Monthly Archives: November 2013

healthcare, healthy habits, quantified self, rapid learning health systems, research methodology

mHealth mediated exercise prescriptions work

  • mobile technologies improve outcome measures associated with exercise interventions when compared to those interventions alone
  • not definitive, but certainly encouraging

Source: http://www.fiercemobilehealthcare.com/story/mhealth-improves-risk-profile-cardiovascular-disease-type-2-diabetes-patien/2013-11-08

Abstract: http://www.biomedcentral.com/1471-2458/13/1051/abstract

Provisional paper (PDF): Lifestyle interventions

mHealth improves risk profile in cardiovascular disease, type 2 diabetes patients

November 8, 2013 | By 

A provisional article published in the peer-reviewed journal BMC Public Health suggests that mHealth technology supporting exercise prescription interventions can be effective.

The findings are based on a Canadian study of 149 adults with at least two metabolic syndrome risk factors, one group using the intervention and one control group.

“Mobile health technologies have proved to be a beneficial tool to achieve blood pressure and blood glucose control in patients with diabetes,” argue the authors, who are currently completing their analyses‎ and will be submitting their data for publication in the next few weeks. “These technologies may address the limited access to health interventions in rural and remote regions. However, the potential as a tool to support exercise-based prevention activities is not well understood.”

The study was undertaken to “investigate the effects of a tailored exercise prescription alone or supported by mobile health technologies to improve metabolic syndrome and related cardiometabolic risk factors in rural community-dwelling adults at risk for cardiovascular disease and type 2 diabetes,” states the article. The authors hypothesized that the primary outcome, systolic blood pressure, and secondary outcomes would be improved in both groups, but to a greater extent in the mobile health intervention group at 12 weeks and that these changes would be better maintained at 24 and 52 weeks in the intervention group with mobile health support, compared with the active control group.

The results of the study “will contribute to the current literature by investigating the utility of mobile health technology support for exercise prescription interventions to improve cardiometabolic risk status and maintain improvements over time, particularly in rural communities,” concludes the provisional article, which serves as a protocol paper.

Study participants were recruited from rural communities in Ontario, Canada. Participants were randomized to either: an intervention group receiving an exercise prescription and devices for monitoring of risk factors with a smartphone data portal equipped with a mobile health application; or an active control group receiving only an exercise prescription.

In addition to the exercise prescription, the intervention group received a mobile health technology kit for self-monitoring of biometrics and physical activity. The kit included a smartphone (Blackberry Curve 8300 or 8530) equipped with Healthanywhere health monitoring app (Biosign Technologies), a Bluetooth-enabled blood pressure monitor (A & D Medical), a glucometer (Lifescan One Touch Ultra2) with Bluetooth adapter (Polymap Wireless) and a pedometer (Omron).

Nevertheless, a recent study in the Journal of Medical Internet Research found that although mobile health interventions are effective in promoting physical activity, their degree of validity reported in studies is unclear.

Using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework, the review revealed a recent increase in studies conducted to determine the effectiveness of mHealth interventions for the promotion of physical activity. Yet, quantity, not quality, seems to prevail, the authors argued.

To learn more:
– read the article in BMC Public Health

healthcare, nutrition, policy

BBC Horizon: The Truth About Fat

Yet another BBC documentary on obesity, this time featuring an emaciated looking surgeon who specialises in removing skin lesions. It was an excellent exposition of how broken and inappropriate it is to apply a reductionist, scientific lens to a problem of this kind.

A bunch of Imperial College scientists banging on about grellin and PPY and twin studies and epigenetics and fMRI and finishing up with a mandatory reference to bariatric surgery as the only successful intervention that actually changes the way your mind thinks about food.

If only there was a more expensive and complicated way to intervene?

Are we going to get to the point where bariatric surgery becomes a standard procedure, like desexing a dog?

The more of these programs I watch, the more distasteful and disappointing they seem.

If the end goal is to stop people eating crap, and also feel fuller quicker, then there has to be a better, more positive, less invasive way to achieve this than with surgery or a pill.

 

 

Program Site: http://www.bbc.co.uk/programmes/b01dzfgb
Video Source: http://vimeo.com/64960883

 

healthcare, policy

NYT: GE pursuing medical home in the US to contain costs…

  • GE are using their market power to experiment with different health care delivery
  • Pushing strongly for the introduction of medical homes
  • Early results are promising: patients enrolled in medical homes had 3.5 percent fewer visits to the emergency room and 14 percent fewer hospital admissions over the four years from 2008 through 2012
As Some Companies Turn to Health Exchanges, G.E. Seeks a New Path

CINCINNATI — Although the new federal health care law is designed to help people buying individual policies, even people with employer-provided policies are beginning to see changes in their coverage as companies rethink health care for their workers, discontinuing it in a few cases and redesigning it in many others.

They are motivated by a need to rein in health care costs, which continue to rise faster than overall inflation, but the federal health care law is also changing how some view their obligations to their employees.

Some major firms, like Walgreen, the drugstore chain, are giving those who qualify money to buy insurance on a private health exchange. Aon Hewitt, a benefits consultant that will oversee health plans on Walgreen’s behalf, said 18 large employers had signed up so far, including Sears and Darden Restaurants.

But here in Cincinnati, General Electric is taking the opposite approach.

One of the largest employers in the nation, it spends more than $2 billion a year offering coverage to 500,000 employees and retirees and their families. And it is using its considerable clout in places like this — where its giant aviation business gives it a major presence — to work directly with doctors and hospitals to improve care and reduce costs.

“I don’t know anybody who isn’t trying almost everything,” said Helen Darling, president of the National Business Group on Health, which represents employers providing benefits. “We’re going to see a lot of activity in the next couple of years.”

Over the last few years, G.E. has pushed for the creation of so-called medical homes, in which an individual medical practice closely coordinates a patient’s care by having access to all of the patient’s medical records.

In Cincinnati, about 118 doctors’ practices have converted to medical homes, and all five of the major health systems are making their primary care practices move in that direction. G.E. has also pushed for greater transparency of results.

“If we don’t take accountability ourselves for figuring this out, we’re part of the problem,” said Sue Siegel, a senior executive at G.E., who sees transformation of health care both as a business opportunity and a business necessity.

“We have to be involved in the solution,” she said. “We can’t just wait for someone to tell us that it is going to be fixed.”

What distinguishes the effort by G.E. is its direct focus on hospitals and doctors. Companies looking to the private exchanges are largely hoping to save money and want to be freed from the headache of administering health benefits.

In Walgreen’s case, the company says it doesn’t plan to lower its share of its workers’ health care costs but hopes to foster more competition among insurers, leading to better prices and more choice for employees.

In Cincinnati, G.E. took on both a cheerleading and coordinating role. In early 2010, Jeffrey R. Immelt, its chief executive, addressed local business leaders and urged them to think strategically and align their efforts to make more of a difference. There were already significant efforts under way to foster medical homes, for example, and G.E. pushed to find more financing to expand the concept to more medical practices and keep the focus on that initiative.

“The ever-present vigilance of the employers help nudge things along,” said Craig Brammer, chief executive of three area health care coalitions, including the Greater Cincinnati Health Council, which is made up of the area’s hospitals, health plans and employers.

The city’s health systems say they recognize that insurers and employers are increasingly going to reward them for better tracking their patients in and out of the hospital. “We are clearly gearing up to change directions from fee for service for what I’ll call payment for value,” said Will Groneman, an executive vice president for TriHealth, one of the systems.

The medical home also appears to resonate with employees. When Mary Farris, a 44-year-old marketing executive for G.E., found herself going to a local urgent care center because she could never get an appointment with her physician, she switched to a practice that had become a medical home.

What strikes Ms. Farris was how much time the doctor and medical assistant spent gathering her medical history and making sure there weren’t additional medical issues. While she came in for a spider bite, the focus was on her well-being as a working mother whose father was seriously ill at the time. “The picture was more on all of me as opposed to one isolated incident,” she said. “Somebody was trying to connect the dots.”

In Cincinnati, there are beginning to be grudging signs of success. Early results are promising: patients enrolled in medical homes had 3.5 percent fewer visits to the emergency room and 14 percent fewer hospital admissions over the four years from 2008 through 2012. G.E. plans to ask an outside firm to do a more detailed analysis.

But employers looking to adapt a similar strategy will find “it’s hard to do,” said David Lansky, the chief executive of the Pacific Business Group on Health, which represents West Coast employers. While “the opportunity is significant,” he said, companies may not have the time or resources to work in too many of their locations, with different hospitals and health plans in each market.

Some companies — Trader Joe’s for example — decided to send at least some employees to the new public exchanges. Trader Joe’s has left coverage for three-quarters of its work force untouched but is giving part-time workers a contribution of $500 to buy policies in the newly created state marketplaces. Because of the employees’ low incomes, the company says it believes many will be eligible for federal subsidies to help them afford coverage.

But a few major employers are taking even more aggressive stances and are trying to reshape how health care is delivered in this country.

They are increasingly looking to make direct connections with health systems, particularly well-regarded institutions that can deliver good care for what can be very expensive back or heart problems. G.E. recently signed an agreement with Hospital for Special Surgery in New York, a high-volume orthopedic hospital, to oversee the care of some employees getting hip and knee replacements. Last year, Walmart contracted with health systems like the Cleveland Clinic, Mayo and Geisinger, among others, to take care of employees who need transplants, heart and spine care. The company says it will soon expand the program to other centers of excellence.

The decision doesn’t always sit well with the home team. In Cincinnati, the UC Health System, which includes an academic medical center that also serves the area’s major source of care for the uninsured, says it would welcome a similar opportunity to provide joint replacements for G.E., but executives say they simply cannot afford to offer significant discounts. “We don’t have the resources to cut deals,” said Dr. Myles Pensak, an executive for UC Health.

G.E. is unapologetic. The company says it will continue to try a variety of approaches until it finds a way to tame health care costs even more than the annual growth rate achieved so far of under 3 percent. “You’ll see many, many experiments across the board,” Ms. Seigel said.

data saving lives, healthcare, rapid learning health systems, technology

Hammerbacher heads big data at Mt Sinai

  • accountable care is a system in which hospitals are paid to keep people healthy
  • the new economic incentives drive a need for data regarding the population being treated
  • Joel Dudley (Director of Informatics at Mount Sinai Medical School) is running diabetic patient data through an algorithm to cluster them according to phenotype and genotype.
  • This work aims to to replace the general guidelines doctors often use in deciding how to treat diabetics and replace them with risk models—powered by genomics, lab tests, billing records, and demographics—making up-to-date predictions about the individual patient a doctor is seeing, not unlike how a Web ad is tailored according to who you are and sites you’ve visited recently.

Source: http://www.technologyreview.com/news/518916/a-hospital-takes-its-own-big-data-medicine/

MIT Technology Review Report: A Cure for Health Care Costs (good infographics)

A Hospital Takes Its Own Big-Data Medicine

The person leading the design of the new computer is Jeff Hammerbacher, a 30-year-old known for being Facebook’s first data scientist. Now Hammerbacher is applying the same data-crunching techniques used to target online advertisements, but this time for a powerful engine that will suck in medical information and spit out predictions that could cut the cost of health care.

With $3 trillion spent annually on health care in the U.S., it could easily be the biggest job for “big data” yet. “We’re going out on a limb—we’re saying this can deliver value to the hospital,” says Hammerbacher.

Mount Sinai has 1,406 beds plus a medical school and treats half a million patients per year. Increasingly, it’s run like an information business: it’s assembled a biobank with 26,735 patient DNA and plasma samples, it finished installing a $120 million electronic medical records system this year, and it has been spending heavily to recruit computing experts like Hammerbacher.

It’s all part of a “monstrously large bet that [data] is going to matter,” says Eric Schadt, the computational biologist who runs Mount Sinai’s Icahn Institute for Genomics and Multiscale Biology, where Hammerbacher is based, and who was himself recruited from the gene sequencing company Pacific Biosciences two years ago.

Mount Sinai hopes data will let it succeed in a health-care system that’s shifting dramatically. Perversely, because hospitals bill by the procedure, they tend to earn more the sicker their patients become. But health-care reform in Washington is pushing hospitals toward a new model, called “accountable care,” in which they will instead be paid to keep people healthy.

Mount Sinai is already part of an experiment that the federal agency overseeing Medicare has organized to test these economic ideas. Last year it joined 250 U.S. doctor’s practices, clinics, and other hospitals in agreeing to track patients more closely. If the medical organizations can cut costs with better results, they’ll share in the savings. If costs go up, they can face penalties.

The new economic incentives, says Schadt, help explain the hospital’s sudden hunger for data, and its heavy spending to hire 150 people during the last year just in the institute he runs. “It’s become ‘Hey, use all your resources and data to better assess the population you are treating,’” he says.

One way Mount Sinai is doing that already is with a computer model where factors like disease, past hospital visits, even race, are used to predict which patients stand the highest chance of returning to the hospital. That model, built using hospital claims data, tells caregivers which chronically ill people need to be showered with follow-up calls and extra help. In a pilot study, the program cut readmissions by half; now the risk score is being used throughout the hospital.

Hammerbacher’s new computing facility is designed to supercharge the discovery of such insights. It will run a version of Hadoop, software that spreads data across many computers and is popular in industries, like e-commerce, that generate large amounts of quick-changing information.

Patient data are slim by comparison, and not very dynamic. Records get added to infrequently—not at all if a patient visits another hospital. That’s a limitation, Hammerbacher says. Yet he hopes big-data technology will be used to search for connections between, say, hospital infections and the DNA of microbes present in an ICU, or to track data streaming in from patients who use at-home monitors.

One person he’ll be working with is Joel Dudley, director of biomedical informatics at Mount Sinai’s medical school. Dudley has been running information gathered on diabetes patients (like blood sugar levels, height, weight, and age) through an algorithm that clusters them into a weblike network of nodes. In “hot spots” where diabetic patients appear similar, he’s then trying to find out if they share genetic attributes. That way DNA information might add to predictions about patients, too.

A goal of this work, which is still unpublished, is to replace the general guidelines doctors often use in deciding how to treat diabetics. Instead, new risk models—powered by genomics, lab tests, billing records, and demographics—could make up-to-date predictions about the individual patient a doctor is seeing, not unlike how a Web ad is tailored according to who you are and sites you’ve visited recently.

That is where the big data comes in. In the future, every patient will be represented by what Dudley calls “large dossier of data.” And before they are treated, or even diagnosed, the goal will be to “compare that to every patient that’s ever walked in the door at Mount Sinai,” he says. “[Then] you can say quantitatively what’s the risk for this person based on all the other patients we’ve seen.”

healthcare, policy, rapid learning health systems

The inevitable evolution of medical care delivery…

  • medicine is an information intensive industry
  • HIT uptake is growing rapidly due to policy incentives
  • Healthcare looks similar to the retail sector from the 1980s
  • Retail worker productivity grew 4% per year since 1995
  • The biggest changes are likely to come from re-imagining the role of the patient – the single most underused person in healthcare, currently considered as close to a nuisance
  • Health care will be less frustrating when the power shifts from sellers to buyers
  • The Institute of Medicine suggests that inappropriate care, lack of adequate prevention, administrative waste, and prices that are too high account for nearly one-third of medical spending. Just the billing and collection operations in health care account for 25 percent of total costs; Walmart and Amazon spend an order of magnitude less on administration. Prices have fallen across the board in the retail sector.

Source: http://www.technologyreview.com/news/518906/why-medicine-will-be-more-like-walmart/

Why Medicine Will Be More Like Walmart

What health care will look like after the information technology revolution.

The idea that technology will change medicine is as old as the electronic computer itself. Actually, even older. In 1945, Vannevar Bush, the man with the vision for the National Institutes of Health, foresaw a Memex computer program that would allow access to past books and records. A lone physician searching for a diagnosis in far-flung case histories was one of the applications Bush imagined.

Medicine is an information intensive industry. Yet there’s still no medical Memex. Even though the Internet teems with health information, study after study shows that medical care often differs greatly from what the guidelines say—when there are guidelines. Doctors frequently rely on their own experience, rather than the experience of millions of patients who have seen thousands of doctors. Not only is the past lost, the present is missing. How many times has a patient received a drug that causes an allergic reaction, just because that information is not available at the time it is needed?

Bit by bit, this situation is changing. The 2009 American Recovery and Reinvestment Act (aka the stimulus bill), created the HiTech program, which allocates billions of dollars for doctors and hospitals to buy electronic health records systems. Since the program was enacted, rates of ownership of such systems have tripled among hospitals and quadrupled among physicians. In just a few years, it is reasonable to think that the entire medical system will be wired.

What will happen then? The introduction of information technology into the core operations of hospitals and doctors’ offices is likely to make health care much more like the retail sector or financial services. Health care will be provided by big institutions, in a more standardized fashion, with less overall cost, but less of a personal touch.

medicine Walmart chart

Health care today looks a lot like the retail sector did in the early 1980s, when clothes and household products were sold by many local stores and small chains. Quality was haphazard, prices were higher, and buyers’ experiences were mixed. Consumers had only the information they could see in the store or the Sunday paper.

Retail firms got larger when information technology became widespread. Walmart replaced the corner drug store and Amazon put the local book shop out of business because large firms can use information technology better than small ones—to manage inventories, create consistency, automate routine activities, and lower prices. Output per worker grew over 4 percent annually in the retail sector since 1995. Output per worker has fallen in health care over the same time period.

When the medical Memex finally arrives, look for health care to follow the retail track. The solo practitioner is likely to be the first to go. He or she will have to decide whether to try to become an IT manager as well as a doctor, or join a larger group of doctors. For most, the choice will be easy. The chance that a doctor over 65 works alone or in a two-person practice is about 40 percent. For young doctors, it’s less than 5 percent.

Small hospitals will suffer the same fate. Already, small hospitals that have seen the price tag of medical records systems—$20 million or more to purchase, then millions to maintain—are seeking shelter in the arms of their big neighbors. I suspect most cities will go from 10 to 15 independent institutions a decade ago to three to five large health-care systems a decade hence. These systems will do everything: checkups, nursing the elderly, treating heart failure, and dispensing allergy pills.

Who treats us, and where, will change as well. With an electronic backbone in place, one doesn’t need to see a doctor for every issue. There is little the primary care doctor does that can’t—and increasingly isn’t—being done by a nurse practitioner, perhaps at a clinic in a Walmart or CVS. Routine prescriptions for medication refills can be handled online, with an electronic doctor watching. Even high-end services can be spread widely, with specialized centers coördinating the treatment of patients far from its walls.

medicine Walmart chart

The biggest changes are likely to come from reimagining the role of the patient—the single most underused person in health care. Today, patients are thought of as close to a nuisance (“I told him to take his pills …”). But imagine that the patient was a participant and contributor to the medical Memex. Blood-pressure cuffs can be in the house of every person with high blood pressure; the daily pressure would be transmitted to the doctor’s electronic record and monitored by a computer for outlying values. Decision-support software might allow people with localized cancer to choose between surgery, radiation, and watchful waiting—decisions which are, today, heavily influenced by doctors (and none too objectively).

Information technology is going to change the game because it will affect how people view themselves, their illness, and the people who care for them. Amazon’s loyalty comes in no small part because it uses our past searches and the searches of people like us to predict what we will want. The customer is part of Amazon’s Memex. Health care will be less frustrating when the power shifts from sellers to buyers, and when patients are more in charge.

Some worry that a health-care system that’s concentrated like retail will drive up costs. But it’s also true that organizational changes are easier when more doctors work together in one system. According to the Institute of Medicine, inappropriate care, lack of adequate prevention, administrative waste, and prices that are too high account for nearly one-third of medical spending. Just the billing and collection operations in health care account for 25 percent of total costs; Walmart and Amazon spend an order of magnitude less on administration. Prices have fallen across the board in the retail sector.

Norman Rockwell’s classic painting, “Doctor and the Doll,” is memorable for how the doctor is comforting the little girl by listening to her doll’s heart. Norman Rockwell’s doctor knew everything about the girl and her family. The doctor of the future will not. Rather than being a living electronic record consulting an internal Memex, tomorrow’s doctor will be there to direct patients to the right specialized resources, to reassure those in need, and to comfort the terminally ill. This life may not be as exciting as the surgeons or diagnostic sleuths one sees on TV, but it is a noble calling nonetheless.

David Cutler is the Otto Eckstein Professor of Applied Economics at Harvard University and author of the forthcoming, The Quality Cure: How Focusing on Health Care Quality Can Save Your Life and Lower Spending Too.

entrepreneurship

Big Think: Everyone Wants to Create the Product of Tomorrow. You Also Need to Deliver on the ‘Today’.

http://bigthink.com/big-think-edge/everyone-wants-to-create-the-product-of-tomorrow-you-also-need-to-deliver-on-the-today

Like moths, we are attracted to light. In a company, that light is innovation. Everyone wants to be a part of the latest greatest thing. But that should not come at the expense of delivering on a product that has already been developed.

Stephen Miles argues that a balance must be maintained between optimization on one front and growing things on the other front. “I think a lot of times we optimize on one or the other which sub-optimizes the company,” Miles says.

He presents three key ways to maintain this balance.

  • To be successful, innovation requires both the planting of seeds and the pruning of buds.
  • Experimentation is a strategy that supports innovation without sacrificing optimization.
  • Leadership teams should contain a complementary mix of planters and pruners, or innovators and optimizers.
complex adaptive systems, data saving lives, entrepreneurship, healthy habits

Google’s Calico – extending health life years

  • Calico is about extending healthy life years, not just life
  • Larry Page’s view is that ageing is the cause and diseases are the consequence of this ageing
  • Google will use all data it has access to – from search terms, to location data and including genomic data when it becomes more readily available
  • Curing cancer is not as big an advance as you might think” saying it would only add about three years to average life expectancy.

Source: http://mashable.com/2013/10/24/google-calico/
Source: http://www.technologyreview.com/view/519456/google-to-try-to-solve-death-lol/

Google Wants You to Live 170 Years

BY DANI FANKHAUSER

Along the lines of self-driving cars and smart glasses, Google‘s newest venture promises to wow the tech scene. Only, it’s not quite tech, at least in the traditional sense. The venture is called California Life Company, or Calico for short, and its goal is to extend human life by 20 to 100 years.It sounds surreal, until consider that we already extended human life by 20 years over the past century. The average girl born today will live to be 100, a once outlying achievement.

Other research outlets have made relevant discoveries over the years, including worms thatdivide stem cells without aging and that resveratrol, found in red wine, seems to defend against diseases related to aging and could be manufactured as a more potent synthetic drug.

Meanwhile, companies such as Elixir Pharmaceuticals, Sirtris Pharma and Halcyon Molecular set out to extend human life, only to shut down (or be acquired, then shuttered by the buyer), many times running out of money before bringing a product to market.

Don’t be quick to assume Google’s involvement is strictly to benefit the common good, however. CEO Larry Page is pushing to spend on long term rather than incremental R&D. There’s money to be made here. The regenerative medicine industry is valued at $1.6 billion, and anti-aging products are virtually resistant to economic cycles. Therapies available today may be expensive,untrustworthy and could produce horrific results.

But one thing is true: The quest to live just a bit longer is in demand.

But living longer comes with its own challenges. One imagines doubling our elderly population and the strain that would put on their families and on resources in general. On the other hand, by allowing people to age slower, it’s possible a solution could extend our productive years, rather than the elderly years — so, an extra decade of being 30, rather than an extra decade of being 90 — a more attractive option for both individuals and culture as a whole.

Mashable spoke with experts in the space, who predict Calico will indeed approach the latter (Google declined to comment for this story). It won’t likely be one magic bullet solution, but rather, a group of solutions — a suite of products that will catch our imagination just as Google Glass and self-driving cars have.

The Problem With Aging

In a TIME profile, Larry Page said that solving individual diseases, even ones as pervasive as cancer, would not increase life expectancy by much. To reframe, cancer is the symptom; the true disease is aging itself. As we age and our cells wear down, it causes other old-age diseases.

Currently, much of our technology that extends life actually extends life in poor health, while thenumber of years lived in good health remains unchanged.

Our retirement age of 65 was originally set because hardly anyone ever reached that age.

“Today we spend an incredible amount [of money] out of keeping people alive in a bad state of health,”

“Today we spend an incredible amount [of money] out of keeping people alive in a bad state of health,” says Aubrey de Grey, chief science officer of the SENS Research Foundation, who presented a TED Talk on anti-aging.

This might explain why many people have no interest in living longer.A Pew study shows 56% of Americans would not choose to slow the aging process, even if such medical treatments were available.You may have read about the suicide of 60-year-old sports blogger Martin Manley. His website reveals his distaste for the physical and mental limitations of old age.But de Grey doesn’t expect a solution from Google to follow this trend, adding length to the “unwell” years of life while the number of healthy years remains the same.

“We will not be able to extend life without extending health,” he says. “Longevity is a side effect.”

Why Google?

For most of us, Google’s investment into longevity was a surprise (but note, Google will not be operating Calico, only backing it). Others already in the space were able to see the connection.

What Google brings to the table is data. “Not just one set of data, multiple forms,” says Harry Glorikian, founder of life sciences consulting firm Scientia Advisors. “Search data, GPS data, all sorts of other pieces, electronic breadcrumbs that you produce all out there to get a picture of you.”

This data could be paired with each person’s genome — a partial genome can be mapped today for $99 via 23andMe (another Google investment), but many are hoping a full genome will cost as much in the next few years.

Daniel Kraft, medicine and neuroscience chair of Singularity University, affirms that this will require people to relinquish some privacy, in hopes of helping others and themselves, but predicts it to be something many will do.

“Lot of folks will be happy to share elements of health history,”

“Lot of folks will be happy to share elements of health history,” he says.

For an example of how data can impact health, just look to Google’s Flu Trends, which predicted flu outbreaks based on search data, although it turned out to be accurate only in certain cases.

Finally, note that Google isn’t entirely new to this space. Singularity University has had a lot of cross-pollination with Google, Kraft says, and Ray Kurzweil, director of engineering at Google, is an advisor to Maximum Life Foundation, says founder David Kekich.

Glorikian notes that, much like how Google’s development of Glass inspired developers to create uses for it, the Calico announcement will bring further attention and energy to life extension.

“When one of these behemoths points to a certain place, everyone has to believe that there’s something there,” Glorikian says.

The Solution Won’t Be a Magic Pill

We won’t see an anti-aging product from Calico come to market in a year — it’s a long-term venture. The company is likely assembling a team (the announcement only mentioned leadership of Art Levinson, who is former CEO of biotech company Genentech) and deciding what kind of research to do. Of course, there are several types.

First, there is the idea of the engaged patient. You have the “ability to manage your prevention if you know the risk of certain diseases,” says Kraft. Again, think genome mapping.

Second, de Grey maintains that a medical solution will be discovered before a solution involving nanotechnology — and the medical solution will allow some of us to live long enough to also benefit from future solutions. A medical solution might involve cell therapy, gene therapy or injections. Nanotechnology could include tiny robots that repair our cells or assist organs.

Who Will Pay for It?

An early criticism of Calico was that it sounded like something that would increase the split between the rich and the poor, leaving millionaires to live as long as they like (a few extra years to spend all that money doesn’t hurt), while less privileged people would settle for traditional lifespans or shorter (many children in developing countries continue to die without lack of access to clean water).

The rich already have the option of cryonics, preserving their bodies after death in hopes future technology will revive them. It costs $200,000.

It is possible individuals will not need to cover costs of anti-aging treatments themselves? Much like health care today, it makes for a convincing job perk.

De Grey expects these solutions to be paid for by neither the individual or the employer, but rather, the government. Between social security and Medicaid, the government spends billions on treatment for old-age illnesses and providing for the aging population. Perhaps a product that slows aging will be seen as preventative care — over time, it may prove cheaper and could save government money down the road.

“These therapies will pay for themselves so quickly,” de Grey says.

Further Questions

An extra 100 years to live that you didn’t expect is a daunting idea. But because many of these solutions will piggyback over time, it’s not likely to be a sudden burden. As any technology comes to market, we as a culture must learn to use it both safely and with respect for others.

But still, asking the ethical questions is an important step. With an extra set of productive years, should people have second careers (or second marriages)? If you’ll be in this world for longer, does it reduce the drive to have children? Will a larger population mean more competition for resources?

A popular Steve Jobs quote communicates life’s brevity as a benefit to the human race:

“Death is very likely the single best invention of life. It’s life’s change agent.”

But even with increased lifespan, death is never too far away. When asked about the difference between solving death and solving aging, de Grey was quick to point out the obvious: “I’m not working on a solution to stop people from getting hit by cars.”

complex adaptive systems, data saving lives, healthy habits, nutrition

Thesis: Food composition is not as important as physical structure in determining satiety, and therefore overweight and obesity

vanishing caloric density: energy dense foods that meltdown rapidly in the mouth, often lack satiety (Dr. Drewnowski)

the problem with sugared soft drinks: energy consumed as fluid calories are not counted by the body as contributing to satiety, in the same way that energy consumed in solids.

Putting these two data points together, It would therefore seem that non-solid foods don’t satiate.

It makes sense that industry includes these forms of food in our diet, as the less satiety we experience, the more food we eat.

This also explains why fruit juice, but not solid fruit, leads to weight gain. It’s nothing to do with fibre slowing the absorption of calories in the gut, it’s to do with the satiating effects of calories derived from solids vs liquids.

This thesis makes sense in evolutionary terms, as the only pre-agricultural sources of liquid calories would have been honey – water being the mainstay.

recipe

Damn fine roast chicken

This is a riff on Jamie Oliver’s Perfect Roast Chicken, circa 1999. Really good with gravy, mashed potato, roast cauliflower and/or broccoli…

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Ingredients
1.8kg Chicken
2 Lemon quarters
5 Rosemary sprigs
1 Bunch Fresh basil
3 Sprigs Fresh oregano
5 Bay leaves
Chilli flakes
3 Garlic cloves
Olive or Macadamia oil
Salt & pepper
Roasting twine

Directions

  1. Wash chicken and pad dry with paper towel
  2. Fill bilateral pouches in the potential space between the breast meat fascia and skin with basil, oregano, oil, salt, pepper
  3. Place quartered half lemon, rosemary, bay leaves in body cavity
  4. Rub spare herbs, oil, salt, pepper over chicken
  5. Place rosemary and bay leaves between legs and wings and body then tie up chicken with twine
  6. Cut leg meat to aid thorough cooking
  7. Place the chicken breast down in heated heavy pot
  8. Place pot in 200 C degree pre-heated oven for 10 minutes
  9. After 10 minutes, turn chicken over and cook on the chicken’s base breast side up
  10. Cook chicken for another hour (total oven time 80-90 minutes)
  11. Take chicken out, let stand for 10 minutes
  12. Capture juices for use in gravy