Category Archives: healthy habits

Human evolutionary biology and mismatch diseases

  • Book: The Story of the Human Body: Evolution, Health and Disease
  • Questions our culture’s overwhelming focus on treatment of symptoms instead of prevention
  • We’re adapted to put on fat, not lose it. We’re adapted to be physically active, not inactive

Type 2 diabetes a ‘mismatch disease’ for our Paleolithic bodies

21-Oct-2013

When we examine the long list of noninfectious diseases that trouble modern society—which run the gamut in severity from flat feet to acid reflux, anxiety, certain cancers, high blood pressure, obesity and type 2 diabetes—it helps to look back, way back, to the root causes to find answers, said Daniel Lieberman, chair of the Department of Human Evolutionary Biology at Harvard University.

Cool, automatic, calorie tracking standing desk

http://www.medgadget.com/2013/12/stir-kinetic-desk-tracks-calories-burned-and-helps-you-stay-fit-at-work.html

Stir Kinetic Desk Tracks Calories Burned and Helps You Stay Fit at Work

by GAURAV KRISHNAMURTHY on Dec 19, 2013 • 2:03 pm

smart desk Stir Kinetic Desk Tracks Calories Burned and Helps You Stay Fit at WorkThe latest fitness trend in offices around the country is employees giving up their chairs in order to stand while working. Now Stir, a Pasadena, CA company, is helping this fitness cause with their smart desk called Stir Kinetic that adapts to the user’s position and also helps track the additional calories burned due to standing.

tabld eside Stir Kinetic Desk Tracks Calories Burned and Helps You Stay Fit at Work

In order to start using the Stir Kinetic desk, the user has to first enter his or her standing and sitting heights, as well as the amount of time he or she would like to stand per day while working, using the touch screen console on the desk surface. The hardwood desk then uses motors to move its position from seated height to standing height by a mere double tap on the console. The smart desk tracks the amount of standing time per day in order to provide the user a count of the calories burned and has a Whisperbreath feature that automatically changes the desk’s height by one inch up or down, forcing the user to change positions, thereby incorporating some physical activity into office jobs.

The algorithm running the Stir Desk works to create changes in desk height at appropriate times and tracks the user’s work patterns to teach itself the best times to coax the user to change positions. The smart desk has been equipped with Bluetooth and WiFi connectivity to be able to transmit data to a smartphone in the future and Stir aims to roll out wellness and fitness smartphone apps that work with the smart desk.

The desk is currently available for purchase for a premium price of $3890, and comes in two top surface color options of either white lacquer or espresso-stained.

Six percent of strokes avoided by reduced salt intake – Netherlands

Six percent of strokes can be avoided by meeting sodium reduction recommendations: Study

18-Dec-2013

Achieving salt intakes in line with the recommendations may reduce stroke cases by 6%, but many consuming are still consuming way too much, says a new analysis from The Netherlands.

 

Zeitgebers

Zeitgerbers: Outside time cues that make fine adjustments which mimic the changes in light and dark that take place throughout the year.

http://www.newyorker.com/online/blogs/elements/2013/12/science-of-sleep-trouble-with-snooze-buttons.html

DECEMBER 10, 2013

SNOOZERS ARE, IN FACT, LOSERS

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On a typical workday morning, if you’re like most people, you don’t wake up naturally. Instead, the ring of an alarm clock probably jerks you out of sleep. Depending on when you went to bed, what day of the week it is, and how deeply you were sleeping, you may not understand where you are, or why there’s an infernal chiming sound. Then you throw out your arm and hit the snooze button, silencing the noise for at least a few moments. Just another couple of minutes, you think. Then maybe a few minutes more.

It may seem like you’re giving yourself a few extra minutes to collect your thoughts. But what you’re actually doing is making the wake-up process more difficult and drawn out. If you manage to drift off again, you are likely plunging your brain back into the beginning of the sleep cycle, which is the worst point to be woken up—and the harder we feel it is for us to wake up, the worse we think we’ve slept. (Ian Parker wrote about the development of a new drug for insomnia in the magazine last week.)

One of the consequences of waking up suddenly, and too early, is a phenomenon called sleep inertia. First given a name in 1976, sleep inertia refers to that period between waking and being fully awake when you feel groggy. The more abruptly you are awakened, the more severe the sleep inertia. While we may feel that we wake up quickly enough, transitioning easily between sleep mode and awake mode, the process is in reality far more gradual. Our brain-stem arousal systems (the parts of the brain responsible for basic physiological functioning) are activated almost instantly. But our cortical regions, especially the prefrontal cortex (the part of the brain involved in decision-making and self-control), take longer to come on board.

In those early waking minutes, our memoryreaction timeability to perform basic mathematical tasks, and alertness and attention all suffer. Even simple tasks, like finding and turning on the light switch, become far more complicated. As a result, our decisions are neither rational nor optimal. In fact, according to Kenneth Wright, a neuroscientist and chronobiology expert, “Cognition is best several hours prior to habitual sleep time, and worst near habitual wake time.” In the grip of sleep inertia, we may well do something we know we shouldn’t. Whether or not to hit the snooze button is just about the first decision we make. Little wonder that it’s not always the optimal one.

Other research has found that sleep inertia can last two hours or longer. In one study that monitored people for three days in a row, the sleep researchers Charles Czeisler and Megan Jewett and their colleagues at Harvard Medical School found that sleep inertia took anywhere from two to four hours to disappear completely. While the participants said they felt awake after two-thirds of an hour, their cognitive faculties didn’t entirely catch up for several hours. Eating breakfast, showering, or turning on all the lights for maximum morning brightness didn’t mitigate the results. No matter what, our brains take far longer than we might expect to get up to speed.

When we do wake up naturally, as on a relaxed weekend morning, we do so based mainly on two factors: the amount of external light and the setting of our internal alarm clock—our circadian rhythm. The internal clock isn’t perfectly correlated with the external one, and so every day, we use outside time cues, called zeitgebers, to make fine adjustments that mimic the changes in light and dark that take place throughout the year.

The difference between one’s actual, socially mandated wake-up time and one’s natural, biologically optimal wake-up time is something that Till Roenneberg, a professor of chronobiology at Ludwig-Maximilians University in Munich, calls “social jetlag.” It’s a measurement not of sleep duration but of sleep timing: Are we sleeping in the windows of time that are best for our bodies? According to Roenneberg’s most recent estimates, based on a database of more than sixty-five thousand people, approximately a third of the population suffers from extreme social jetlag—an average difference of over two hours between their natural waking time and their socially obligated one. Sixty-nine per cent suffer from a milder form, of at least one hour.

Roenneberg and the psychologist Marc Wittmann have found that the chronic mismatch between biological and social sleep time comes at a high cost: alcohol, cigarette, and caffeine use increase—and each hour of social jetlag correlates with a roughly thirty-three per cent greater chance of obesity. “The practice of going to sleep and waking up at ‘unnatural’ times,” Roenneberg says, “could be the most prevalent high-risk behaviour in modern society.” According to Roenneberg, poor sleep timing stresses our system so much that it is one of the reasons that night-shift workers often suffer higher-than-normal rates of cancerpotentially fatal heart conditions, andother chronic disease, like metabolic syndrome and diabetesAnother study, published earlier this year and focussing on medical-school performance, found that sleep timing, more than length or quality, affected how well students performed in class and on their preclinical board exams. It didn’t really matter how long they had slept or whether they saw themselves as morning people or not; what made a difference was when they actually went to bed—and when they woke up. It’s bad to sleep too little; it’s also bad, and maybe even worse, to wake up when it’s dark.

Fortunately, the effects of sleep inertia and social jetlag seem to be reversible. When Wrightasked a group of young adults to embark on a weeklong camping trip, he discovered a striking pattern: before the week was out, the negative sleep patterns that he’d previously observed disappeared. In the days leading up to the trip, he had noted that the subjects’ bodies would begin releasing the sleep hormone melatonin about two hours prior to sleep, around 10:30 P.M.A decrease in the hormone, on the other hand, took place after wake-up, around 8 A.M. After the camping trip, those patterns had changed significantly. Now the melatonin levels increased around sunset—and decreased just after sunrise, an average of fifty minutes before wake-up time. In other words, not only did the time outside, in the absence of artificial light and alarm clocks, make it easier for people to fall asleep, it made it easier for them to wake up: the subjects’ sleep rhythms would start preparing for wake-up just after sunrise, so that by the time they got up, they were far more awake than they would have otherwise been. The sleep inertia was largely gone.

Wright concluded that much of our early morning grogginess is a result of displaced melatonin—of the fact that, under current social-jetlag conditions, the hormone typically dissipates two hours after waking, as opposed to while we’re still asleep. If we could just synchronize our sleep more closely with natural light patterns, it would become far easier to wake up. It wouldn’t be unprecedented. In the early nineteenth century, the United States had a hundred and forty-four separate time zones. Cities set their own local time, typically so that noon would correspond to the moment the sun reached its apex in the sky; when it was noon in Manhattan, it was five till in Philadelphia. But on November 18, 1883, the country settled on four standard time zones; railroads and interstate commerce had made the prior arrangement impractical. By 1884, the entire globe would be divided into twenty-four time zones. Reverting to hyperlocal time zones might seem like it could lead to a terrible loss of productivity. But who knows what could happen if people started work without a two-hour lag, during which their cognitive abilities are only shadows of their full selves?

Theodore Roethke had the right idea when he wrote his famous line “I wake to sleep, and take my waking slow.” We do wake to a sleep of sorts: a state of not-quite-alertness, more akin to a sleepwalker’s unconscious autopilot than the vigilance and care we’d most like to associate with our own thinking. And taking our waking slow, without the jar of an alarm and with the rhythms of light and biology, may be our best defense against the thoughtlessness of a sleep-addled brain, a way to insure that, when we do wake fully, we are making the most of what our minds have to offer.

Maria Konnikova is the author of “Mastermind: How to Think Like Sherlock Holmes.”

Photograph: Keystone-France/Gamma-Keystone/Getty.

BMJ: Exercise just as good as drugs in war on major disease

  • BMJ article highlights relative effectiveness of exercise vs drugs for common conditions
  • Only drug/condition combo that was better than exercise was heart failure/diuretics

Source: http://www.telegraph.co.uk/health/healthnews/10515917/Exercise-just-as-good-as-drugs-in-war-on-major-disease.html#!

Exercise just as good as drugs in war on major disease

Photo: Alamy

By , Health Correspondent

1:00PM GMT 13 Dec 2013

Exercise could be as effective as some of the best drugs which protect against major diseases, research has found.

A study of more than 300 trials has found that physical activity was better than medication in helping patients recovering from strokes – and just as good as drugs in protecting against diabetes and in stopping heart disease worsening.

The research, published in the British Medical Journal, analysed data about studies on 340,000 patients diagnosed with one of four diseases: heart disease, chronic heart failure, stroke or diabetes.

Researchers said the findings suggested that regular exercise could be “quite potent” in improving survival chances, but said that until more studies are done, patients should not stop taking their tablets without taking medical advice.

The landmark research compared the mortality rates of those prescribed medication for common serious health conditions, with those who were instead enrolled on exercise programmes.

The research found that while medication worked best for those who had suffered heart failure, in all the other groups of patients, exercise was at least as effective as the drugs which are normally prescribed.

People with heart disease who exercised but did not use commonly prescribed medications, including statins, and drugs given to reduce blood clots had the same risk of dying as patients taking the medication.

Similarly, people with borderline diabetes who exercised had the same survival chances as those taking the most commonly prescribed drugs.

Drugs compared with exercise included statins, which are given to around five million patients suffering from heart disease, or an increased risk of the condition.

The study was carried out by researcher Huseyin Naci of LSE Health, London School of Economics and Political Science and Harvard Medical School, with US colleagues at Stanford University School of Medicine.

He said prescription drug rates are soaring but activity levels are falling, with only 14 per cent of British adults exercising regularly.

In 2010 an average of 17.7 prescriptions was issued for every person in England, compared with 11.2 in 2000.

Mr Naci said: “Exercise should be considered as a viable alternative to, or alongside, drug therapy.”

Dr John Ioannidis, the director of the Stanford Prevention Research Center at the Stanford University School of Medicine, said: “Our results suggest that exercise can be quite potent.”

Other medications compared with exercise included blood-clotting medicines given to patients recovering from stroke, and alpha-glucosidase inhibitors given to patients on the cusp of developing diabetes.

Only the patients who were recovering from heart failure fared best when prescribed drugs, where anti-diuretic medication was most effective.

However, they said their analysis found far more trials examining drugs, than those which measured the impact of exercise.

They said there was a need for more research into the benefits of exercise for those suffering from serious health problems.

Researchers stressed that they were not suggesting that anyone should stop taking medications they had been prescribed, but suggested patients should think “long and hard” about their lifestyles, and talk to their doctors about incorporating more exercise into their daily routines.

Forcing the prevention industry – a 10 year journey

Vision

  • The Future of Human API www.thehumanapi.com
  • Forcing the prevention industry into existence
  • Stage Zero disease detection and treatment

Critical trends:

  • lab-in-a-box diagnostics
  • quantified self
  • medical printing

When these trends converge, there’ll be an inflection point where a market is established.

Health data moves from system of record >> system of engagement.

Promoting the evolution from a Product mentality to a Market mentality

As treatment starts to focus on Stage Zero/pre-clinical disease,  it turns into prevention.

 

Video: http://www.youtube.com/watch?feature=player_embedded&v=gJHaoqeucX8

http://www.forbes.com/sites/johnnosta/2013/12/12/the-asymptotic-shift-from-disease-to-prevention-thoughts-for-digital-health

The Asymptotic Shift From Disease To Prevention–Thoughts For Digital Health

It’s been said that good artists borrow and great artist steal.  And I believe that Picasso was right.  So, I guess I’m somewhere between a thief and a artist and that suits me just fine.

I’ve stolen from two great thinkers, so let’s get that out of the way.  The first isDaniel Kraft, MD. Daniel Kraft is a Stanford and Harvard trained physician-scientist, inventor, entrepreneur, and innovator. He’s the founded and Executive Director of FutureMed, a program that explores convergent, rapidly developing technologies and their potential in biomedicine and healthcare. He’s also a go-to source on digital health. I’m stealing “zero stage disease” from Dr. Kraft. Simply put, it’s the concept of disease at its most early, sub-clinical stage.  It’s a point where interventions can halt or change a process and potentially eliminate any significant manifestation of disease.

The second source of inspiration is Richie Etwaru.  He is a brilliant and compelling speaker and a champion for global innovation, Mr. Etwaru, is responsible for defining and delivering the global next generation enterprise product suite for health and life sciences at Cegedim RelationshipManagement. His inspiring video, The Future of Human API really got me thinking.

At the heart of Mr. Etwaru’s discussion is the emergence of prevention–not treatment–as the “next big thing”.

EtwaruSlide

Ok, nothing new so far.  But the important changes seen in the digital health movement have given us a profound opportunity to move away from the conventional clinical identification of a that golf-ball sized tumor in your chest to a much more sophisticated and subtle observation. We are beginning to find a new disease stage–different from the numbers and letters seen in cancer staging.  The disease stage is getting closer and closer to zero.  It’s taking an asymptotic path that connects disease with prevention. The point here is that the holy grail of prevention isn’t born of health and wellness.  Prevention is born out of disease and our new-found ability to find it by looking closer and earlier.  Think quantified self and Google Calico.

And here lies the magic.

We all live in the era of disease.  And the vast majority of healthcare costs are spent after something happens. The simple reality is that prevention is difficult to fund and the health-economic model is so skewed to sickness and the end of life that it’s almost impossible to change. But if we can treat illness earlier and earlier–the concept of an asymptote–we build a model where prevention and disease share the very same border.  They become, in essence, the same. And it’s here that early, early, early disease stage recognition (Stage Zero) becomes prevention. The combination of passive (sensor mediated) observation and proactive life-style strategies for disease suppression can define a new era of health and wellness.

Keep Critical! Follow me on Twitter and stay healthy!

 

A Big Fat Crisis

From: http://www.foodpolitics.com/2013/12/weekend-reading-a-big-fat-crisis/

Weekend reading: A Big Fat Crisis

Deborah A. Cohen.  A Big Fat Crisis: The Hidden Forces Behind the Obesity Epidemic—And How We Can End It.  Nation Books, 2013.

Cover: A Big Fat Crisis

Here’s my blurb:

Deborah Cohen gives us a physician’s  view of how to deal with today’s Big Fat Crisis.  In today’s “eat more” food environment, Individuals can’t avoid overweight on their own.   This extraordinarily well researched book presents a convincing argument for the need to change the food environment to make it easier for every citizen to eat more healthfully.

And from the review on the website of the Rand Corporation, where Deborah Cohen works:

The conventional wisdom is that overeating is the expression of individual weakness and a lack of self-control. But that would mean that people in this country had more willpower thirty years ago, when the rate of obesity was half of what it is today. Our capacity for self-control has not shrunk; instead, the changing conditions of our modern world have pushed our limits to such an extent that more and more of us are simply no longer up to the challenge.

Prevention Economics

Right. So I’m now comfortable with the idea that the greatest failing of modern healthcare is for it to have extended lifespan without having extended healthy life years. The challenge then, is to extend fully productive life to something far closer to our life expectancy. This can be done with a plant based diet, fasting and moderate exercise. No pills. No fads. Jus a new norm.

But how do we pay for it? Determine the economic cost of extending a life’s productivity by a year seems like a reasonable first step. Then take a piece of that?

Bring in the direct beneficiaries of such a change – the life insurers, super funds and broccoli farmers.

What a great bunch of business partners they’d be.

Giddy up….