Posts tagged health
All this masculine body-consciousness has some critics concerned. “There’s a lot of evidence that men are starting to be more strongly affected by the cultural discourse in terms of fatness being less tolerated even among men than it was quite recently,” says Paul Campos, a professor of law at the University of Colorado at Boulder and author of The Obesity Myth. “We’re just getting to see the internalization of the self-hatred and the pathologizing of variations of body size among men in ways we’ve always seen among women.” he says. “This culture is so completely f—ked up about it that it’s hard not to have a screwed-up attitude.”
Eating disorders: Now for men too!

What Would Jesus Eat?

Here’s Begley, on how depictions of the food portions in paintings of the Last Supper have grown over the millenium:

Over the last 1,000 years, the portions and plates depicted in 52 paintings of the last meal Jesus ate with his apostles have grown bigger and bigger, finds a study to be published in the April issue of The International Journal of Obesity. From dishes to bread to entrees, it’s all been supersized, find marketing professor Brian Wansink of Cornell University and his brother, Craig Wansink, an ordained minister and professor of religious studies at Virginia Wesleyan College.
“We took the 52 most famous paintings of the Last Supper and analyzed the size of the entrees, bread and plates, relative to the average size of the average head in the painting,” said Brian Wansink. Over the last 1,000 years, the entrées have grown 69 percent; plate size, 66 percent; bread size, 23 percent. As art imitates life, he suggests, changes to larger portions and plate sizes “have been reflected in paintings of history’s most famous dinner.”

About 90 percent of my animal patients are geriatric—and, as odd as this sounds, the veterinary world may hold lessons for the broader health-care system. While pet insurance exists, only roughly 3 percent of owners carry it; even then, clients pay a substantial portion of costs themselves. That means they usually want to know the rationale behind each test. I explain what I think is going on, what I want to look for, and which tests I need to perform to find it. I rank the diagnostics from most to least essential and lay out approximate costs. My clients then choose what they want done, with an understanding of the relative importance, risk, and cost of each option. This step-by-step approach may seem time-consuming, but it dramatically reduces the number of expensive, unnecessary tests. And the process is more gratifying.
Karen Oberthaler, V.M.D., on what vets can teach us about health care
We feel so righteous when we buy organic food or a compact fluorescent bulb or a Prius that our internal moral cup runneth over. According to this model, which is called compensatory ethics, people have an inner sense of how morally virtuous they need to feel to support their self-image. If a few actions (including espousing actions for other people) are enough to justify how we like to think of ourselves, then we do not need to perform any additional virtuous actions. It’s as if we accumulate moral points for ethical actions, and having accumulated “enough” we are free to act amorally, or even immorally. That’s why reminding people of what wonderful humanitarians they are causes them to give less to charity.

Consider the excitement over cocaine vaccines. Composed of a bacterial protein plus a molecule that is a coke look-alike, they train the immune system to produce antibodies against both. The antibodies also bind to cocaine, preventing it from entering the brain and causing a high. The good news is that the vaccine makes crack less pleasurable, notes Meg Haney of Columbia University, who led a 2010 vaccine study. That suggests the vaccine indeed kept the drug out of the brain. The bad news is that the level of antibodies in the volunteers (55 coke users in a 2009 study, 10 crack users in Haney’s) varied widely. Only 38 percent of the coke users produced enough antibodies to dull the effects of cocaine, and, of those, only half stayed clean more than half the time.

In contrast, a 2008 analysis of 34 studies of behavioral treatments for addiction to cocaine, marijuana, and other drugs showed impressive efficacy. “There is still no generally effective [medication]” for coke, pot, and meth addictions, notes psychiatry professor Kathleen Carroll of Yale University. “But the behavioral therapies we have are quite good,” bringing a 67 percent improvement. Yet that research gets the response of the proverbial tree falling in an empty forest.

Howard Brody, a family physician at the University of Texas Medical Branch, recently proposed, in The New England Journal of Medicine, that every medical specialty identify five procedures—diagnostic or therapeutic—that are done a lot and cost a lot but provide no benefits to some or all of the patients who receive them. Five is just a suggestion, high enough to be meaningful but low enough to exclude procedures in which the science is still open to debate, such as annual mammograms for women under 50. “I’m pretty convinced that each specialty could come up with 15 or 20, but in calling for five I think we can find uncontroversial ones,” says Brody. It’s not just about saving money, either. Any time a doctor performs a procedure, there is the risk of medical error and side effects, such as an elevated risk of cancer from CT scans. Unnecessary care kills 30,000 Americans every year, estimates Dr. Elliott Fisher of Dartmouth Medical School—and that figure includes only Medicare patients.

Medical groups have not exactly beaten a path to Brody’s door, so NEWSWEEK contacted several to see if they would play along. Reactions ranged from “we do no unnecessary care” (dermatology) to “only five?!” (emergency medicine). Allen Lichter, CEO of the American Society of Clinical Oncology, nominates what he calls “nth-line therapy”—the third or fourth or fifth chemotherapy drug for a patient whose cancer has not been felled by the first or second. “I don’t know what n should be,” he says. “But at some point chemotherapy has an extremely low chance of extending life and a high chance of shortening life due to toxicity.”

All-Nighters: A series of essays on insomnia (New York Times)http://opinionator.blogs.nytimes.com/category/all-nighters/

psychotherapy:

I completely forgot to mention this short series that was running last week on the New York Times Opinion blog, focused entirely around sleep and insomnia.  The link above will take you to all the essays, and they’re all equally worth reading!

Excerpt:

While in theory “sleep hygiene” makes sense, in today’s culture, which affords no time for relaxation, it’s hard to put into practice.  We’re on the computer at all hours and then we snuggle with our Blackberries. Our kids are even more hyperactive, texting way past their bedtimes, although today even the concept of “bedtime” sounds quaint.  To compensate for being so tired in the mornings, they eat caffeinated foods, gulp energy drinks, and pop Adderall and Ritalin…As the anthropologist Matthew Wolf-Meyer notes, “If a society can’t rest, how can it sleep?”


Nwk has been fascinated by sleep, and lack thereof, for years. We love this series.

The annual number of American medical students who go into primary care has dropped by more than half since 1997. It’s hard to get an appointment with the doctors who remain. In some surveys, as many as half of primary-care providers have stopped taking new patients. The other half are increasingly overworked and harried. Clearly we need to find a way to increase their ranks, and both the congressional health-care bills and President Obama’s reform proposal make moves in that direction. But those efforts are somewhat limited, and a more comprehensive solution could be thwarted by the same thing that’s stalled the rest of health-care reform so far: politics.

The reason behind America’s doctor gap is a matter of money. The average income in primary care is somewhere in the mid-$100,000s, which sounds like a lot but is less than half what specialists such as radiologists and dermatologists make. Given that doctors may graduate with as much as $200,000 in med-school debt, it’s easy to see why primary care started hemorrhaging recruits more than a decade ago and why radiology and other well-paid, high-tech specialties took off in popularity.

Scientists have been surprised at how deeply culture—the language we speak, the values we absorb—shapes the brain, and are rethinking findings derived from studies of Westerners. To take one recent example, a region behind the forehead called the medial prefrontal cortex supposedly represents the self: it is active when we (“we” being the Americans in the study) think of our own identity and traits. But with Chinese volunteers, the results were strikingly different. The “me” circuit hummed not only when they thought whether a particular adjective described themselves, but also when they considered whether it described their mother. The Westerners showed no such overlap between self and mom. Depending whether one lives in a culture that views the self as autonomous and unique or as connected to and part of a larger whole, this neural circuit takes on quite different functions.

Would you run away? Play dead?

magicmolly:

In college I wrote a piece about Adderall and for a little while after that I was contacted occasionally by outlets looking for an Adderall-using teen specimen. Random people also emailed me asking where they could get Adderall, and a very well-spoken long-time speed addict told me to stop noodling around with it, which I did.

Not considering myself a specimen of anything, I declined all of the requests (except one to anthologize the essay in a college sociological textbook about cheating—sweet!). When Newsweek got in touch about using me as an anonymous source for a piece, however, I said yes, because I love being an anonymous source. If you comb through issues of Teen Vogue from 2003-2004 you will find anonymous quotes from me about many things, including the size of Beyoncé’s butt.

During the Newsweek interview I tried to be candid and interesting. Then I graduated and moved to Los Angeles. When the magazine contacted me about a photoshoot, I agreed; I’ve always wanted to be one of those “anonymous source” photos with my face in dense chiaroscuro or photographed through a pill bottle.

I was living in a bungalow in Los Feliz at the time. When the photographer and stylist arrived I expected we’d go somewhere else, but they liked the backdrop of the house. For some reason I’d fixed my hair in Heidi braids. The stylist did not like this but accepted it.

The first set-up involved me watering plants in the front-yard (they were all cactuses which did not need water) with the spray blocking my face. Next I stood behind a tree with a banana leaf concealing my face. Finally we moved to the back patio, where I showed them my zucchini plants and stood bisected by a trellis.

After the shoot I heard nothing for eight or twelve weeks. Then I got an email notifying me that the piece had been killed, which was a relief. In the intervening months I had grown more cautious about going on the record, and was feeling guilty about doing so in exchange for an anecdote. I saved the email, considered the whole thing over, and forgot about it.

That was two years ago, more or less. This morning I opened a long-unread book and discovered, wedged between chapters, a test Polaroid from the shoot—one determined “not anonymous enough”, for obvious reasons. It was like finding the old canceled stamp from a specific, significant letter.

Here is Anonymous Molly:

We love this, and wish the story had run…

Yes, But What Kind of Life is That? We Think the Living Would Envy the Dead


Willett/Underwood, "How Public Policy Can Prevent Heart Disease"

Until last year, the residents of Albert Lea, Minn., were no healthier than any other Americans. Then the city became the first American town to sign on to the AARP/Blue Zones Vitality Project—the brainchild of writer Dan Buettner, whose 2008 book, The Blue Zones, detailed the health habits of the world’s longest-lived people. His goal was to bring the same benefits to middle America—not by forcing people to diet and exercise, but by changing their everyday environments in ways that encourage a healthier lifestyle.

What followed was a sort of townwide makeover. The city laid new sidewalks linking residential areas with schools and shopping centers. It built a recreational path around a lake and dug new plots for community gardens. Restaurants made healthy changes to their menus. Schools banned eating in hallways (reducing the opportunities for kids to munch on snack food) and stopped selling candy for fundraisers. (They sold wreaths instead.) More than 2,600 of the city’s 18,000 residents volunteered, too, selecting from more than a dozen heart-healthy measures—for example, ridding their kitchens of supersize dinner plates (which encourage larger portions) and forming “walking schoolbuses” to escort kids to school on foot.

The results were stunning. In six months, participants lost an average of 2.6 pounds and boosted their estimated life expectancy by 3.1 years. Even more impressive, health-care claims for city and school employees fell for the first time in a decade—by 32 percent over 10 months. And benefits didn’t accrue solely to volunteers. Thanks to the influence of social networks, says Buettner, “even the curmudgeons who didn’t want to be involved ended up modifying their behaviors.”

Isn’t it time we all followed Albert Lea’s example? Diet and exercise programs routinely fail not for lack of willpower, but because the society in which we live favors unhealthy behaviors. In 2006, cardiovascular disease cost $403 billion in medical bills and lost productivity. By 2025 an aging population is expected to drive up the total by as much as 54 percent.

Botox May Really Keep us From Feeling Sadhttp://www.newsweek.com/id/233142

alittlespace:

Is not feeling sad worth a face full of botulism? (maybe?)

Via Newsweek:

“The idea was to see whether the treatment affected their ability to feel certain emotions. We already know that Botox affects the ability to convey emotions such as anger, and a 2006 study found that it might even alleviate depression, as NEWSWEEK reported, presumably by the same mechanism: block the facial expression of sadness, prevent the related emotion.”

Last month Britain’s General Medical Council completed a new two-and-a-half-year investigation into whether study lead author Andrew Wakefield & Co. followed proper research ethics in their study, and the answer was no. The 143-page decision (you can find a PDF of the report here) calls Wakefield’s conduct “dishonest” and “misleading” in numerous respects. But the bottom line is that he misled The Lancet about how children came to be studied (that is, through the attorneys), that the ethical statement in the paper (denying any conflict of interest) was false, and that the hospital where the research was conducted had not approved it. Most damning, the GMC found that Wakefield “showed a callous disregard for the distress and pain that [he] knew or ought to have known the children involved might suffer,” that he “abused [his] position of trust as a medical practitioner,” and that he brought “the medical profession into disrepute.”