A quiet spot by the river.

Without mental health there can be no true physical health“… WHO Director-General Dr Brock Chisholm, 1954

In Nov the UK govt released their #ThrivingAtWork report, showing 330 thousand people lose their jobs per year due to chronic mental health problems – at an annual cost of nearly one billion pounds. Depression, and alcohol abuse are also linked to anxiety about losing one’s job. It’s recommended that workplaces:
• Produce, implement and communicate a
mental health at work plan;
• Encourage open conversations about
mental health and the support available
when employees are struggling;
• Provide employees with good working
conditions and ensure they have a healthy
work life balance and opportunities for
development;
• Routinely monitor employee mental health
and wellbeing.
‘Monitoring’ health might seem intrusive. Yet checks such as Blood Pressure, blood sugar, or BMI haven’t resulted in career risk – rather, they’re investments in staff longevity. So this is all good*, and indeed focuses on the neglected aspect of the bio(psycho)-social model of mental wellbeing, ie the environment we find ourselves in. This redresses medicine’s emphasis upon biological causes in illness, with resultant treatment by frequently harmful medications. Instead, a regulatory stick comes down on unsafe employers, using Health & Safety Executive inspectors to review work pressure as is done for OH&S risk. Victoria’s WorkSafe will launch an informational resource program in 2018 also. Advocates such as BeyondBlue have made great inroads to removing the stigma that surrounds mental illness and its exacerbation by a toxic workplace, but are these campaigns really helpful to sufferer’s wellbeing? What if it’s better to cut your losses and quit, than to Soldier On? Why are you even in this busyness?

“Camouflage”

Dr Stephen Carbone from Beyond Blue commented on Australia’s rise to world #2 in antidepressant usage with spin: “You could argue we are ahead of the game in raising public awareness and the destigmatisation of the conditions“. No worries, eh mate? The simple reality is, that the pharmaceutical industry is at hand, and seeking professional support will result in script for a medication. Just as cold & flu symptoms can be alleviated sufficiently to work, and infect your colleagues, anxiolytic eg Valium and anti-depressant usage is rampant. Wikipedia explains that until ’93, a distinction was made: “Endogenous depression was initially considered valuable as a means of diagnostic differentiation with reactive depression. While the latter’s onset could be attributed to adverse life events and treated with talk therapy, the former would indicate treatment with antidepressants”. But then the American Psychological Assn showed that meds are equally applicable in both situations, and this is what’s taught today (according to Prof Jayashri Kalkarni of Monash Alfred Psychiatry research centre).

Surprisingly, our over-consumption of antidepressants didn’t ring any alarms at the Drug Utilisation Sub-Committee of the PBS, which reviews anomalies in projected usage against actual prescriptions. The last ABS data is from 2011, showing 11% of Australians filled at least one script for a mental health medication. Mental health meds trends since are difficult to discern from the annual summaries, owing to DHS changes, but suffice to say that antidepressant usage grew 11% from 2013-15 (the last couple of reports available for N06A).

In psychotherapist James Davies book ‘The Importance of Suffering’ he writes: “emotional discontent… is not always something to be anaesthetised, feared or avoided, but is an experience which, if understood and managed correctly, can facilitate the important process of positive individual and/or social transformation.” That positive aspect is the hope for redemption, to quote Thomas Hardy’s poem ‘In Darkness’: “If a way to the better there be, it first exacts a full look at the worst“. Over a hundred years later the idea is salient but an industry has grown, like ivy over a garden, to hide our hurt. Somewhat oxymoronically, the August ’17 article ‘Why feeling pain is key to our happiness’ endorses medicated blocking of feeling thus:

ERIC VAN BEMMEL (University of Melbourne podcaster): “…antidepressants, things that would dull us from physical and emotional pain. So is that consumerism? We’re taking advantage of the technology that brings these drugs.
BROCK BASTIAN (UniMelb Psychologist): “When you come to painkillers I think that’s a slightly different thing. When things are there that can take the pain away, I mean we’re going to more often than not take the advantage of those. I certainly do for one, you’d be silly not to.”

“I don’t need to spend my money but still do”, Noddy from Slade in ‘Mama Weer All Crazee Now’

Block it out, fill it in. Davies went on to claim that intolerance of suffering creates the climate for abuse of antidepressants, addictive consumption, and frantic activity. Unsustainable spend increases our dependence upon work, a spiral to despair. Attitudes that cause working when it’s unhealthy, or medicating instead of adapting, or avoidance of solitude arise out of fearfulness of looking within. In ‘The Benefits of Boredom’ a psychologist points to the benefits for children’s creativity of leaving empty timeslots. Overstimulated kids are on their way to being ‘too busy’ adults, and encouraging a wandering mind is the first step towards a calm, still mind.

Buddhists see pain as just one manifestation of suffering. The steps of approaching, rather than avoiding, unpleasant feelings provided by mindfulness are being adopted by increasing numbers of health professionals. Looking inwards and understanding self will result in a greater sense of connectedness to others, where the support of community can be beneficial in many cultures. Less so in the modern, manic societies, where getting pilled is a worrying norm. A psychiatrist reviewer of Davies’ book Cracked finds it emotive in style,  but is impressed by the exploring of imperialism – harm done by exporting notions of distress as a biological malfunction into societies that had been functioning healthily.

The year is ending. Frenetic activity to finish up, followed by the glitz of Christmas will leave many aching for the summer break. Carole’s and my favourite spot is on a camping chair in the pools of the Yarra at Warrandyte. The question is, how to find this calm year-long?

 

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Be afraid, be very afraid

The heading is the tagline from Cronenberg’s 1986 The Fly, although not a typical horror genre – Geena Davis is horrified by the suffering of the charming Jeff Goldblum as he degenerates. Which doesn’t really segue into this blog’s theme, but is merely excusing a rip of the Cramps * …

In trying to make sense of the Trump era, it is prudent to recall history and Italy’s Berlusconi regime: being another real estate mogul bereft of decency nor having any comprehension of conflict-of-interest. A great philosopher and commentator on that time was Umberto Eco (b. 1932 d.2016) and his fame claim could have been from authoring ‘The Name of the Rose’, made into a movie starring Sean Connery, or else the novel ‘Foucaults Pendulum’. But for me, his essays revealed a timeless wisdom, and I’m drawn to the cyclical themes collected in ‘Turning Back the Clock’ (p. 2005). After expounding on neowar, that is, the asymmetric conflicts against stateless fanatics, his article ‘Back to the Seventies’ describes activities of the communist Red Brigades in particular: “terrorism aims to goad the government in power into hysterical repression, which the citizens will then find anti-democratic and unbearably dictatorial, and hence to spark an insurrection... actually they did a great deal to stabilize things, because a country in which all the political forces commit themselves to defending the state against terrorism has persuaded the opposition to be less aggressive“. No reasonable person or party can be against clampdowns on violence.

Leaders appear stronger when spouting age-old rhetoric such as Pericles used in starting Athens’ war against Sparta in 431BC: “the extension of [our father’s] empire is our work… For our trust is placed more in our boldness in action than in the preparation of defences and in trickery”. Although oppressed, in a lengthy speech the citizens are flattered for their unity, exhorted to follow tradition, and attack – when diplomacy would’ve avoided the consequent 27 years of war that destroyed Greece’s wealth. The domestic law’n’order tactic is played much more often than the ruling party’s popularity gamble of declaring war in some far-off place, but the matter of internal security is a win/win on both counts. The opposition is muted, and must begrudge their assent. All that’s required is a ploy for divisive fear within the community.

Govt ad “If you see something, say something” is a propaganda ruse used in both Obama’s post 9/11 America and in Victorian train stations (coincidentally the month before the 2014 state election!). What matters most is creating fearfulness in the populace, and dependence upon others’ political will to protect us. The railway PSO is a police resource devoted to the task of making us “feel safer“, and numbers are on the increase despite absence of statistics proving their worth. The rest of bureaucracy grows too. Total employees in the State empire grew by 3% last year, which in turn was up 2% on 2014/15. Safety per se isn’t actually on the govt agenda – else the populist demand for harm reduction to addicts by allowing a supervised injecting room in Melbourne would get the go-ahead. What drives policy is the public’s perception of safety, and in that case it behoves politicians desire for a climate of fear to keep drug users invisible, underground. Evidenced only by their damage caused, not the damaged user.

An amusing turn in this argument came from the photo below. Two thrillseekers, circled, went looking for adventure, and found it beyond the safety of Hotham resort, an unstable drift in Alpine backcountry. Emergency services issued a warning alert, and resorts are now tasked with routine avalanche monitoring. Obviously skiing is a risky sport, but focus should be on the real probability of an accident rather than a contrived danger. Risk management is formalised in standard ISO31000 – when both high likelihood of the risk being realised and a severe impact ensues, then mitigations must be found, or else imposed for your own safety. Govt doesn’t prioritise according to likelihood, but per suitability for their own cause.

Australia’s version of an avalanche

The point to be made, is that constantly being fearful does the great majority no good. There will be risk-takers seeking an adrenalin rush in every avenue of life, but responding to every risk with a protective policy simply exacerbates everyone’s tension. Travellers and locals alike have commented on the ‘nanny state’ in Australia, but there aren’t many nannies so obsessed with constantly warning on potential risk. If there are any, the infants in their charge are destined for therapy. Stress activates fight/flight response through the sympathetic nervous system and the hypothalamus-adrenal axis ramps up cortisol.  It’s harmful though. There was a time that the species being in constant tribal conflict required this hormone go into production ready for repairing battle damage, but now the prescribed therapeutic supply from prednisolone is minimised to as brief as possible – cortisol cures, but toxic side-effects are imminent (even if it’s just the suppression of natural synthesis when using the med.)

The media are very much complicit in scaremongering. The majority of news items aren’t reports, but speculation along the lines of “Fears rise that….”. Or there’s the A Current Affair/Today Tonight tagline in their promos of “A story no parent [taxpayer, motorist, sentient being] could afford to miss”. Why not give it a deliberate miss – since your health’s at stake?

* Psychobilly lost its pioneer Lux Interior in 2009. Bold, brazen, his band The Cramps creation of a musical genre is another expression of adventurous spirit. Best not totally suppress such stepping outside the boundaries, else we’d be all the same.

Gratatouille

The French are voracious carnivores and eat anything that runs, crawls, swims or flies. They’re particularly fond of all the nasty bits that civilised people reject including hoofs, ears, tails, brains, entrails … a flippant David Hampshire, ‘Living and Working in France’.

Tongue-in-cheek is a euphemism best avoided in Paris, where it may be interpreted as a request 😉 and not a form of ridicule. Yes, your gastronomic sensibilities will be challenged. But food is an utterly sensual delight here, more so than elsewhere, and taken very seriously. Surprisingly great food is affordably priced, since nobody in this egalitarian country would settle for less, and a higher standard becomes the norm. This applies equally to the staples as it does to refined dining, so leaving your mind open is advised – it’s all good. Swoon at the macaroons or devour baguettes, and be grateful for their fastidious focus on ingredients. I have only childhood memories of cantaloupe (rockmelon) of such quality in Oz.

In the animated movie the ultimate prize is achieved through comfort food, and the acerbic critic’s name Monsieur Ego is ironic. Ratatouille is a simple mashup of courgette (zucchini), aubergines (eggplant), tomato, etc and this rustic dish is reminiscent of the qualifying test for the chef in ‘The Hundred-Foot Journey’ – Hassan’s masala omelette. Furthermore, this blog is recall of Carole and my visit to Paris via India this year.

Ratatoille © Pixar 2007

Although we only had a few words of French, and spent most time in regional non-English speaking Bretagne/Normandy, we felt very much at home. Unless dealing with hordes of Anglo tourists the French were kindly, warmly welcoming, and anytime ‘Bonjour’ wasn’t sung out was anomalous (but being on a cycle did seem to be the endearing factor). Parisians too, were outgoing -it being summer, displaying gregarious appreciation of civic parks, and a neighbourliness that we portrayed to the Brits in ‘Neighbours’ on TV (but rarely display).

The TV phenomenon that is ‘Masterchef’ epidomises where we’ve gotten it wrong. Society should have moved on from gladiatorial battle over the last couple of thousand years, but animalistic survival of the fittest happens to be the armchair spectacle de jour. A pretentious pressure-cooker setting is however, an echo of the pomp that met its fate with the ultimate chopping block in 1793. Food is best savoured at leisure, and consumerist ‘wanting it now’ (if not sooner) is a bastardisation borne of insatiable demand for immediate gratification. Urgency is ill-advised in France, and it is rare to find a business in a French town open at lunchtime – which may run quite a long time. Food is social, is central to life.

The ‘Arrogant Frog’ stereotype is a farce. This is a society that has overturned an aloof aristocracy, and embraces all peoples. Being grateful for being in France surrounded by fabulous patisseries is much less arrogant than it is simply appreciating the privilege of a cuisine that excels. I must confess though, some dishes in France didn’t go down easily. Thanks for the memories, Blackadder. 

Wander in wonder

The aboriginal elder played by David Gulpilil tells Satellite Boy: “You are always running away – who are you?”
This is to an aimless kid on the edge of western society, suffering lost connection to traditional culture. He lives at a derelict drivein cinema, an apt consumerist image – replaced by the video and DVD store, and they in turn by broadband. Satellite Boy is a metaphor for being adrift among the stars, yet in the midst of the spectacle of the Milky Way.

Satellite Boy, Catriona McKenzie 2013

It’s a great movie, and of course his epiphany comes from a return to the land – even if he doesn’t leave where he is. Being present where you are is a mindfulness technique attributed to a Hindu, the Buddha, but has roots in all the spiritual traditions. Catholics St. Francis deSales and St. Ignatius lived meditative lives, seeing God in all things. The repetitive patterns of Islamic architecture reproduce God’s perfection, and rejoining broken parts gave us algebra الجبر from Persian moslem al-Khwarizmi. On the flip(pant) side, self-obsessive “every man for himself” makes for the perfect wandering joke in ‘A Fish Called Wanda’.

The Kevin Kline character is a buffoon, but Otto West’s thought undermines our precious unity. It’s an idea that, until recently, seemed attractive to the majority of Americans. Whether dharma or dogma, personal agendas have both shaped and distorted erstwhile pure messages throughout history. We must evolve. I’m midway through Buddhist Peace Fellowship’s teachings on anger management, U Mad? These people are revolutionary activists, taking a stand at Standing Rock, and publicly protesting conservative policies of greed. The course’s first interview was with a monk who discussed switching alms for arms in rageful times, which I found alarming, but then I haven’t suffered his persecution as a gay Afro-American.

The second was with Prof Rebecca Li, reminding us that anger is pain directed outwardly. It’s unhelpful to blame the Obama supporter turned Trump voter for what they did, while they struggled with the costs of the Affordable Healthcare Act. Their wishful thinking was fueled by one of the greatest conmen ever seen, and all that now remains is to deal with the consequences. Our immediate path has been chosen, there’s no running away, and more universal suffering will demand of us greater compassion.

Carole and I are off on ‘sabbatical’ next week. I couldn’t resist the airline’s offer of a ticket to Europe if only you’ll stopover in an India summer awhile. Which fitted in with an antiOxidants conference. Dharamsala will be interesting, for it’s one thing to have access to the teachings, but entirely another to experience the environment of Tibet’s refugees. See you in July, Geoff

Storm 2

Artist Sam Leach's 2010 winning portrait
Artist Sam Leach and his 2010 award winning portrait

When hardliners fight over what they believe to be in the best interests of clients, those who simply seek a wellness solution that meets their own needs, then we’re being no more helpful than superpowers bombing civilians so as to prove supremacy over each other.

Archibald portrait model Tim Minchin (shown in 2-dimensional form) is often quoted from his rant ‘Storm’, “Do you know what they call alternative medicine … That’s been proved to work? Medicine.” Storm is another guest at a dinner party, who commits the heretical crime of suggesting that the ‘human body is a mystery’. Deemed guilty by Tim, and having prior convictions (indicted by a butterfly tattoo), she’s fair game for ridicule.

From two generations of surgeons, Tim’s acquired a disposition toward bullying, and incited by her claim that Big Pharma is ‘immoral and driven by greed’ he launches a hilarious, albeit vicious attack – for our amusement.

He’s right, up to a point. An example is linked. In determining which holistic (i.e. considering mind and body jointly) therapies are beneficial in a chronic pain syndrome, the successful mindfulness study was classified as being psychotherapy. This despite the clinical trial being by a Dr Schubiner who’d studied under mindfulness pioneer Jon Kabat-Zinn at U.Massachusetts Med School, and his book ‘Unlearn Your Pain’ copied MBSR meditations. Proven success means it’s called medicine. Not alternative, allied health, or complementary. It’s mainstream. Mmm ‘kay!

Medicine is overly silo-based, and Integrative practitioners rare, so be very appreciative if your GP is holistic. Most doctors’ training drew demarcation lines at the base of skull. Do Not Cross!  Complementary/Alternative Med (CAM) therapies consider body & mind together, which means they’ve stolen a march on the physician who’s failed to keep up with advances in neuroscience. Including mind states in treatment regimes means that Complementary Medicine (CM) is better able to exploit the rapidly growing evidence base built with use of advanced fMRI techniques, or even consumer EEG devices.

Back to the poem attacking CAM as unscientific. After a potty-mouthed reference to the Pope, I take further exception to these lyrics ‘Let’s go watch Oprah, interview Deepak Chopra’. You’ll find that the sledged New Ager is actually relying on science. Harvard is just one of six Universities that his institute has tasked with testing as to whether meditation can reverse biological markers of aging. Deepak’s Ayurvedic founding could be laughed away as Eastern mysticism, or admired for its plain commonsense. One’s temperament (dosha) deserves consideration in therapy – be it airy, hot&cold, or earthy. Standby for catchup from your doctor. The newfangled proposal in medicine is to customise care to the patient, exploiting genetic profiling advances. Just … be … patient …

Going further, and beyond my comfort zone (having not read a horoscope in decades) there’s a cynical dismissal of Storm’s starsign – followed by Tim’s gloating endorsement of a pain pill, aspirin. This treebark derivative is oh-so very important in the early stages of a heart attack. It breaks up clots. This was proven beyond doubt in 1988 with a massive study published in the Lancet here, but just for fun, the cardiologists analysed birthdates as a factor. Oxford’s Peter Sleight found that this benefit wasn’t true for Gemini (inconsistent? Well, hellooo…!), and Librans (another contradictory sign). Me, I think that if your personality has been moulded to a certain disposition from birth, then you’ll end up behaving true to form. Like it or not, astrology provides an insight into how you’ll respond to a medication. I simply have to accept this science, even if it raises questions *. The facts are 1 in ten thousand that it’s a fluke conclusion (p=0.00001). But science which you choose not to believe in becomes a matter of faith, Tim.

Even more remarkable is the fact that it’s taken over a century for interest in willow bark to really take off. The NHMRC’s largest grant allocation is to ASPREE (aspirin for reducing events in the elderly), with each of its 13 substudies examining benefits for a single disease. Advances in medicine are rarely as cataclysmic as Catalyst (ABC TV) would have you believe. Too much hype is generated with each and every new insight, to help secure the funding for nurture of a new pill through its first dozen years. From the lab to the pharmacy is an arduous and expensive journey, which then leads onto longterm uncertainty about undesirable side effects. The pharmacovigilance movement, spearheaded by Professors Gotzsche (‘Deadly Medicines’) and Healy (‘Pharmageddon’), and Dr Goldacre (‘Bad Pharma’) comprises many industry insiders turned whistleblowers. The foundations of medical science aren’t quicksand, but nor are its truths set in stone.

A cheap shot is an easy one, since Minchin’s fans can readily recall stereotypes that endorse his posit. So let’s explode a myth. The most vocal perspectives from alternative health come from the anti-vax lobbyists. But often the truth is first casualty, and a systematic review in the journal ‘Vaccine’ of Aug 2016 breathes equanimity into opposing camps. Collating all articles that report on CM practitioner & advocates’ attitudes to childhood vaccination, no evidence was found indicating any association that may influence parental decision. Included studies ranged from 93% of chiropractors being either pro-vax or else unqualified to advise (Lee & Kemper 2000), to 76% of naturopathy users uninfluenced or deciding in favour of vax after practitioner discussions (Busse & Wilson 2011). Despite the confounding issue of selective immunisations instead of multijab, it’s already clear that CM doesn’t mean Closed Mind.

There’s no need for a divide in healthcare. Them or Us is a manufactured construct, which isn’t in the interests of the patient or client. It behoves no-one to sanctimoniously sneer at the opposition, as was evidenced by Health Minister Hennessy’s very public bullying by anti-vax trolls.

The take-home point is to choose carefully your dinner guests. Avoid smartarses. Storm rides out the insults with her dignity intact, drawing upon classical posits. Her Shakespeare quote switching ‘dreamt’ and ‘exist’ reflect the everyday phenomena studied by Horatio at Wittenberg Uni as being at odds with a talking ghost (Hamlet 1.5.167-8). Me, I rarely get to dine with company – but Carole is all I need.

* Biostatisticians out there will be aware that the principle at stake is subgroup analysis, condemned as anathema but exploited for their own purposes by Schultz, Chalmers and Altman in Feb 1995 Jnl of American Medical Assn. Only available in the original hardcopy. I was generously sent a copy by Doug Altman, whereupon I challenged his hypocrisy. No reply.

 

Connecting the dots

No man is an island, entire of itself…. Each man’s death diminishes me, for I am involved in mankind (John Donne, 1624)

Connected
Connected

Einstein was of the same mind in writing: “A human being is a part of the whole, called by us ‘Universe’, a part limited in time and space. He experiences himself, his thoughts and feelings as something separated from the rest — a kind of optical delusion of his consciousness.” At this point opinions diverge as to whether his letter goes onto search for meaning in religion, or release from confinement in a delusional prison through compassion. Nonetheless, from poets to scientists, it’s obvious that we all have a need to be connected. That’s in sharing communities, and not just online 24/7 in Zuckerberg’s empire 😉     The eternal battle to subdue isolated individuality is most apparent when we struggle with illness – Maslow put physiological and safety needs as a priority ahead of belongingness, and indeed health and wellbeing take our focus when in pain.

In the last few years Patient Reported Outcomes (PROs) collect information on the impact of illness, and gather data on solutions. Every ‘breakthrough’ story on social media will draw a following and perhaps develop a market, but it’s only when all success stories are aggregated that we can discern gold-raking from true nuggets. An example allows your experimentation with this idea by querying the database for other’s experiences, leveraging nearly half a million subscribers.

My other blog demonstrates a practical use for the power of community. Their premise at PatientsLikeMe is to donate your data to find a cure, realistically however this is underhand collection of feedback on medications by their sponsors. Nonetheless, if you subscribe and use their search facility to connect with others who use meds that may have been recommended to you, or have similar bloods pathology, or experience like impact to QualityOfLife…… then you allow the likes of me to extract rankings of treatments by efficacy. This appears to be an unintended consequence, since when I thanked the administrators for their data one query window was promptly closed. But that type of portal opening provides weak observations only.

There is no way to control for the confusing of data due to an individual’s choices. If, as with Carole & I, the PRO subscriber is interested in mind and body, then other Complementary and Alternative Medicine therapies are likely to be used also. Who can say which of these multi-disciplinary treatments is the most beneficial? The solution to this is medicine’s gold standard for evidence, the Randomised Clinical Trial. Participants are randomly allocated regardless of their disposition to receive either the intervention under investigation, or else standard care. They, and the trial staff, are blinded as to which group the coin-toss has placed them in, so as to preclude bias. This is vital when the measured outcome is subjective, as described by our Indian friends.

A significant difference between group’s results means that it was a strong enough result that it was improbably due to chance (eg four heads in a row is surprising when head or tail results are equally likely, but possible with odds of 1 in 16). A cutoff point of 1 in 20 is universal, written as p=0.05 or less. To get a significant result when the difference between control and intervention is small requires larger studies (more tosses of the coin), since halving precision from say p=0.1 means quadrupling the participant count. An inadequately budgeted trial will often be a pilot study, so as to prove the worth of that fourfold funding increase.

The last public grants round from NHMRC only approved one sixth of applications. Industry often makes up for this shortfall, and minor benefits can be shown as significant with their larger budget 😒     Blinding now allows corruption of results, as secrecy is applied to the identities of peers who’re reviewing articles for probity and accuracy. That link explodes some fallacies associated with concealment, a good suggestion by biostatisticians  but one that’s subject to cunning workaround.

Blind Lady Justice - consigned to mythology?
Blind Lady Justice in mythology – consigned to oblivion ?

Only universities are allowed to conduct such research, and it’s highly regulated. Accelerated understanding of biomedicine from the laboratory (in vitro) or in animals (in vivo) has set a pace that human drug trials have been unable to match. Breakthroughs from reckless self-administration early in the 20thC, then followed by cruel and callous human experimentation in the middle years (including the Tuskagee trials on Afro-Americans along with the holocaust atrocities), means bureaucratic oversight of research has grown to verge on a totalitarian structure. There’s many complaints of staleness, of copycat ‘me-too’ or copyright extending ‘me-again’ drugs. All done behind closed doors.

It is to be hoped that the online trend to open source communities – some examples being Android/Linux computing, Creative Commons licensing, or Public Library of Science publishing will encourage further usage of other PROs than PatientsLikeMe. Outside the system, and managed by those whose self-interest is patient welfare rather than career.

 

 

 

Long term gain

[… continuation of Geoff’s article on supplements]

That’s usually the promise made to sweeten the bitter pill of short term pain. Toughen up! …. push harder in exercise, scrimp and save for the security of a house purchase, & always the offer of a reward in heaven for a life of sacrifice. But it’s at odds with capitalist society’s offer of immediate gratification (if not sooner): borrow 100% (or more), pre-order the new model before anyone else, live the life you dreamed of after watching ‘The Entourage’, or even discover Buddhism in our short online course…… join the herd of satisfied customers using our secret formulation.

Extorting the easy $ (No pain, no gain?)
Extorting the easy $ (No pain, no gain?)

The sugary pill is an easier sell. Little wonder that under Tony Thirlwell our Heart Foundation sold out to his sugar industry at the expense of your health. An approving Tick √ for foods with up to 71% sugar, and consumer’s appreciation of their instant hit of high GI made donating to the charity an act of gratitude. Their CEO’s submission to a government inquiry “… there is a lack of evidence linking sugar to diabetes, heart disease, high blood pressure, hyperactivity or inadequate nutrient intake” rapidly became a joke after he stepped down.

There are no shortcuts in a system as complex as your own body. Anabolic steroids lead to impotence, testosterone supplements will decrease the body’s own supply – with longterm implications. Many protein/peptide boosters have high risk. Just recently 4Corners showed a PBS/NYTimes investigation into supplements, which explained how taking Vitamins actually increased mortality rates (FnMyalgia.com/2016/05 has more on this). Powerful antioxidants are important to a plant, for which oxygen is toxic effluent. Breathing is a delicate balance for us however, harnessing the power of highly reactive free radicals of oxygen, for both delivery of energy and also destruction of unwanted cells. Subtle adjustments are vital.

The science is best explained in Catalyst, another ABC documentary. The idea of the 6-minute workout would seem to be just another fastrack furphy, but it just describes the intense burst to conclude an exercise session that has warmed up muscles suitably. The desperate panting for air means more oxygen to toughen up the cellular engine rooms, mitochondria. Rather than stressing our immune system, it builds it, according to the newest theories of hormesis. Rebound after a hurtful session creates future resilience. The adaptive response described in ‘Extending life span by increasing oxidative stress’ is however, suppressed by dosing with those products that the antioxidant industry sell. The authors’ expertise in nutrition then leads down the paleo path, to a ketogenic diet. Glycolysis of carbs is not only an incredibly inefficient means of creating usable energy, it also outputs lactic acid as a burden to the liver.

Carbs are deadly
Carbs are deadly

Bring back the fat. Maker of ‘That Sugar Film’ joined with cardiologist Dr Aseem Malhotra on a recent speaking tour of this title. Another recent review points to the source of many of our troubles. “Astoundingly, the [Ketogenic Diet] appears to have broader efficacy than any currently available anti-epileptic drug, suggesting a more general mechanism of action that protects the brain” in ‘Epilepsy Research, July 2012’ attempts to explain the empirical evidence. Their theorising is on the basis of clinical results, whereas Harman’s 1956 free radical theory of aging is a speculation that’s yet to be substantiated.

And if it appears that a cherrypick of maverick ideas from around the globe is selected, start your thinking with papers by the University of Sydney’s Prof Luis Vitetta (onetime bioscientist at Epworth hospital). Or if the very idea of saturated dairy fats is repulsive, here’s a little sweetener 😉