Archive for August, 2011

Can there be long Life without Life?

Tuesday, August 30th, 2011

A "fountain with Youth" that's real

I was reading two articles, in our local paper last weekend when I realized I was channeling Yogi Berra and his famous quote, "It's déjà vu all over again. What's happened is a return to Herodotes, the Greek historian (5th century BCE) who told of a fountain in Ethiopia responsible for extraordinary lifespan and to Ponce de Leon, the Spanish explorer who traveled on Columbus' second voyage (1493) and described the Fountain of Youth, supposedly found in Florida.

Now we have a huge contingent of baby boomers (estimates in the 70 million range) who are about to reach 65 and don't want to grow or look older. The market for anti-aging remedies is currently about $80 billion a year and is expected to top $110 billion in the next four or five years. We live in a society that worships youth and many of our compatriots are being sold magic potions that some claim will prevent aging or at least most of its signs.

One of the articles had an amazing photo of Dr. Jeffrey S.Life, age 72, a body builder and author of a book titled The Life Plan: How Any Man Can Achieve Lasting Health, Great Sex and a Stronger, Leaner Body. You can buy this $26 book for $14.94 on Amazon, but I think I'll skip it.

Dr. Life's program includes diet, exercise and a healthy lifestyle; it also features, for at least some of his patients, injections of human growth hormone (at roughly $15,000 a year) plus testosterone.

The data on these hormone replacement regimens is, to say the least, not as rock solid as Dr. Life's toned torso. The NIH has a division called the National Institute On Aging (see link below), and the Geriatrician who heads this organization is solidly against widespread use of hormone replacement therapies.

What makes sense to me is exercising regularly, staying lean (or getting there) and stopping smoking. I noted that Dr Life's mentor died at age 69, a long ways short of my physician Dad's 94-year lifespan. Dad ran most days until his late 70s, stayed trim and quit smoking as a young doc when he realized he had three cigarettes going in three ashtrays in his three-room office.

lots of these out there

I think many baby boomers and others would like to find a magic bullet, a tonic or elixer that would allow them to eat what they want, do what they want and live to 100.

Until you show me a long-term, controlled study that points that way, I think we're as shy of the Fountain of Youth as we were in the days of Ponce de Leon or Herodotes.

Eat less and spend your money on a health club membership or a pair of running shoes instead.

Dengue fever; global warming effects versus a new hope

Friday, August 26th, 2011

avoid at all costs

I haven't thought about Dengue Fever in years, probably since I returned from an Air Force tour of duty in the Philippines in 1986. Now global warming and a fascinating NPR tidbit brought it back to the forefront of my consciousness.

Dengue, a major cause of illness and death in the tropics and subtropics, is a viral illness spread by mosquitoes. Worldwide it causes up to 100 million infections and 25,000 deaths per year. The typical result is a high fever, headache, muscle/joint/bone pain and a rash. There is no effective vaccine available and avoidance of mosquito bites is the most effective preventive strategy.

So why am I concerned enough about dengue to bring it to your attention? Simple, we're traveling more, cases have been seen in Florida, Texas and Hawaii; it's an endemic disease in Puerto Rico and, with our climate heating up, I'm concerned that we may see the disease spreading further in the United States and elsewhere. I'll add a link to information on dengue from the NIH's PubMed website.

There's another concern; more than 5% of Key West residents monitored in a 2009 study had antibodies to the one of the four viruses that cause dengue. That puts them at risk for a much more severe form of the disease if they're bitten by a mosquito carrying a different dengue virus than they were first exposed to.

Dengue hemorrhagic fever is a serious problem, though relatively uncommon. It can lead to a generalized rash, bruising and bleeding and, potentially to a shock-like state, liver and brain damage, and seizures. Early diagnosis and aggressive care measures  can improve survival rates, but half of untreated patients who go into shock die.

Most physicians in the US probably have never seen a case of dengue hemorrhagic fever. I have, in the Philippines, but that was the result of working there for a year and a half. So bringing this disease to the attention of doctors (and potential patients) in locations that previously haven't seen dengue makes sense to me.

the old way to control mosquitoes

But now for the good news. Research scientists in Australia recently released specially-bred mosquitoes, infected with a bacteria that is a parasitic microbe, seen in roughly a sixth of other neotropical insects. Apparently Wolbachia-infected mosquitoes will not spread dengue to humans, but when allowed to intermingle with uninfected mosquitoes, results, in a relative brief period, in those insects also being unable to spread the disease. The article on these experiments came out in Nature, online on the 24th and in print yesterday.

Now it's time for large-scale projects in multiple countries, but it looks like dengue may finally have met its match.





Beating the heat by using the new data:

Tuesday, August 23rd, 2011

Ready, set, eat well

A recent article in The Wall Street Journal described how the Houston Texans professional football team is using data I read in the Archieves of Internal Medicine online to improve player safety. The Texans are facing some of our worst summer heat and are going to extraordinary lengths to prevent heat-related injury.

I'm not at all sure I agree with their stategem, practicing in triple-digit weather outdoors in the full sun. Their theory is that doing so helps their players remain fresh in the heat of early-season games. Other teams have opted for temperature-controlled practice arenas or night-time workouts or cooler climes.

We'll wait and see the results, but at least they're using the latest medical research and some practical concepts.

Players are weighed pre-practice and afterwards (the team, collectively, lost an incredible average of 450 pounds per two-hour session one week). That's in spite of replacement fluids and ice to the tune of 100 gallons of water, 50 cases of Gatorade and three quarters of a ton of ice for ninety men. One three-hundred-plus tackle lost seven pounds and had to receive IV fluids.

The Archives  article and a subsequent Harvard Heart Letter detailed research and historical perspective. Our intake of sodium, in table salt and foods, is important, but the ratio of how much sodium to potassium in our diets may be even more crucial.

An older edition of the Harvard Heart Letter compared our modern diet to that of our primitive ancestors. Paleolithic man consumed sixteen times as much potassium (in milligrams) as sodium; today our typical diet has nearly five times as much sodium and less than a quarter of the potassium as the hunter-gatherers ate, so the ratio has marked changed.

lots of potassium in this bunch

So how do you return to a healthier diet, in those terms. Well, a banana, for instance has over 400 milligrams of potassium and almost no sodium (1 milligram). An orange has over 230 times as much potassium as sodium, steamed Brussels sprouts 35 times as much (I mean in milligrams in all cases, so scientifically my comparisons are ratios).

The Texan's head dietician and senior trainer are altering the team's diet, using lots (and I mean lots) of electrolyte-containing vegetables and fluids. They even formed a players' food committee to make sure the team members would have choices that they would like. Southerners want okra and potatoes, so that's what they get. The team members were concerned about blood pressure effects from all the salt they're getting; then they heard how the new research showed foods high in potassium and other electrolytes can balance out the effects of sodium.

The proof is in the pudding is the old saying; we'll see how the Houston team does when the season starts.

But I can certainly see the sense behind their approach.


A better school lunch: Greeley in the New York Times Breaking News

Saturday, August 20th, 2011

It's time for a better school lunch

I was reading the NYT breaking news on my Kindle this morning, when to my surprise I saw an article, "Schools Restore Fresh Cooking to the Cafeteria," on school lunches in Greeley, Colorado. We live 20-25 miles northwest of Greeley and I'd never thought of the city as being a hotbed of innovation.

At a tad under 93,000 inhabitants, Greeley is mid-sized at best, but 60% of its 19,500 students qualify for lower-priced or free meals, so they have decided those meals will be healthy ones.They're not alone in this endeavor. The Physicians Committee for Responsible Medicine has a campaign whose motto is,"Foods served in schools should promote the health of all children." Their 2008 school lunch report card ranked twenty school districts across the nation with letter grades from A to F.

Here's that URL:

At the top with A's were schools in Montogomery County, MD, Omaha, NE, and Pinellas County, FL, I was pleased that my grandson Jordi's schools in Fairfax County, VA got an A-.  At the bottom were schools in two areas of Louisiana. I bet Greeley will climb up the list in the next few years.

So what's their plan? Like many Colorado schools, they've participated in Cooks for America, a group that runs a chef's boot camp for school cooks  Here's what that organization's website says: "Distinguishing the Cook for America® approach from that of countless other school food reform projects is its emphasis on holistic, systemic change through the creation of a school foodservice work force that is both capable of preparing healthy scratch-cooked meals from whole, fresh foods, and empowered and motivated to do so."

Greeley schools will be cooking from scratch, roughly three-fourths of the time at the start of this school year according to the NYT article, and aim to reach 100% in the 2012-2013 time frame. They'll be using fresh ingredients, avoiding chemicals (e.g., their bean burritos will have 12 ingredients this year versus 35 last year).

Although Colorado has the lowest obesity rate in the nation, Weld County, where Greeley is located, had rates growing faster than much of the state. So the numbers were crunched with amazing results: cooking from scratch will actually save money. A large foundation grant helped with construction and new equipment and the old central kitchen was renovated, so the budget for staff was actually reduced.

Chenically-colored macaroni and cheese

The district hired an experienced executive chef who trained at the Culinary Institute of America (the other CIA) and worked in high-end restaurants. He hopes his concepts for healthy cooking will wend their way back to the districts homes. One of his innovative ideas is to replace the chemically-colored commercial macaroni and cheese with a version whose familiar yellow will come from the Indian spice turmeric. His salad dressing will have no sugar and only a quarter of the sodium that's been present in the factory-made variety.

My hat's off to Greeley.


Antibiotics for Food-Producing Animals, Part Two

Tuesday, August 16th, 2011

This turkey could end up as ground meat

The August 13th edition of The Wall Street Journal contained an article extending the discussion of the recent ground-turkey-related disease outbreak and the routine use of antibiotics in animals raised as food. It noted that the FDA has been reviewing the subject for 40+ years without issuing firm restrictions, supposedly because of a lack of data on resultant health risks in people.

There's a long, long pattern of recommendations coming from scientific panels without any conclusive followup by the FDA or the USDA. The history of these committees and advisory groups is well documented in a Health and Human Services paper I found online and will briefly summarize. I'll provide a link for your own perusal if you get interested in reading more on the subject.

In 1968 the UK started a Joint Committee on the Use of Antibiotics in Animal Husbandry and Veterinary Medicine . The "Swann report" presented to Parliament the following year concluded "that the administration of antimicrobials to food-producing animals, particularly at sub-therapeutic levels, poses a hazard to human and animal health."

That seemed clear-cut to me. The report said that the increase in antibiotic-resistant enteric (intestinal) bacteria of animal origin resulted from the use of those drugs for growth promotion of farm animals.

enteric bacteria in their home turf

Since then, there have been a number of "expert panels" and task forces, both in the United States and elsewhere that have reached essentially the same conclusions. What's lacking is any large study (preferably more than one)  showing a direct connection between antibiotics being given to entire herds and resultant human illness. There has been a lot of "indirect evidence" implicating the widespread use of these drugs in animals as a potential human health hazard.

The animals in question, typically turkeys, chickens, cattle or pigs, are  not being treated for specific diseases. They are, en masse, given antibiotics in their feed or water, primarily to increase their weight gain (and thus their profitability for the companies raising them).

A spokeswoman for the National Turkey Federation was quoted as saying, "Antibiotics have been safely used on farms...for half a century to treat and control disease in animals and to improve the animal's (sic) overall health, allowing for greater productivity."

The article in The Wall Street Journal said, "Industry groups are cautious about regulation." They feel human health may actually be improved by the longstanding practice of antibiotics being added to feed and that meat prices are lower becuase the animals use less energy fighting disease and therefore grow faster.

Now six members of Congress asked the FDA to actually implement the proposed rules. After all, it's only been 40+ years and a number of outbreaks since the concept has first been proposed. There was another recall in April 2011, this one of ~55,000 pounds of ground turkey.

It's about time to tighten up the rules.

Beating the Heat

Friday, August 12th, 2011

Cooling down

We've been away for a short vacation with our eleven-year-old grandson at Harry Potter Wizarding World in Orlando. It was hot and humid much of the time, although the frequent rain storms helped cool things off.  One of the reasons we moved from the San Antonio area to Colorado after retiring from the Air Force was the heat. My comment in the late 1990s was, "Texas has Summer and the other three days."

I grew up in Wisconsin, my wife in Montana, and although we lived in a number of locales during each of our 20+ years as USAF officers, most of them were in warmer climates. We wanted four seasons in our retirement location and we certainly have them now.

Florida brought back memories of my years in Texas; sixteen of my twenty-three active duty years were spent there. So the article in the August 2, 2011 edition of The Wall Street Journal titled "Spotting and Taming Signs of Heatstroke" caught my attention.

I've had very little experience with heatstroke, but considerable dealings with heat exhaustion, a milder manifestation of heat-related illness. A lot of that was with basic military recruits, many of whom moved to their initial Air Force training from cooler places. Most of my own exercise these days during the summer months is in an indoor setting, so I'm at somewhat lesser risk in spite of being seventy.

Heatstroke killed over 3,000 Americans from 1997 to 2007 and the National Weather Service statistics said 138 in 2010 and at least 64 in thus far in 2011 died from heat-related illnesses. In some years heat causes more deaths than hurricanes or floods, the other major weather-linked agents of fatalities.

Games offer less risk than practice

Hydration, hydration, hydration is a major, but not infallible preventive step with water being ranked as good as sports drinks according to a co-author of the American College of Sports Medicine' guidelines. High-school and college football players, who suffer the majority of heat-related sports deaths, need rest breaks, shade, and water, especially during practice, according to that expert who had his own brush with heatstroke in 1985 during a 10K race. During the games themselves, he says, rest breaks are built in.

Along with athletes (and infants left in a hot car), older adults are at high risk, especially those with underlying diseases treated with medications that can worsen the severity of the reaction to heat.

Treatment of heatstroke is a medical emergency, so early diagnosis is critical. Look for confusion, irrational speech, skin that is red, hot and dry, rapid pulse, throbbing headache, dizziness  and nausea; some of those casualties become unconscious. Call 911 and get the victim into the shade.

Beyond that lies controversy with some professional groups recommending cooling the afflicted person as rapidly as possible in a cold or ice-water bath, others such as the American Heart Association suggesting fanning and sponge-bathing the person or misting them with cool water, rather than ice water.

Looking at online news articles, I think we may break records this year for heat-associated illness and deaths.


Turkey, anyone?

Thursday, August 4th, 2011

Delicious if cooked correctly; potentially deadly otherwise

Last evening I was reading The New York Times breaking news on my Kindle. I scanned several articles and then read "Linked to Outbreak." This morning the same topic was reported on the second page of The Wall Street Journal.

In brief, the Cargill company has recalled 36 million pounds of ground turkey, both fresh and frozen, believed linked to 79 illnesses and one death (so far) from contamination with the bacteria salmonella, in this case a strain of the common organism that is markedly antibiotic resistant. They've shut down one of their plants, in Arkansas, and says that's been the only one of their four turkey-producing plants involved.

That rang an alarm since I knew they had a plant in Fort Morgan, Colorado, roughly 80 miles east, where my in-laws live. I Googled Cargill and noticed there's even a branch here in Fort Collins. I found out the local branch is a research organization developing new forms of canola oil, but the Fort Morgan branch is a meat processing entity.

So I found background information on salmonella. One helpful website is a USDA Q&A four-page Fact Sheet. It mentions that salmonella bacteria are among the most common causes of foodborne illness, what we often term as "food poisoning." I'll paste in the link below, but wanted to mention some interesting background facts.

In Federal testing ten to fifteen percent of ground turkey is contaminated with salmonella and more than three fourths of those bacteria are resistant to at least one kind of antibiotic, since our current practice in raising food animals is to routinely give them drugs to prevent illness and, supposedly, to promote growth.

Katic Couric has a CBS News article online (see link below) where in February 2010 she explored the question Is "Animal Antibiotic Overuse Hurting Humans?" That story centered on MRSA, a drug-resistant staph strain that has become a major problem in and outside hospitals.

But the discussion veered off to the routine antibiotic use in other factory farm animals. One veterinarian said not every animal gets antibiotics on these huge farms, but drug distributors and dozens of farm workers in four farm belt states -Iowa, Missouri, Arkansas, and Oklahoma - said antibiotic use to promote growth is widespread on factory farms.

So what can and should we be doing in our own kitchens?

First thing is to be aware that cross contamination can occur; in other words when you're preparing raw turkey meat, your hands, utensils and cutting boards can help spread the bacteria to other foods.

learn to use this correctly

Then you need to thoroughly cook these meat products, an internal temperature of 165 degrees measured with an accurate meat thermometer should be sufficient to kill salmonella, according to several government sources.

Leftovers have to be properly stored, within an hour if the ambient temperature is 90 or above, in a refrigerator at 40 degrees or below. I leave a thermometer in our refrigerator and check the temp every time I open the door. I also make sure it's fully shut after I put food in for storage.

That's a brief overview; check the links for more information.


Drinking and driving

Wednesday, August 3rd, 2011

lots of choices, all with alcohol

Twenty-four years ago I was the brand new Deputy Chief of Staff at our largest Air Force medical center. My counterpart at the Army's hospital across town called and asked if I'd like to attend a party. I said, "Sure, what's the occasion?"

His commander had just gotten a second star and, as a new major general, would be moving to DC soon. His immediate boss was going to get the one-star job running the medical center. That never happened. I don't know the exact details, but was told one drink too many led to an off-color comment to the wrong person and then to a lost opportunity.

I got sensitized, through this episode, to drinking at events and, of course, to drinking and driving. I was in a culture where wine and beer flowed freely at parties, but decided I'd be a one-drink person. My wife and I were outliers sometimes; a friend who was a fellow commander when I moved up to lead a small hospital once told me, "I got picked up CWI last night."

"I know what DWI means; what's CWI?"

He replied, "Crawling while intoxicated." Actually he was joking, while telling his story of leaving a party at the commanding general's home and feeling unsteady while slowly walking to his own quarters, two houses down.

The Wall Street Journal on July 2, 2011, had an article titled "Testing the Limits of Tipsy." Our US legal limit for driving used to be a blood alcohol concentration (BAC) of 0.15%; now it's 0.08%. In much of Europe it's 0.05%; in India it's 0,03% and in China it's 0.02%. That exceedingly low BAC limit may turn out to be the most realistic, especially on crowded streets and roads.

But the results can be bad, even to metal bodies

Our alcohol-related traffic fatalities have fallen by 50% since 1980, but still account for one-third of all deaths on the highway. Your BAC after drinking depends on a number of factors: your weight, age, prior drinking history, rate of consumption, if you're also eating (consuming food may slow absorption of alcohol, but some foods help more than others) and menstrual cycle (women apparently metabolize alcohol a little more rapidly just after ovulating).

Once you've absorbed alcohol, your BAC falls roughly 0.015% per hour (for either gender), so it may take a long time to reach a "safe" level, if there is such a thing. As you age your liver tends to metabolize alcohol more slowly; on the other hand, an elevated BAC may affect younger brains more adversely.

Having read this, I'll plan to continue our long-standing policy: when we go to a function one of us is the "designated drinker," and usually has only one drink at that. The other is the designated driver. We've occasionally each had a glass of an event where we'll be eating and not driving for a number of hours. It may be time to re-evaluate that policy.

On holidays like New Years Eve, when we know others will be drinking more than we do, we get off the roads early.