Category Archives: healthy habits

data saving lives, entrepreneurship, healthcare, healthy habits, nutrition, politics, rapid learning health systems

Excruciating Clarity

PROBLEM

  • Contemporary health systems, and the health R&D systems that inform their behaviour, are failing to address the major threat of chronic disease because they are bound to legacy business models that depend on process over outcome.
  • These characteristics are leading to increasing health care costs in the absence of improving population health outcomes.
  • In frustration, Governments around the world are indicating that there is no more new money, with health systems being asked to operate within their current (and in some cases, diminishing) means.

SOLUTION

  • In response, the accepted business model for health care is slowly changing from a fee-for-service regime, to a value-based approach where providers are paid to improve health outcomes.
  • Similarly, the business model for medical research is changing, from a publish-or-perish, incremental-impirical regime, to a value-based approach where research is recognised ultimately for its clinical outcomes impact.
  • These changes will take time to occur is Australia, but are already well underway in the US, the UK and China.
  • To preserve their sustainability and viability, modern health systems will need to become sentient, focusing on prevention of harm from the contemporary modern food systems.
  • While health systems will always need to attend to illness as and when it presents, they will need to fund these activities out of savings made by avoiding preventable illness.
  • To achieve this, future health systems, and the R&D systems that inform them will be sentient, and feature the application of behavioural economics, real-time analytics, and predictive analytics to deliver low-unit-cost automated behavioural interventions.

OPPORTUNITY

  • The great Canadian ice hockey player Wayne Gretzky is often quoted as saying “A good hockey player plays where the puck is. A great hockey player plays where the puck is going to be.”
  • As a respected, successful and self-described entrepreneurial research institute, the George Institute is uniquely placed in Australia, but also internationally, to lead, and ultimately profit from these seismic disruptions in health system operations and performance.
  • There is an opportunity for the George Institute to establish a scalable, for-profit wellness generating clinic (working title: George Wellness) that, as a baseline, applies the latest understanding of wellness and prevention to a recruited population, but then uses continuous/frequent monitoring and real time analysis to develop a proprietary, preventive learning algorithm that delivers wellness to, while protecting this population from various harms in a powerful and demonstrable way.
complex adaptive systems, data saving lives, entrepreneurship, healthcare, healthy habits, nutrition, quantified self, rapid learning health systems, technology

Lunch date with Dickon

From: Paul Nicolarakis [mailto:paul.nicolarakis@outlook.com]
Sent: Thursday, 24 October 2013 8:09 PM
To: ‘Dickon Smart-Gill’
Subject: RE: Singpaore

Beautifully captured Dickon, and thank you for the eBook (it won’t go anywhere).

References for some of my contributions:

–          Online CBT pioneer: Prof. Helen Christensen/Black Dog Institute > blackdoginstitute.org.au // moodgym etc.

–          Research on protein and satiety in locusts, mice and men > Stephen Simpson

–          The Vitality Group (Sth Africa) – 15 min intro video on front page helpful, similarly 1hr webinar http://www.thevitalitygroup.com/

–          A short White Paper on Health Insurance billing analytics

 

Things we didn’t even get to, but expect to at some stage:

–          Antifragile by Nassim Nicholas Taleb (author of Black Swan) >> totally rocked my world, suspect you might enjoy

–          Very strong case for plant based diet by Michael Greger MD

–          4 Hour Body by Timothy Ferris >> where I started my body hacking journey (slow carbs, protein, cruciferous, blow out, but also stuff on sex etc.)

–          Proteus Digital Health – end to end health monitoring, including blood composition via skin patches (warning: interesting but potential ufero)

–          Scanadu – personal medical tricorder

–          Ginger.io – behavioural health analytics platform

–          Omada Health – evidence-driven, online preventive health programs

–          Eatery by Massive Health – recently acquired by Jawbone, but previously doing some interesting things with diet, analytics and amazon’s mechanical turk  (warning: interesting but potential ufero)

–          Kaggle – data modelling competition platform (I’m mates with its founding chairman)

 

Rough vision for what I want to get going over the next 5 years (from diary post):

Over the next five years, I want to develop a health-generating, outcome-remunerated, scalable, for-profit enterprise dedicated to the effective (i.e. live outcome data and analytics, a la rapid learning health system), efficient (i.e. probably not involving doctors) optimization of population health through the application of mobile-mediated behavioural economics, epigenetics, ubiquitous sensors, real time, predictive analytics and the social determinants of health.

 

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Thursday, 24 October 2013 7:11 PM
To: ‘Paul Nicolarakis’
Subject: RE: Singpaore

 

Notes from our lunch

 

CBT apps are as effective as face to face with professionals. Mood Gym

 

Body by science – Doug McGuff – high intensity, simple exercises.

 

Eatstop eat attached.  A quick and easy read. I bought it, so please don’t forward it on to others just in case my name is encoded into the pdf somehow.

 

Leangains.com – 16-8 protocol. Obviously this guy is genetically gifted, but the fasting technique works for me too.  The key is ‘never any guilt’ if you mess up one day, simply forget it and try the next day.

 

80/20 rule for weight loss 80% being diet, the 20% being exercise.

 

Vitality – south Africa – interesting model to approach insurance companies.

 

Your potential opportunity with the data analysis for medical insurance claims/fraud. Possibility for the same sales approach that they used in the stock trading world.

 

Cauli dabbed with macadamia oil in an 210 degrees fan oven. Crunchy yet still moistish in the centre. Excellent snack food. I suggested adding turmeric (curcumin) for it’s anti inflammatory characteristics. Though not to modify the taste as that is already in order.

 

Standing desks (we both use them and see the benefits).

 

Feel free to add what I missed.

 

Dickon

 

 

 

 

 

From: Paul Nicolarakis [mailto:paul.nicolarakis@outlook.com]
Sent: Wednesday, 23 October, 2013 7:18 PM
To: ‘Dickon Smart-Gill’
Subject: RE: Singpaore

 

Great. How about 1230 for something meaty at:

 

Royal Mail

2 Finlayson Green

Ascott Raffles Place

 

http://www.ladyironchef.com/2012/12/the-royal-mail-prime-ribs-singapore/

 

 

 

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Wednesday, 23 October 2013 7:02 PM
To: Paul Nicolarakis
Subject: Re: Singpaore

 

Looking good for lunch. Name the time and place. I’m easy.

Sent from my iPhone
On 23 Oct, 2013, at 15:21, “Paul Nicolarakis” <paul.nicolarakis@outlook.com> wrote:

How are you looking for tomorrow? Any chance of lunch or afternoon instead of evening?

 

 

 

From: Paul Nicolarakis [mailto:paul.nicolarakis@outlook.com]
Sent: Friday, 18 October 2013 10:56 AM
To: ‘Dickon Smart-Gill’
Subject: RE: Singpaore

 

done

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Thursday, 17 October 2013 12:59 PM
To: Paul Nicolarakis
Subject: Re: Singpaore

 

Pencil in the evening of the 24 th.

Sent from my iPhone
On 17 Oct, 2013, at 8:15, “Paul Nicolarakis” <paul.nicolarakis@outlook.com> wrote:

I’m currently leaving on the 25th Dickon, but may stay longer… shall we try for something on the 24th?

 

Cheers, Paul

 

 

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Thursday, 17 October 2013 12:01 PM
To: ‘Paul Nicolarakis’
Subject: RE: Singpaore

 

Hi Paul,

 

I’m in Bangkok now.

 

However, on the 24th, 25th 26th, I’m in Singapore.

 

Does that overlap with your travel?

 

Dickon

 

From: Paul Nicolarakis [mailto:paul.nicolarakis@outlook.com]
Sent: Thursday, 17 October, 2013 5:31 AM
To: ‘Dickon Smart-Gill’
Subject: Singpaore

 

Checking in again… will be in Singapore next week, let me know if you’re around for a bevvy. Cheers, Paul

 

 

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Saturday, 14 September 2013 12:47 PM
To: ‘Paul Nicolarakis’
Subject: RE: g’day

 

I’m in Bangkok right now and will still be in Bangkok on Wednesday.

 

Thanks for the invite, if I were in singapore I would definitely have met up with you.

 

Dickon

 

From: Paul Nicolarakis [mailto:blackfriar@gmail.com]
Sent: Saturday, 14 September, 2013 5:05 AM
To: Dickon Smart-Gill
Subject: g’day

 

Hey Dickon,
Am in town through to Wednesday – would be good to catch up if you’re around?
Cheers, Paul

healthy habits, nutrition

Michael Greger MD – Plant-based diet warrior

In these epic lectures, Michael Greger MD explores the various ways our modern diets, in concert with our modern health system, deliver ill-health to the community. While some views are extreme, the gist of it is that many of our modern maladies are the result of modern lifestyle choices, and that making healthier choices delivers direct health benefits, particularly with regard to plant-based diets and cardiovascular disease.

July 2013: http://nutritionfacts.org/video/more-than-an-apple-a-day-preventing-our-most-common-diseases/

July 2012: http://nutritionfacts.org/video/uprooting-the-leading-causes-of-death/

data saving lives, entrepreneurship, healthy habits, quotes & aphorisms, rapid learning health systems

Today’s the day I realised it’s time for me to step up

Had a really interesting day today.

Have settled nicely into the VLCD regime and feel I could persist with it as required. Caffeine delivered by green tea has added a pleasant boost.

I had a terrific meeting with Fiona Turnball and David Pieris at the George Institute.

I also met with the producer of an eHealth event in Melbourne who has asked me to speak (interestingly, George Margelis, the MC of the session, didn’t think to contact me, so am grateful that Steve Leeder did).

Bought Floppy’s 30th birthday opal from the least likely of vendors and prepped for the Hong Kong trip.

Among all that, I had a typically entertaining chat with Mark Hayman. Among the many pearls, one stuck out:

“I’ve reached a time in my life where I no longer want to be pissed off by what others say and do, and instead be happy to piss others off with what I say and do”

I also managed to crystallize what I want to dedicate the remainder of my professional life to. In essence, I want to develop a health creating, outcome remunerated, scalable, for-profit business dedicated to the effective, efficient population health optimization utilizing all the insights of behavioural economics, epigenetics, ubiquitous sensors, real time, predictive analytics and the social determinants of health.

healthy habits

Fastr

I’m at the beginning of Day 3 and things are getting easier – less foggy and less lethargic.

On a fullness per calorie basis, microwaved broccoli is by far the stand out – 1 spear of broccoli delivers on 10 calories but leaves one feeling stuffed.

As such, 3 meals a day of 1 serve of sardines/smoked salmon (about 100 calories per serve) with a spear of broccoli will leave me more than satisfied and with a fair amount of wiggle room for snacks like tomatos or cucumber.

I’m going to take advantage of the flight on Wednesday to extend the fast through to when I land in Hong Kong and start feasting.

healthy habits

Fast

So finally had a clear weekend to give fasting a go. Not real fasting, but less than 500 calories, referred to as very low calorie diets (VLCDs). I’m winging it a little after absorbing the gist of Michael Moseley’s 5:2 ideas (2 non-consecutive VLCD days per week) and a recent presentation I saw at University of Sydney by Amanda Salis (fast for as long as you wish because accumulated ketones drive hunger suppression after 4 days and you may as well take advantage of that rather than falling back into normal eating again – her suggestion: 2-4 wks on, 2-4 wks off). I’ll also be sprinkling it with elements of what I picked up from 4 Hour Body.

The idea is basically to radically reduce caloric intake to drive rapid weight loss, maintaining protein consumption at 1g/kg to prevent loss of lean body weight (i.e. muscle). On the plate, it looks like this over a day, with most of it consumed earlier in the day.

1. Quarter to half tin of refried beans (complex carbs, protein)
2. Two – three tins of sardines (protein)
3. 100g smoked salmon (protein)
4. One broccoli or cauliflower (fibre, protein)
5. Tomatoes/cucumbers (no nutritional value but take the edge off)
6. One or two punnets of blueberries (antioxidants, carbs)
7. Lots of water/soda water (hydration)

After one and a half days, it’s been entirely tolerable, and if anything, I’ve enjoyed indulging in a slightly snarly attitude, at least more so than my Mum’s dog for whom I’ve had very little tolerance. I’ve also felt some how sharper minded, though slower and more cautious when driving.

At this point, I suspect I could get used to this, at least a whole lot more than anyone at close quarters to me. I won’t be able to carry it off this week due to conferences, meetings and travel, but look forward to integrating into my less busy times on as frequent a basis as possible.

Will see how we go!

data saving lives, healthcare, healthy habits, nutrition, policy, rapid learning health systems

futuresupermarkets…

I received this email on Thursday from my local supermarket. Not my local supermarket chain. My local supermarket. It featured personalised in-store specials for what I like to buy.

And so it begins.

Prompted by this development, I just searched for Coles and Health Insurance and came up with this media release from June 2013 announcing a partnership between Medibank Private and Coles whereby you get double flybuy points for buying fruit and vegetables.

And so it has already begun. Sure it is Vitality-lite, but you have to start somewhere. Awesome.

FlybuysCapture

 

content of personalised flybuys email (PDF)

Coles and Medibank Reward Customers for Better Health (PDF)

TripleFlybuys_MedibankGenerationBetter

 

Generation Better Triple Flybuys TVC: http://www.youtube.com/watch?v=Ftq2i9f6PBo

healthy habits

Daily Rituals of Great Minds

What better way to commence a personal blog than with a reference to a Guardian review of a book on the daily rituals of great minds – an interesting book that I’ll almost certainly never read, but am happy exists?

Key observations:
1. Get over yourself… there is no perfect environment for success – just work hard and apply your gifts [in progress]
2. William James’ belief in routine’s ability to unleash creativity [tick]
3. Benjamin Franklin’s morning ‘air baths’ i.e. naked morning loitering [tick]
4. Ernest Hemmingway’s early rising with the sun [tick]
5. Pare away unnecessary decisions from the day like meal selection [in progress]
6. Walking in natural settings, presumably clothed [in progress]
7. Strategic stimulant abuse [will investigate]

At this stage in life, it seems entirely feasible to integrate these principles, supplemented by sound nutrition, intense, intermittent training and regular social contact.

Will endeavour to keep myself posted on progress.

Rise and shine_ the daily routines of history’s most creative minds _ Science _ The Guardian (PDF)