

Insurers are trying to create rating systems, but reports are vague about what they’re rating.

One objection to ratings is that

such measures can be wrong more than 25 percent of the time

A 25 percent error rate sounds like a valuable improvement over the current near-blind guesses that consumers currently make. Does anyone think that info such as years of experience, university attended, or ability to make reassuring rhetoric produces an error rate in as low as 25 percent? Do medical malpractice suits catch the majority of poor doctors without targeting many good ones? (There are some complications due to some insurers wanting to combine quality of outcome ratings with cost ratings – those ought to be available separately). Are there better ways of evaluating which doctors produce healthy results that haven’t been publicized?

More likely, doctors want us to believe that we should just trust them rather than try to evaluate their quality. I might consider that if I could see that the profession was aggressively expelling those who make simple, deadly mistakes such as failing to wash their hands between touching patients.

Medical Tourism Seasteads

Posted by Peter on October 28, 2009
Posted in: Freedom, Health. Tagged: .

How can a hospital-like business operating outside of existing territorial jurisdictions avoid harrassment by governments whose medical lobbies want to spread FUD?

Given that these businesses will initially have no track record to point to and less protection than existing medical tourism providers from whatever government provides a flag of convenience to the business, merely providing comparable quality medical care won’t be enough for such businesses to thrive. So I’m proposing practices which could enable those businesses to argue that current U.S. hospitals are more dangerous. I’m not suggesting this just for marketing purposes – I want safe hospitals to be available, and regulatory costs in the U.S. make it easier to start an innovative hospital offshore than in the U.S. (especially for types of innovation that don’t respect doctors’ prestige).

It has been known since 1847 that doctors kill patients by failing to wash their hands often enough. Yet this threat is still common. An offshore hospital could offer patients documentation showing when medical personel who touch the patient washed their hands (e.g. by providing the patient with video recordings of the procedures sufficient for the patient to verify cleanliness), with a double your money back guarantee. There are many other less common errors that patients could use such videos to check for.

The book Counting Sheep argues that hospitals often impair patients’ health by disturbing their sleep. Paying patients if night-time noise or light levels exceed some pre-specified limits should reduce this problem.

Next, I want the hospital’s fee structure to give it increased incentives to avoid failure. For procedures with objectively measurable results, I want the hospital to charge the patient only if those results are achieved, and to pay the patient some pre-specified amount if results leave the patient measurably worse off. (For hard to measure results such as change in pain, this approach won’t work).

The article You Get What You Pay For: Result-Based Compensation for Health Care has more extensive discussion of incentives and of strategies that hospitals might use to reduce the rate at which they harm patients.