an autodidact meets a dilettante…

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The statin controversy

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Never edit your own writing! Brian J Ford.

one thing thing you can be sure of – this claim (posted by a British chiropractor) is meaningless bullshit

I read Ben Goldacre’s quite demanding book Bad pharma some years ago, and that’s where I learned about statins, but I don’t recall much. I do recall that, not long after I read the book, I was at a skeptics meet-up when Dr Goldacre’s name came up. The man next to me started literally spitting chips at the mention – he was eating a massive bowl of chips and was grossly overweight (not that I’m assuming anything from this – just saying, haha). He roolly didn’t like Dr Goldacre. What went through my head was – some people may be really invested in having a magic pill that allows them to live forever and a day no matter what their diet or lifestyle.

I’ve just discovered that Goldacre has a new book out, entirely on this topic, which I intend to read, but my current decision to explore the issue is based on listening to Dr Maryanne Demasi’s talk, ‘statin wars – have we been misled by the evidence?’, available on YouTube. I very much recall the massive Catalyst controversy a few years ago, when a two-part special they did on statins led finally to the demise of the program. Without knowing any details, I thought this was a bit OTT, but when I heard Dr Norman Swann, a valued health professional and presenter of the ABC’s Health report, railing about the irresponsibility of the statin special, I frankly didn’t know what to think.

So statins are lipid-lowering medications that come in various flavours, including atorvastatin, fluvastatin, lovastatin and rosuvastatin. Lipitor, a brand name for atorvastatin manufactured by Pfizer, is the most profitable drug in the history of medicine. I’ve never taken statins myself, and I’m starting this piece as a more or less total beginner on the topic. I’ve read the Wikipedia entry on statins, which is quite comprehensive, with a very long reference list. Of course it’s not entirely comprehensible to a lay person, but that’s not a criticism – immunobiology and related research fields are complex. It’s also clearly pro-statin. It includes this interesting sentence:

 A systematic review co-authored by Ben Goldacre concluded that only a small fraction of side effects reported by people on statins are actually attributable to the statin.[63]

It’s interesting that Goldacre, and nobody else, is mentioned here as a co-author. It makes me wonder…

My only quibble, as a lay person, is that the positive effects of these statins, and their relatively few side-effects, seems almost too good to be true. I speak, admittedly, as a person who’s always been ultra-skeptical of ‘magic bullets’.

Which brings me to issues raised in Dr Demasi’s talk, and not addressed in the Wikipedia article. They include the idea, promoted by an ‘influential group’, that statin use should be prescribed for everyone over 50, regardless of cholesterol levels. Children with high cholesterol levels are being screened for statin use and Pfizer has apparently designed fruit-flavoured statis for use by children and adolescents. Others have suggested using statins as condiments in fast-food burgers, and even adding statins to the public water supply. It’s easy to see how such ‘innovations’ involve making scads of money, but this isn’t to deny that statins are effective in many if not most instances, and we should undoubtedly celebrate the work of the Japanese biochemist Akiro Endo, who pioneered the work on enzyme inhibitors that led to the discovery of mevastatin, produced by the fungus Penicillium citrinum.

But Demasi made some other interesting points, firstly about how drug companies like Pfizer might seek to maximise their profits. One obvious way is to widen the market – for example by lobbying for a lowering of the standard level of cholesterol in the blood considered dangerous. From the early 2000s in the US, ‘high cholesterol’ was officially shifted down from as high as 6.5 down to below 5, moving vast numbers of people onto having a ‘need’ for these cholesterol-lowering drugs. Demasi points out that this lowering wasn’t based on any new science, and that the body responsible for these decisions, the National Cholesterol Education Program (NCEP), was loaded with people with financial ties to the statin industry. To be fair, though, one might expect that doctors and specialists concerned with cholesterol to be invested, financially or otherwise, in ways of lowering it. They might also have felt, for purely scientific reasons, that the level of cholesterol considered dangerous was long overdue for adjustment.

Another change occurred in 2013 when two major heart health associations in the US decided to abandon a single number in terms of risk factors for heart disease/failure. Instead they looked at cholesterol, blood pressure, weight, diabetes and other factors to calculate ‘percentage risk’ of cardiovascular problems. They evaluated this risk so that if it was over 7.5% in the next 10 years, you should be prescribed a statin. A similar percentage risk system was used in the UK, but the statin prescription started at 20%. Why the huge discrepancy? Six months later, the Brits brought their threshold down to 10%. The US change brought almost 13 million people, mostly elderly, onto the radar for immediate statin prescription. The method of calculation in the US was independently analysed, and it was found that they over-estimated the risk, sometimes by over 100%. Erring on the side of caution? Or was there a lot of self-interest involved? It could fairly be a combination. The term for all this is ‘statinisation’, apparently. It’s attributed to John Ioannidis, a Stanford professor of medicine and a noted ‘scourge of sloppy science’. If you look up statinisation, you’ll find a storm of online articles of varying quality and temper on the issue – though most, I notice, are five years old or more. I’m not sure what that signifies, but I will say that, while we’ll always get the anti-science crowd baying against big pharma, vaccinations and GM poison, there’s a clear issue here about vested interests, and the need to, as Demasi says, ‘follow the money’.

This brings up the issue of how trials of these drugs are conducted, who pays for them, and who reviews them. According to Demasi, the vast majority of statin trials are funded by manufacturers. Clearly this is a vested interest, so trial results would need to be independently verified. But, again according to Demasi (and others such as Ioannidis and Peter Gotzsche, founder of the nordic Cochrane Collaboration) this is not happening, and ‘the raw data on statin side-effects has never been released to the public’ (Demasi, 2018). This data is held by the Cholesterol Treatment Triallists’ (CTT) collaboration, under the Clinical Trial Service Unit (CTSU) at Oxford Uni. According to Demasi, who takes a dim view of the CTT collaboration, they regularly release meta-analyses of data on statins which advocate for a widening of their use, and they’ve signed agreements with drug companies to prevent independent examination of research findings. All of this is described as egregious, which might seem fair enough, but Elizabeth Finkel, in a long-form article for Cosmos magazine in December 2014, takes a different view:

.. [the CTT] are a collaboration of academics and they do have access to the raw data. It is true that they do not share that data outside their collaboration and are criticised by other researchers who would like to be able to check their calculations. But the trialists fear mischief, especially from drug companies seeking to discredit the data of their rivals or from other people with vested interests. Explains [Professor Anthony] Keech, “the problem with ad hoc analyses are that they can use methods to produce a particular result. The most reliable analyses are the ones done using the methods we published in 1995. The rules were set out before we started.” And he points out these analyses are cross-checked by the academic collaborators: “Everything is replicated.”

As a regular reader of Cosmos I’m familiar with Finkel’s writings and find her eminently reliable, which of course leaves me more nonplussed than ever. I’m particularly disturbed that anyone would seriously claim that everyone over fifty (and will it be over forty in the future?) should be on these medications. I’m 63 and I take no medications at all, which I find a great relief, especially when I look at others my age who have mini-pharmacies in their homes. But then I’m one of those males who doesn’t visit doctors much and I have little idea about my cholesterol levels (well yes, they’ve been checked and doctors haven’t raised them to me as an issue). When you get examined, they usually find something wrong….

In her talk, Demasi made a comparison with the research on Tamiflu a few years ago, when Cochrane Collaboration researchers lobbied hard to be allowed to review trial data, and it was finally revealed, apparently, that it was certainly not as effective and side-effect free as its makers, Roche, claimed it to be. The jury is still out on Tamiflu, apparently. Whether it’s fair to compare the Tamiflu issue with the statin issue is a matter I can’t really adjudicate on, but if Finkel is to be believed, the CTT data is more solid.

There’s also an issue about more side effects being complained of by general users of statins – complaints made to their doctors – than side effects found in trials. This has already been referred to above, and is also described in Finkel’s article. Many of these complaints of side-effects haven’t been able to be sheeted home to statins, which suggests there’s possibly/probably a nocebo effect at play here. But Demasi suggests something more disturbing – that many subjects are eliminated from trials during a run-in period precisely because the drug disagrees with them, and so the trial proper begins only when many people suffering from side-effects are excluded. She also notes, I think effectively, that there is a lot of play with statistics in the advertising of statins (and other drugs of course) – for example a study which found that the risk of having a heart attack on statins was about 2% compared to 3% on placebos was being advertised as proving that your heart-attack risk on statins is reduced by a third. This appears to be dodgy – the absolute percentage difference is very small, and how is risk actually assessed? By the number of actual heart attacks over period x? I don’t know. And how many subjects were in the study? Were there other side-effects? But of course we shouldn’t judge the value of statins by advertising guff.

Another interesting attack on those expressing doubts about the mass prescription of statins has been to call them grossly irresponsible and even murderers. This seems strange to me. Of course doctors should be all about saving lives, but they should first of all be looking at prevention before cure as the best way of saving lives. Exercise (mental and physical) really is a great form of medicine, though of course not a cure-all, and diet comes second after exercise. Why the rush to medicalise? And none of the writers and clinicians supporting statins are willing to mention the financial bonanza accruing to their manufacturers and those who invest in them. Skepticism is the lifeblood of science, and the cheerleaders for statins should be willing to accept that.

Having said that, consider all the life-saving medications and procedures that have preceded statins, from antibiotics to vaccines to all the procedures that have made childbirth vastly safer for women – who cares now about the pharmaceutical and other companies and patentees who’ve made their fortunes from them? They’re surely more deserving of their wealth than the Donnie Trumps of the world.

So, that’s my initial foray into statins, and I’m sure the story has a way to go. In my next post I want to look at how statins work. I’ve read a couple of pieces on the subject, and they’ve made my head hurt, so in order to prevent Alzheimer’s I’m going to try an explanation in my own words – to teach myself. George Bernard Shaw wrote ‘those who can, do, those who can’t teach (it’s in Man and Superman). It’s one of those irritating memes, but I prefer the idea that people teach to learn, and learn to teach. That’s why I love teaching, and learning…

By the way, the quote at the top of this post seems irrelevant, but I keep meaning to begin my posts with quotes (it looks cool), so I’m starting now. To explain the quote – it was from a semi-rant by Ford in his introduction to the controversial dinosaur book Too big to walk (I’ve just started reading it), about writers not getting their work edited, peer reviewed and the like, and being proud or happy about this situation. This, he argues, helps account for all the rubbish on the net. It tickled me. I, of course, have no editor. It’s hard enough getting readers, let alone anyone willing to trawl through my dribblings for faults of fact or expression. Of course, I’m acutely aware of this, being at least as aware of my ignorance as Socrates, so I’ve tried to highlight my dilettantism and my indebtedness to others. I’m only here to learn. So Mr Ford, guilty as charged.

References

Dr Maryanne Demasi – Statin wars: Have we been misled by the evidence?

https://en.wikipedia.org/wiki/Statin

https://cosmosmagazine.com/society/will-statin-day-really-keep-doctor-away

https://en.wikipedia.org/wiki/John_Ioannidis

https://www.smithsonianmag.com/science-nature/what-is-the-nocebo-effect-5451823/

http://www.center4research.org/tamiflu-not-tamiflu/

Written by stewart henderson

September 9, 2019 at 9:44 pm

On cramp, sensation and pain

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hard to find a non-athletic-looking image of leg cramp

In recent times I’ve been suffering from cramp, usually in bed in the early mornings, almost always in the calf but sometimes in the foot, around the toes but sometimes at the back of the foot, and invariably on the left leg. So all of this leads to a great variety of thoughts and anxieties. What is cramp? What causes it? Can it be cured or prevented? Why only on the left side? Why now and not in the past? Will it keep getting worse? How to describe the sensation? What’s the difference between a description of a sensation and the sensation itself?  Can pain be measured? Can it be distinguished from pain response?

The cramps I suffer from are clearly not the same thing as those experienced by footballers near the end of a go-for-broke cup final, when they crumple in a heap of agony and have to be massaged back to life by a team-mate, an exercise which also seems to involve a stretching of the afflicted muscle. I’ve heard this has to do with a lack of oxygen getting to the muscle when it’s being strenuously exercised. I don’t know if I’ve ever experienced that kind of cramp (does it feel different?) but I do recall getting a sharp pain in the abdominal region, referred to by others as ‘the stitch’, when, either during a football game or a school run, I exercised myself beyond my level of fitness – which was very easily done. That pain, however, was qualitatively different from the cramps of today. It didn’t feel muscular.

 So now to what the pundits say. First, on ‘stitch’, this BBC health and fitness website has it that ‘most scientists believe the pain is caused by a reduction of blood supply to the diaphragm, causing it to cramp’. It’s certainly common in long-distance runners, but as I recall – and it’s been a long time since I’ve been silly enough to bring on that particular pain – it felt very different from the leg cramps, more like an organ pain, of the stomach perhaps, or the duodenum (I’ve no idea). If it is a muscular cramp, it’s an indication that these cramps can feel very different from each other.

It hasn’t taken me long to realise that the science of cramps isn’t particularly well-developed. Though perhaps that’s a bit unfair – better to say that it’s not settled, due largely to its complexity. Some cramps, though surely not mine, are caused by muscle fatigue, while others are caused by a lack of electrolytes, or it could be a combo.

So what are these electrolytes? Salts, acids and bases mostly, which become ionised in solution when an electric current passes through it. The major electrolytes in our body are calcium, sodium, magnesium, potassium, phosphate and chloride.

Okay, I’ve got it slightly wrong. These electrolytes, or ‘lytes’ as the pundits call them, dissolve in any ‘polar solvent’, such as water, and separate into cations and anions. I learned a bit about this at school but I’ve forgotten. Basically the dissolved lytes become ionised, I don’t know why, becoming either positively charged (having fewer electrons than protons, making them cations), or negatively charged anions (with more electrons than protons). These anions and cations disperse more or less uniformly through the fluid, making it electrically neutral. But when an electric potential (something very complicated, but I think it basically means an electric charge) is applied to the fluid, the cations gravitate (surely the wrong word!) to the electron-rich electrode, the anions to the … other one.

What does this mean for cramp sufferers? Fuck knows, but I think it means that if you don’t have enough of these lytes, for whatever reason, you don’t get this ionisation happening and that’s bad for your body. Anyway, we’ve all presumably heard of these probably bogus electrolyte-bearing drinks that are advertised as a salvation for athletes, of which I’m very obviously not one, but it does seem possible that I’m a bit light on my lytes. What I’m doing here is engaging in a bit of deductive reasoning a la Sherlock Holmes. If you eliminate all the impossibles, whatever’s left, however improbable, is probably true, or something like that.

So… my cramps are definitely not caused by hyperflexion (flexing of a muscle beyond normal limits), or by hypoxia (deprivation of oxygen at the tissue level). Nor is it likely to be a complication of pregnancy (I wish). I don’t want to think about it being symptomatic of kidney or thyroid disease (I feel otherwise healthy), but they’re extreme improbabilities that might need to be looked at later. Three other conditions are highlighted on the fabulous Wikipedia: hypokalemia, hypomagnesemia and hypocalcaemia. Careful inspection from the astute reader should render these terms intelligible. They refer, bien entendu, to a, presumably chronic, lack of potassium, magnesium and calcium, respectively (the aforementioned lytes). A quick glance at the symptoms of these three conditions suggests to me that they can be relegated to the bottom section of the list of probable causes. Often they result from the use or overuse of prescription medication. I don’t take any.

Now I’m starting to run out of possible causes, and I don’t want to complicate the problem too much. Actually the best advice I’ve read so far on the Wikipedia website is this: Stretching, massage and drinking plenty of fluid, such as water, may be helpful in treating simple muscle cramps. Obviously they don’t include wine as a useful fluid in these circs. That may be my downfall – alcohol tends to dehydrate, which is negative in itself but also seems implicated in cramping. It narrows the blood vessels (hypoxia enfin? the blood vessels oxygenate the muscles don’t they?), which is probably what gives that headachey hungover feeling I sometimes have in the morning. It also causes a build-up of lactic acid, another probable cause of cramping. I’m beginning to feel that a few small adjustments, such as drinking some water before bed-time, avoiding excessive alcohol intake, and keeping the muscles of the lower leg warm (cramping always seems more excruciating in winter) might be enough to solve my problems, which are only minor after all.

So that’ll do me, all that philosophical stuff about the nature of pain will have to wait for another day. I need to hydrate and keep warm, firstly, and I’ll see how that helps as winter is coming.

Written by stewart henderson

April 29, 2017 at 5:53 pm

Posted in fitness, health, pain

Tagged with , ,

Recalling romance: the incomparable Ha Ji-won

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a young Ha Ji-won looking determined, in the 2002 comedy/drama Sex is Zero

Canto: Okay, so we’ve been so busy pretending to be sciency savants that we’ve forgotten about the romantic side of this blog…

Jacinta: You’re right, the Urbane Society for Skeptical Romantics must be a confusing name for some, unless they can find some romance in our scientific interests, which would be nice…

Canto: So we’re changing all that by doing occasional pieces on heroines around the world, since we’re both into female supremacy, right?

Jacinta: Okay and you’ve chosen a very romantic heroine first up, and I must say I approve of her wholeheartedly, though I may play devil’s advocate during this dialogue.

Canto: Fine, well I’ve chosen a real people’s heroine, the dazzling Ha Ji-won, from Korea. She’s a hugely successful star of film and television drama, a household name over there, but I’ve picked her for, inter alia, her many portrayals of strong women – from teenage misfits to action heroes to royalty to suburban divorcées, she’s one of those actors who dominate the screen and inspire women everywhere – at least everywhere in Korea – to be feisty and independent, and that’s a fine thing.

Jacinta: Actually I like her because she comes across mostly as a warm and sensitive person, a sort of ‘what the world needs now’ sort of person, but admit it, what’s the real reason you’ve chosen her?

Canto: Ah well, of course it’s purely a romantic one, I’m totally besotted with her and I’m sure my usual razor-sharp judgment has been blunted by my adoration, so you’ll have to provide the skepticism I’m afraid.

Jacinta: Well I’m quite attracted myself I have to say, though I definitely get the impression that girl-girl love, or lust, is much more frowned upon in South Korea than it is here.

Canto: Yes it does strike me as a rather buttoned-up, conservative, class-oriented and overly materialistic society by Australian standards, judging by their movies and dramas, but it’s a dynamic society, and a little more open, I think, than, say, Japanese society, so hopefully this obsession with the ‘right’ education and ‘pedigree’ instead of evident talent will be blown away by outside influences. Actually I think women like Ha Ji-won are contributors to this sort of levelling process. From her various bios I’ve not discovered whether she comes from a privileged background or not – she seems to have made it on ability, hard work and, okay, extreme good looks.

Jacinta: To those in the west who might not be familiar with her, I’d describe her as a sort of blend of Angelina Jolie action figure and a slightly more boyish version of Emma Watson. What do you think?

Canto: Mmmm no, neither of those women come to mind. For a start she’s no statuesque figure, she’s quite slim and slightly built. I don’t really compare her to any western actors – she’s incomparable. She’s definitely a sporty type with energy to burn, and with an independent nature…. It’s fascinating to me that she’s never married, though she’s approaching forty, and still absolutely stunning.

Jacinta: Well, we’ve been doing some background checks, via Google haha, and her private life, at least regarding relationships, is a completely closed book. I get the impression she’s something of a workaholic, with an extraordinary list of performances over twenty years, and a very healthy bank balance with her star having risen so much over the last decade. So what’s she doing with all that loot?

Canto: Are you being skeptical of her outwardly sweet character or just genuinely questioning? Let me first describe her in the most positive light. I doubt that she’s a fitness fanatic or anything, but I think that especially in her earlier roles, once she got established enough to pick and choose, she relished roles that were physically active and often beautiful, I mean physically, in terms of movement and grace. For example in Sex is Zero (2002) she played an aspiring national aerobics champion and went into full training for the role. For the drama Damo (2003) and the film Duellist (2005) she learned how to wield a sword, and for the ultra-energetic sci-fi action flick Sector 7 (2011) she learned scuba diving and other fancy stuff. But perhaps the most impressive thing I’ve read about her dedication to her craft was her months of boxing training for Miracle on First Street (2007), during which she actually got knocked out. There’s a description here of the filming by the director Yoon JeGyoon, which is essentially a heart-felt tribute to Ji-won. It brought tears to my eyes. And so it goes…

duelling with spirits

Jacinta: I can see you’re getting emotional again, mate. I agree with you she’s amazing in that way. And it wasn’t just in her early roles that she was doing all that physical stuff. In Sector 7 and and in the hugely successful Secret Garden (2010), in which she played a stunt-woman, she challenged herself to the utmost. And don’t forget the film As One (2012), in which Ji-won played South Korean table tennis champ Hyun Jung-hwa. We haven’t seen that one but it recreates a very touching event in recent Korean history, when the two Koreas united to form a single table tennis team in 1991, an act of reconciliation after the downing of a passenger plane by North Korea in 1987. It’s a movie all about women and friendship and I’m really really keen to see it. Ji-won had never played table tennis before and trained intensively for four months, though she was recovering from an ankle injury sustained while shooting Sector 7.  She was under the tutorship of Hyun Jung-hwa herself, and was determined to imitate the details of her playing style.

Canto: Yes, that’s a must-see movie. Now, I’m sure that all good actors throw themselves whole-heartedly into their roles, but I’ve never encountered anyone so determined about it as Ha Ji-won. And what I get from all the sources I’ve read is that she virtually never complains and is always smiling and happy on set, always lifting the spirits of those around her. Everyone seems to love working with her, it’s almost sickening.

Jacinta: She’s very demanding of herself, though. She actually tried to drop out of As One because she felt her table tennis ability wasn’t up to scratch and she’d let the whole film down.

Canto: I could talk about her forever, it’s such sheer pleasure. Also I think it’s because contemplating her keeps me young and frisky….

Jacinta: You’re only as young as the one you love. Shame she doesn’t speak your language. Do you think she’d be into science?

Canto: Mmmm. An important question. I note from her bios  that she’s not religious, that’s a good start. I’m sure she’d be open to it. It’s not just wishful thinking to believe she’s a very smart cookie…

Jacinta: I agree with you there – she’s been very smart about her career, having the foresight to see, once established, the kind of roles that would challenge her and excite an audience. Even though that foresight may well be largely unconscious…

Canto: I think she scores very high on EQ, emotional quotient, if that’s a thing. That’s what gives her the rapport she has with the team around her, and with her fans. She knows how to deal with people without even knowing how she knows how. She’s just a natural. Here’s an example. In this café interview (I can’t find it now – she’s done so many!), she’s asked by a young paparazzi type ‘There’s one question I need to ask you: when did you start to be so pretty?’. So Ha Ji-won’s face turns serious as this question begins to unfold: she’s expecting something heavy, then when it turns out to be frivolous, you can see her serious face registering it, after which she falls forward with a laugh, putting her hand over her face. Totally spontaneous and endearing, and much better than how I might’ve been tempted to react, i.e. with scorn. Then, quickly recovering, she answers with disarming truthfulness, ‘when I was born’, after which she breaks into embarrassed laughter again, as if she’d been immodest. But of course she was correct, she was born pretty, that’s to say very lucky, and she knows it. And she managed to convey that, and yet to keep everything good-humoured and light. Maybe it’s nothing, but I think it’s a kind of genius she has.

Jacinta: You’re in a bad way, mate. Tell me when they ask her some more interesting questions. So do you recommend any of her work?

Canto: Well I’m just exploring what’s available on YouTube, some of which is of poor film quality, and some of which is either poorly translated or not translated at all, especially her earliest stuff – and I want to trace her career from the beginning. So, yes, I’ve become addicted to Ha Ji-won, I’ve chosen her as my guardian angel and guiding spirit – I’ve even thought of dedicating a new blog just to her – but that might be a bit excessive….

Jacinta: Maybe a bit, but whatever floats your boat. Back to my question – any work you would recommend?

Canto: I’m not sure I’ve seen her best work yet, but the film ‘Miracle of a giving fool’ (2008), also known as ‘BA:BO’, has a lovely understated performance from her. A nice intro, though maybe not, as it doesn’t give much indication of her capabilities. The TV series ‘Damo’ (2003) might be better, but I’m having trouble finding a fully translated version. Horse-riding and swordplay aplenty. Anyway, she’s a wonderful woman, an inspiration, and I think you need to see a lot of her work – depth in diversity is her greatest achievement.

spreading the love

 

Written by stewart henderson

April 14, 2017 at 12:41 pm

Posted in feminism, health, modesty, power, romance

Tagged with , ,

no jab no pay starts now

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Untitled-183-587x390

actually, a fairly unsystematic campaign to protect kids, often from their own parents

Jacinta: I believe the federal government is bringing in new rules penalising parents who choose not to vaccinate their children. Do you know the details, and how do you think the anti-vaccination movement, which is quite strong in Australia, is going to react?

Canto: Well, first I’ll note that when looking up this issue on the net I found a disproportionate number of anti-vaccination or ‘vaccination skeptic’ sites cropping up on Google. It’s very disheartening that the ‘AVN‘, formally deceitfully titled the Australian Vaccination Network, now forced by law to call itself the Australian Vaccination-skeptics Network, comes up first all the time. Other depressing sites that come up include nocompulsoryvaccination and ‘natural society‘. These appear to be US sites promoting the ‘nature is better’ fallacy or some dubious form of libertarianism, and I suppose they have ways of maintaining a high internet profile.

Jacinta: Well, this is the thing, they have a ’cause’ to rally around, whereas the immunologists and doctors who know the science don’t see what the fuss is about, and just assume that everybody respects scientific methods and results. Which is obviously far from the case.

Canto: Well anyway yes the federal government, and the Victorian state government, have created bills to better enforce vaccination, and the Australian government’s measure came into force on January 1. Child care payments and family tax benefit part A supplement will only be paid for children who’ve been immunised or have an approved immunisation exemption.

Jacinta: So, can you get an exemption easily, due to your firm belief that vaccinations cause diabetes, or autism or whatever?

Canto: Only on religious grounds.

Jacinta: Ahh, but can’t the refuseniks claim to be religious, since they have very strong beliefs based on no evidence?

Canto: Ha, well, I’m sure they’ll try. And actually I think it’s going to be difficult for the government to enforce this one.

Jacinta: Why should it be? Surely they have immunisation records through Medicare, it would be easy enough to check.

Canto: And what if the child spent the first few years of life overseas? And what if a parent insists the child was immunised but there’s no record?

Jacinta: Mmmm, I think these are minor difficulties, and I belief it has a support level of over 80%.

Canto: Yes so we’ll have to wait and see what plans the AVN have to try and sabotage it. Other state governments, in Victoria, Queensland and possibly elsewhere, are introducing measures in harmony with this, so it does seem to deal a serious blow to the refuseniks. And of course it’s hoped, or expected, that it’ll bounce the fence-sitters off the fence and so increase community immunity.

Jacinta: And that reminds me, I was reading somewhere about anti-vaccination hotspots. Any info on that?

Canto: Well yes, they’re the places to look to for trouble. The low-down on all that can be found at this slightly unlikely source, Mamamia, an entertainment and lifestyle website – and good on them. It also has a graphic from the Department of Health that reveals the alarming rise in ‘conscientious objectors’ to vaccination in Australia over the last 15 years, from 4000-odd in 1999 to over 36,000 in 2013.

Jacinta: So does it mention anywhere in South Australia?

Canto: Yes, and I’ve noticed that these hotspots are often in quite affluent regions…

Jacinta: Depressing.

Canto: Yes, the Adelaide Hills region, which I would think is generally quite affluent, has one of the highest objection rates, with 86% of children under 5 vaccinated compared with the state average of 91.5%. But then they say that many other areas are under 85%, including Port Adelaide, Holdfast Bay – that’s the Glenelg region, and Playford. So a mix of semi-affluent and relatively disadvantaged regions. Hard to make sense of it, but I think there’s a distinction to made here between the refuseniks and those who just don’t get round to vaccinating their kids.

Jacinta: Right, and that wouldn’t necessarily come out in the data.

Canto: Yes, some are slackers and some are refuseniks.

Jacinta: And some might be fence-sitters who might be spurred into getting their kids vaccinated by this stick approach.

Canto: Yeah we’ll have to wait and see whether the unvaccinated numbers go down over the next few years.

Jacinta: Which makes me wonder, how do they know that those figures you quoted before – some 36,000 – were ‘conscientious objectors’?

Canto: Well they probably don’t for sure, but it’s highly unlikely that those numbers have gone up by almost a factor of 10 in fifteen years due to sheer complacency. I mean, is it plausible that in the last 15 years or so we’ve become 10 times more slack as a nation about our children’s health? No, there’s something much more disturbing going on. Mamamia quotes a Melbourne virologist, who claims that in some pockets of the nation our immunisation rates are lower than South Sudan.

Jacinta: Oh well done. I’m guessing they enforce vaccination in South Sudan, or I might be suffering from the delusion that most African governments are brutal dictatorships. Anyway, what are the biggest or worst hotspots nationally? I’m thinking Nimbin.

Canto: Yes, that area – Nimbin, Byron Bay, Mullumbimby, that whole northern New South Wales coastal area has vaccination rates down between 60% and 70%. Mullumbimby is the town with the highest objection rate in Australia, and the lowest immunisation rate, at under 50%. Steiner schools are popular in this region, unsurprisingly, and they’re openly promoting refusenik behaviour. But there are many other problem regions, such as Queensland’s Gold Coast and Sunshine coast. Noosa on the Sunshine coast also has very high objection rates.

Jacinta: These are quite wealthy areas I suppose. Any idea why this is happening?

Canto: Well, I can only speculate, but I think, with wealthy people, there’s a greater degree of resistance to government measures, obviously in the case of taxation, but also with health matters. They’re rich, they’re healthy, they feel they’re already immune, and that if they just maintain a healthy lifestyle they’ll be fine. Clearly they’re not particularly informed about the benefits of vaccination, or choose to believe those benefits are exaggerated. I suspect that the further we remove ourselves from the bad days of TB, diphtheria, mumps and measles, the more we’ll get this creeping belief that vaccines are over-rated. The positive thing, though, is that we still have some 83% of parents in favour of some kind of punitive measure for those who don’t or won’t vaccinate their kids. But I do suspect that percentage will reduce over time. We humans have short memories and an over-supply of hubris, it seems to me. Or perhaps we’re just a bit over-confident with respect to our survival mechanisms. We’re like teenagers, we rarely listen to our parents – they’re history, after all. We need a few life-blows to counter our cockiness.

Jacinta: Hmmm, grim but probably true. Anyway, the government has acted and that might reduce the number of fence-sitters, even if it polarises the issue a bit more.

Written by stewart henderson

January 3, 2016 at 9:09 am

does this change everything? Paris, Naomi Klein, extractivism and blockadia

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Canto: Well I’ve just managed to finish reading Naomi Klein’s great big book about the politics of climate change, This changes everything, and since this more or less coincides with the recent political decisions made about tackling climate in Paris, I thought we might spend this session, or even a few sessions, on the future of clean energy, the fossil fuel industry and so forth.

Jacinta: Ah yes, the Paris conference, can you fill me in on that? All I know is that the outcome is being touted as a turning point, a watershed moment, but I presume none of it is enforceable, and I can’t really see the fossil fuel giants giving up the ghost, or considering anything much beyond business as usual…

Canto: Okay, the UN climate change conference in Paris ended on December 12 2015, having run for about 3 weeks. The principal outcome has been the Paris agreement, which was a more substantive agreement on emissions reduction than has been achieved in the past. It apparently represents a consensus drawn from some 196 national representatives.

Jacinta: And I seem to recall the figure of 2% being bandied about. What was that about?

Canto: Ummm, I think you might be referring to the plan, or hope, to limit global warming to 2 degrees, through zero net greenhouse gas emissions in the second half of the 21st century, globally.

Jacinta: Wow, that’s some hope.

Canto: Well the hope is to keep the warming to well under 2 degrees C, preferably aiming for 1.5, which would entail substantial reductions well before 2050, but of course this is all promises, promises.

Jacinta: So what about enforcement, and how is this going to be achieved nation by nation, considering that some nations are huge emitters, and some nations, like India, are still developing and industrialising?

Canto: Right so there are all these semi-commitments and promises, but crunch time starts in April 2016, from which time the relevant parties are asked to sign up to the agreement – that’s 197 parties in all, including all member nations of the UN, the European Union and some not-quite-nations like Palestine and the Cook Islands. They have a year to sign up, and the agreement will only come into force if 55 countries that produce 55% of global greenhouse emissions sign up.

Jacinta: Wait, does that mean all of the top 55 greenhouse gas emitters, or any 55 that together emit 55% of the greenhouse gases emitted by humans?

Canto: Uhhh, I’m not sure but I think it’s the latter.

Jacinta: Great, so Australia doesn’t have to sign. Quel soulagement!

Canto: Funny that, because the Wikipedia article on the Paris agreement, specifically mentions the climate change ‘skepticism’ of our conservative government…

Jacinta: Wow, what an honour.

Canto: Time to lobby our environment minister. Of course there are a lot of people protesting that this agreement doesn’t go far enough – not so much in the targets as in the voluntary nature of it all. I mean, it may not even come into voluntary force if nations don’t sign up to it, and of course there’s no enforcement mechanism. Here’s how Wikipedia describes the situation:

The Agreement will not become binding on its member states until 55 parties who produce over 55% of the world’s greenhouse gas have ratified the Agreement. There is doubt whether some countries will agree to do so. Each country that ratifies the agreement will be required to set a target for emission reduction, but the amount will be voluntary. There will be [no] mechanism to force a country to set a target by a specific date and no enforcement if a set target is not met. There will be only a “name and shame” system or as Janos Pasztor, the U.N. assistant secretary-general on climate change, told CBS News (US), a “name and encourage” plan.

Jacinta: Well I think it’s definitely a positive development, which will add pressure to the fossil fuel industries and their supporters. I notice that one of our green pollies was castigating the government the other day about the expansion of the Abbott Point coal terminal, citing the Paris agreement. That’s going to be a much repeated dagger-thrust into the future. So how does this all connect with Naomi Klein’s book?

Canto: Well I think you’re right to accentuate the positives. I mean, how can you seriously police or enforce such an agreement without interfering with the ‘national sovereignty’ that so many nations bellow about – especially when there’s a hint of criticism from the UN? So the first real positive coming from this confab is that all the parties are in agreement about the imminent threat of AGW, and they’ve actually managed to come to a broad agreement over a target and a goal. That’s a big deal. The second positive is, as you say, the impact of that consensus on the battle against the cashed-up fossil fuel industries, and the mostly conservative governments around the world that are still into science denialism, including our own government. As to This changes everything, Klein sees the AGW issue as a possible game-changer for the politics of global capitalism and free marketeering, which is rather ambitious, but she puts her faith in the protest movements, the indigenous rights movements and other grassroots movements who are, as she sees it, rising up more than ever before to create headaches for the business-as-usual model. She calls this grassroots approach ‘blockadia’, probably not an original coinage.

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Jacinta: So she sees it as an issue to fight global capitalism, to replace it with… what? Surely the renewable energy industries are capitalist industries too?

Cant: Well yes, I think there’s a certain amount of idealism in her view, an old-fashioned back-to-nature ethic, and I don’t think she emphasises the solutions and the science as much as she emphasises the problems and the politics, but if you take the view that the fossil fuel industries need to be phased out, sooner rather than later, you’ll perhaps be as much inspired by the heroic and hard-working efforts to prevent mining and drilling – which, let’s face it, have caused huge devastation in many areas – as you will by the innovations and improvements in clean energy. Which brings me to the other term used a lot in Klein’s book – extractivism.

Jacinta: Which presumably stands not just for the fossil fuel industry but the whole mentality of ‘what can we extract from this entity?’, be it animal vegetable or mineral.

Canto: The ancient Greeks did it with their slaves, the British did it with their colonies…

Jacinta: And their slaves..

Canto: The tobacco industry are doing it with the resource of willing smokers in non-western countries, poachers are doing it with elephants in Africa, the porn industry is doing it with pretty and mostly impoverished girls in the US and Europe, multinational companies are doing it with cheap labour worldwide. Extractivism has always been with us…

Jacinta: Point taken but I think we’re getting a bit carried away here. I presume Klein was using the term in a more limited sense, though perhaps with a nod to broader extractivist tendencies. And I have to say, quite apart from the devastation caused by tailings and disasters like Deepwater Horizon, I’ve always felt there’s something not quite right about our recent cavalier exploitation of a process of incredibly slow transformation of once-living and evolving entities – our ancestors in a sense – into coal and oil. Doesn’t it seem somehow sacrilegious?

Canto: Well perhaps, but I’m not sure if ‘exploitation’ is the right word. People get exploited. Okay animals can get exploited. But dead matter turning into coal? All species do what they can to survive and thrive, and they don’t worry about the cost to others or to historical processes. Right now parrots are feasting on my neighbour’s fruit trees. They’re extracting what they can in one go, and they’ll be back for more unless someone stops them. My neighbours might consider the parrots a pest, but that’s only because they want to extract as much as they can from those trees, to make jam, or to add fibre and other nutritional elements to their diet. As to the fossil fuels I’m all for keeping them in the ground, but more because of the damage they do to our atmosphere than because it’s ‘nice’ and ‘respectful’ not to extract them.

Jacinta: Spoken like a true instrumental scientist, but I can’t help feeling there’s more to it than you say. But what do you think about the view that this is a game-changer for global politics? Klein subtitles her book ‘capitalism v the climate’, as if one or the other has to come out on top. Do you think that’s really the choice?

Canto: No I don’t, but I doubt that Klein really imagines, or even wants this to spell the end of capitalism. I’m no anti-capitalist of course, but then I see capitalism in much broader terms. Those parrots are capitalising on a resource previously unavailable to them, and they’ll continue to do so unless prevented, by netting or something worse. Fossil fuel companies have learned to capitalise on a resource previously unavailable to them, before we learned how to process and extract energy from such material, and they’ll continue to do so unless they’re prevented, by legislation, by blockadia, or by the availability of more attractive alternatives, such as the more effective exploitation of the sun. Or capitalising on the solar resource.

Jacinta: So you believe that all humans, or rather, all creatures are capitalists? Isn’t that a bit of a narrow view?

the capitalist menace

                                                                                  the capitalist menace

Canto: Well no, as I say, I think it’s a broad view of the capitalist concept. But of course you might say that this hardly accounts for blockadia. If we’re all capitalists at heart, how do we account for the amount of energy so many citizens put into blocking capitalist exploitation? But that’s easily explained by the parrots and fruit example. The parrots’ gain is the neighbours’ loss. The neighbours have gone to a lot of trouble cultivating the ground, planting the trees, watering and fertilising, and these pesky parrots have come along without so much as a by your leave, and devastated the crop. Similarly farmers who have put a lot of time and energy into cultivating their land, and indigenous people who have learned over generations how to fish and hunt in an area in such a way that stocks can still be replenished rather than devastated, are naturally outraged that these fossil fuel companies have come along and ‘poisoned the well’. The farmers and the indigenes are also capitalists, very effective capitalists for their own needs, but they’re faced with different types of capitalists with different needs. So, to me, it’s a matter of resources, needs, diversity and negotiation.

Jacinta: Hmmm, well I’m inclined to agree with you. Of course indigenous people, such as our Aborigines, like to talk of spiritual connections to the land and its bird and animal life, but I’m not much into spirituality. But I like the idea that even though they’re into hunting and killing those creatures in order to survive, they tell stories about them, and exhibit a great deal of respect and fondness for them. That seems healthy to me.

Canto: I agree completely. I’m not trying to say ‘all is capitalism’. There’s much more to life than that. The beauty of that story-telling and that affection for the land and its inhabitants and their ways is that it’s not a kind of master-race view. The Judeo-Christian view has been that all things, including all creatures, have been put here for our benefit. Of course modern Christianity has largely re-interpreted this as custodianship, which is an improvement, but I prefer the perspective that we’re all in this together, and we should look out for each other. Birds have to eat, and they like to eat fruit, and birds are fantastic creatures. They deserve our consideration.

Jacinta: Well that’s a nice note to end on. And what about the fossil fuel industry?

Canto: I think it’s had its day. It’s time to move beyond it.

Written by stewart henderson

December 31, 2015 at 8:45 am

HIT, mitochondria and health

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comparing-hit-with-other-exercise

 

and for a gentler form of exercise...

and for a gentler form of exercise…

Jacinta: Well now, I know you’re dying to explore the recently touted benefits of your favourite exercise, so let’s have it.

Canto: Yes, I’m very much a HIT man, that’s high intensity interval training, highly recommendable because it takes so little time and only requires an exercise bike. I was put onto it by one of Michael Mosley’s documentaries, though I’ve been a rather theoretical enthusiast in recent times, having trouble overcoming my laziness and my pain-avoidance tendencies, because though it’s short exercise it is a little painful.

Jacinta: So the recent Catalyst episode has brought your enthusiasm surging back?

Canto: Naturellement, especially as it brings with it some new research to focus on. Mitochondria – what do you know about them?

Jacinta: That they are organelles in our cells, believed to have originated as bacteria but to have united with our eukaryotic cells way back in time in a process known as endosymbiosis. They’re also responsible for producing ATP, the energy molecules… though I’ve no idea how, or what an energy molecule actually is.

Canto: That’s music to my ears.

Jacinta: The dulcet tones of ignorance?

Canto: In the country of the blind the one-eyed science pundit is king, and I’d rather be a king than a commoner, so hear ye, my subject.

Jacinta: I may be blind but I’m all ears, Your Majesty.

Canto: Well, as the Catalyst program tells us, mitochondria are about a billion times smaller than a grain of sand, but the world at nanoscales has really opened up to us in recent decades. Mitochondria are good for us, and the more the merrier. And the evidence is that HIT exercise can not only increase the production of mitochondria but increase their function.

Jacinta: So how do we produce mitochondria?

Canto: Are you going to keep interrupting me with questions? Okay, the production of mitochondria relies on our oxygen intake. The story goes that we fill our lungs with oxygen and it enters the bloodstream for a specific purpose…

Jacinta: Hang on, we fill our lungs with air, not just oxygen, so how does the oxygen get separated, and how does the blood take up the oxygen? Aren’t you skipping a few steps here?

Canto: Yes, go and research it yourself and you can report on it next time. The destination of this inhaled oxygen is the mitochondria. There are billions of these mitochondria in our musculature, though the more fit and trained up you are, the more you’re likely to have. Mitochondria apparently comprise some 10% of our body mass, which I’m sure will come as a surprise. Now oxygen, as you know, acts as a corrosive through the process known as oxidation, which involves the loss of electrons…

Jacinta: Hang on…

Canto: Please shut up. So oxygen can have a negative effect on proteins, enzymes and even our DNA, but mitochondria uses this corrosive electron-stripping power to break down nutrients and to create energy in the form of adenosine triphosphate (ATP). Don’t ask! Of course this doesn’t just happen in humans but in all other mammals and complex creatures, and in plants. And that brings us to physical fitness, and the VO2 Max, which is, essentially, the measure of the fitness of our mitochondria. The term stands for volume (V), oxygen (O2), and of course maximum, though generally those concerned with aerobic fitness don’t make the association with mitochondria, they’re just looking at increasing their maximum oxygen consumption levels. Now it’s not an easy thing for impoverished nonentities like us to find out what our VO2 Max is, but it’s probably pretty pathetic. It’s something that endurance athletes tend to obsess about as they try to improve their performance – I believe rowers in particular have some of the highest levels. I notice there’s at least one VO2 Max app on the market – going very cheap too – but I’d be very sceptical about its reliability. In the testing facility shown on Catalyst they measure it via a version of HIT. They get the subject to ride an exercise bike, building up speed till she’s going as fast as she can, and she can go no faster and starts slowing down. That peak represents her VO2 Max. She will be tested 16 weeks later, after a mere 6 minutes of HIT a week, and you can bet your rented house that her VO2 Max will have substantially improved.

Jacinta: So for us low-lifes – excuse my interruption – who can’t easily or cheaply measure improvements in our VO2 Max or, say, our fat to muscle ratio, we just have to feel the difference in aerobic fitness, mitochondrial health and the like…

Canto: Yeah, and your weight will go down too, if you’re carrying a bit extra, as we both are. And the exertion will make you feel better and healthier, I guarantee it. We all know that the placebo effect is real after all. But seriously, I’m sure if we keep to a regime of HIT – say 3 bursts of 20-second full-pelt pedalling interspersed with a minute or so of more relaxed pedalling, or even if we start with 10-second bursts and then 15-second bursts, maybe eventually getting up to 30-second bursts, we’ll feel it getting easier, and it won’t be purely subjective even if we have no way of objectively measuring it.

Jacinta: But shouldn’t we consult a doctor beforehand? I already feel a heart-attack coming on.

Canto: I know you’re joking, but certainly anyone who has any kind of heart condition, or are diabetic or pre-diabetic or have any other serious chronic condition should discuss it with their GP, but really, apart from your couch potato tendencies, there’s nothing wrong with you.

Jacinta: You’re right, and I’m looking forward to the challenge, even though I’m already a to-die-for, effortlessly slim, perpetually twenty-two year old intellectual beauty..

Canto: And I’m the ultimate metrosexual hipster of indeterminate age and shoe size, discreetly tattooed and tucked…

Jacinta: Ah, yuck, you stupid twat, tattoos are the most repugnant fashion development of all time. At least you’re not a spornosexual, yuk, stay away from the gym or I’ll never speak to you again .

Canto: Promise? Anyway, around 35 is the average VO2 Max, but that’s a bit meaningless for us low-lifes as you say. Top athletes have levels in the 60s and 70s, with the highest ever recorded being around 96 or 97 for humans, but some mammals – like racehorses and Siberian sled dogs – can reach much higher levels. But there’s also going to be a big improvement in your fat-to-muscle ratio with regular bouts of HIT. In the Catalyst episode, the reporter took a DEXA body composition scan to measure this ratio. It also measures bone density. DEXA stands for Dual Energy X-ray Absorptiometry, that means you’re subjected to 10 minutes of very low-dose x-radiation at two different energy levels. It measures the relative densities of the different tissues. You can get this scan done in Adelaide, for a baseline measure, but it’ll probably cost an arm and a leg.

Jacinta: One way to lose weight. Cheaper to just take it for granted that you’re getting more muscular with every HIT.

Canto: Spoken like a true scientist. But generally, inactivity itself is a health problem, and anything that raises your metabolism, as HIT most definitely does, will be good for you, if it doesn’t kill you. And of course one of the most exciting findings in recent times is that your VO2 Max can be raised, with all the associated health benefits, without spending crazy amounts of time and money at the gym.

Jacinta: So how did they make this discovery?

Canto: Well I suppose they were doing a lot of experimenting and testing around the health benefits of exercise, but one test, a Wingate test, involved 30 seconds of all-out pedalling on an exercise bike, repeated a few times between periods of rest, to make up to two or three minutes of full-on exercise per session.

Jacinta: And this was for already-athletic types, right?

Canto: Yes – not advisable for middle-aged or post-middle-aged couch potatoes to start on that regimen. I’m currently doing three fifteen-second bursts, building up to 20-second bursts, then up to 30 seconds and no more. So researchers found that endurance levels can be dramatically improved after just six minutes or so of this kind of exercise. A doubling of endurance capacity, no less. Compare this to the current recommendations of 150 minutes a week. Who ever does that, apart from gym junkies?

Jacinta: So, it’s like this incredible short-cut to health.

Canto: Well of course it isn’t the solution to all ills, but among other things such a quick turn-around is a great motivator towards a healthier lifestyle all round. And it doesn’t have to be an exercise bike – you can adapt it, for example you can get yourself outside and do interspersed 30-second sprints, but I hate running and I’ve got a gammy knee so I’ll stay on the bike.

Jacinta: So, have they looked more into the actual science of this? What’s happening here?

Canto: Well again it seems to be about sucking in oxygen and providing a drug hit to the mitochondria. They did this rather nasty experiment with mice, genetically modifying them so that their mitochondrial DNA wasn’t functioning properly – their mitochondria were getting worn out. They looked pretty sorry-looking compared to the control mice, prematurely ageing as evidenced in their fur, their neural activity, heart function and sensory abilities. Their life-span was about half that of normal mice, and no drugs improved the situation.  Then they set them on a treadmill regularly, 3 times a week, at a brisk pace, for 45 minutes each session, which you might think would’ve killed them off all the more quickly, but the result was a spectacular improvement in mitochondria production and overall health and energy levels.

Jacinta: And this was in genetically modified mice?

Canto: Apparently so. The program didn’t go into detail about that, except to say that the bad mitochondria were apparently being selected against. Now of course we’re talking about mice here, and this was looking at endurance fitness rather than HIT, but it’s been shown that HIT does all the right things, and in some areas performs better than endurance training. Reductions in blood pressure, improvements in insulin sensitivity, in muscle to fat ratio, in VO2 max all in a matter of weeks, but the really interesting finding was that with HIT, improvement in mitochondrial function was significant – which wasn’t the case after endurance training.

Jacinta: How do they know that?

Canto: They took muscle samples and measured the ability of the muscles to produce oxygen – basically a measure of mitochondrial function. After just four weeks of HIT, mitochondrial function improved by up to 30%, while endurance training over the same period showed little or no change.

Jacinta: Wow. Doesn’t say much for endurance training.

Canto: Well endurance training does improve your VO2 max and it’s hardly bad for you. But the thing with these quick sprints is the difference at the muscle level. Sports medicine distinguishes between fast-twitch, slow-twitch and intermediate muscle fibres. HIT uses a wider range of muscles and muscle types than endurance work, and that seems to be the key. Improvement in mitochondrial function confers a heap of benefits, so this kind of exercise wards off neurological and other conditions, including muscle weakness and epidermal deterioration, the tell-tale signs of ageing. In fact all exercise does this. Ever heard of the stratum corneum?

Jacinta: Mmmm, corneum, cornea, isn’t that part of the eye?

Canto: Excellent guess but wrong in this case. The stratum corneum is the top layer of the epidermis, the skin. It starts to thicken as you age, and the layer underneath gets thinner as your mitochondrial function reduces. You can slow down that process quite significantly with regular exercise. They did skin biopsies of sedentary people over 65 before and after endurance training. After just 3 months the skin showed great improvement – a 20 to 30 ‘youthening effect’, according to one researcher. The dead outer layer thinned, and the dermis, full of collagen fibres, thickened. So, clearly, you’re never too old to start.

Jacinta: Or never too young. So okay I’ll start.

Canto: Great, but let me describe one more impressive study, being done on menopausal women using HIT. Menopause is about a major decline in estrogen, which has serious vascular, heart and metabolic effects, as well as insulin resistance. You tend to produce a lot of bad visceral fat which negatively affects the liver, due to the over-production of cytokines – but that’s another story. Anyway, the women were given a sprint regime, of just a short period of fast peddling interspersed with more relaxing peddling, amounting to eight minutes of fast but not hard exercise all up. The results of this research haven’t been published yet, but the women’s self-reporting is all very positive, which isn’t surprising. The research is also based on previous research with obese young men, and the exercise proved very effective. Visceral fat is generally much easier to reduce than subcutaneous fat.

Jacinta: Okay, so we’re going to do this?

Canto: Absolutely. And finally, here are some links.

 

The Catalyst episode, http://www.abc.net.au/catalyst/stories/4319131.htm

http://www.tabataprotocol.com

https://newsroom.unsw.edu.au/news/health/sprint-fight-fat

High-Intensity Training and Changes in Muscle Fiber, [www.springerlink.com/content/1137px7x66667132]

Written by stewart henderson

October 16, 2015 at 8:34 am

kinesiology, TCM and depression

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a kinesiology wheel - proof positive of profundity

a kinesiology wheel – proof positive of profundity

Jacinta: So, Canto, the new USSR hasn’t posted recently on old Wesley Smith and his wellness treatments. I think we should post on another one of those.

Canto: Oh god, do we have to? I’d rather talk about black holes or the edge of the universe…

Jacinta: I know I know, but, you could think of Wesley’s treatment centre as a black hole of sorts…

Canto; Yes, and like the other kind, the more you look for them the more you find them, and they all have similar properties…

Jacinta: Hopefully, though, they’re not as dangerous…

Canto: Well, that depends. The real black holes are light years away, whereas there’s a black hole of a wellness centre just around the corner from me.

Jacinta: Kinesiology. That’s the subject for today. Know anything about it?

Canto: No, except that, presumably, old Wesley offers it as a treatment. And kinetic energy is energy of motion, right? So, let me guess, kinesiology is the science of getting your energy system moving so fast that it flings your toxins out of every available orifice leaving you feeling not only light-headedly well, but thoroughly exercised, and of course exorcised.

Jacinta: Well I doubt if it’s as scientific as that, but you’re on the right track. Actually there are two meanings of kinesiology. It’s the scientific study of bodily movement, in humans and other animals, which means applying anatomy, physiology, biomechanics, neuroscience, and even robotics, to the understanding of  movement. And then there’s the naturopathically bullshittical meaning of kinesiology as deepily ancient chi-based treatment, much along the lines you just mentioned. And it’s this second meaning, as presented by the Australian Kinesiology Association (AKA), that we’ll be focusing on.

Canto: Chi wizz, this could be fun. Are they really into chi?

Jacinta: Oh yes. Their website gushes with it. It’s teeth-gnashing stuff actually. Apparently it combines western science with traditional Chinese medicine (TCM) to promote your spiritual well-being, among other things.

Canto: Hey, I’ve got an idea. You’ve heard about James Randi’s million-dollar challenge?

Jacinta: The one to psychics, promising a million to anyone who can provide scientific proof of their psychic abilities?

Canto: That’s the one, and I don’t know the details, and of course they all argue that it’s rigged against them, but it’s a good kind of bad publicity for psychics at least, but what if we offered a million dollars to anyone who can provide solid, or liquid, or gaseous evidence of the existence of chi?

Jacinta: Canto, we don’t have a million dollars.

Canto: But we don’t need a million dollars, we know there’s no such thing, right?

Jacinta: Uhhh I don’t think it would work that way. We’d need a rich backer, but in any case we wouldn’t get any takers. Having looked at a few forums discussing chi, its supporters usually say that, though it’s undoubtedly real, it’s not detectable or measurable by western methods, because it’s part of a wholly different mindset, a different way of knowing, a spiritual understanding that takes years to develop. They say, for example, that only by believing in chi can you unlock its healing powers.

Canto: So it’s placebo energy?

Jacinta: Okay small-minded little-faith man, let’s move on to kinesiology. The practice clearly takes advantage of the scientific cachet of kinesiology as body movement studies. Here’s what the AKA has to say about it:

 

Kinesiology encompasses holistic health disciplines which use the gentle art of muscle monitoring to access information about a person’s well being. Originating in the 1970’s, it combines Western techniques and Eastern wisdom to promote physical, emotional, mental and spiritual health. Kinesiology identifies the elements which inhibit the body’s natural internal energies and accessing the life enhancing potential within the individual.

Canto: aka bullshit.

Jacinta: Ha ha, but get what it has to say next:

 

The maturity of ‘Complementary Therapies’ is shown by some of Australia’s major health funds now paying rebates for many therapies, including Kinesiology. This acknowledges what is happening in the health sciences in the 21st Century. Australians spend over $1 billion annually on therapies not part of mainstream medicine. Kinesiology is one of the fastest growing of these and is now practised in over 100 countries.

Canto: Popularity as evidence. They’re really keen to show how legit they are.

Canto: Their choice, isn’t it? Survival of the brightest?

Jacinta: Maybe so, but I think the phenomenon’s worth pondering more deeply. How long does it take to become a qualified doctor in this country?

Canto: A GP? Well, for example, the University of Adelaide offers a six-year MBBS, that’s a Bachelor of Medicine and Bachelor of Surgery, to start off, but in order to get into that you need really good year 12 results – what they call your ATAR score (Australian Tertiary Admissions Rank) plus you have to pass a UMAT test, that’s a 3 hour multiple choice thing. UMAT stands for Undergraduate Medicine and Health Sciences Admission Test. Oh, and then you have to do well in an interview before a medical panel. So once you’ve been accepted and done your 6-year MBBS, you can apply to do Australian General Practice Training (AGPT) – or maybe you can apply while you’re doing the MBBS and integrate it into your undergraduate degree, I’m not sure. Anyway the AGPT takes another 3 0r 4 years, so it’s a pretty long journey.

Jacinta: Well, thanks for that fulsome response, it well illustrates the gap between evidence-based medicine and naturopathy. I see they’re very much into four-letter acronyms (FLAs) in that field. TLAs aren’t good enough?

Canto: Yes they like to consider themselves more lettered than others. But I should also point out that once they’ve been accepted into the ranks of GPs, or any other medical specialisation, they’ll automatically be able to access the latest medical knowledge in their field. In fact they’ll be bombarded with it, and will be expected to keep up to date. Whereas naturopaths are usually relying on ‘traditional’ techniques and ‘ancient’ herbal treatments, none of this new-fangled invasive or big pharma stuff.

Jacinta: Well I suppose there are a few properly qualified doctors who are into naturopathy, but by and large you’re right. So why is it that so many people are choosing naturopaths over these highly-trained and knowledgable practitioners of the latest evidence-based medicine?

Canto: Well, isn’t it because they aren’t getting what they want from GPs or other specialists? Whatever that might be. Holistic treatment, as they like to call it. A sense of trust. Something psychological, I suspect.

Jacinta: Yes, there’s that – some doctors are still not getting the message about how to share information with their clients, and how to see the approach to health as an interactive process. But it could be that evidence-based medicine is the victim of its own success?

Canto: How so?

Jacinta: Well these days, and WHO figures bear this out, patients are increasingly presenting with chronic conditions. That’s to say, the ratio of chronic illness to acute illness is increasing, and I’d say that’s largely due to the success of evidence-based medicine in the treatment of acute illness. Now of course chronic conditions can be serious and life-threatening – 60% of the world’s population die of them, according to the WHO – but they represent a whole gamut of complaints, from degenerative diseases to niggling backaches, neuralgia and the more difficult to pin down stuff such as chronic fatigue syndrome and fibromyalgia, or the chronic itching that some attribute to Morgellons disease. And then there’s depression…. So some of these ailments are met with skepticism or at least contradictory responses from trained medicos…

Canto: ‘Medical experts are baffled… ‘

Jacinta: Precisely, and many naturopaths see this area as their niche. They can get in and ‘listen’ to the client and treat her ‘holistically’ – that’s to say sympathetically. Much of it is feel-good treatment, so much more pleasant than what’s offered by hard-nosed, know-it-all, condescending doctors.

Canto: So it’s all perfectly harmless, then?

Jacinta: Well perhaps mostly, but there are obvious problems with giving too much legitimacy to these largely bogus treatments. An example of this is precisely what the AKA says on its website, that the ‘maturity’ of naturopathy is proven by the fact that many of their therapies are attracting health fund rebates. This is complete BS, it’s simply a populist move from the health funds, who know full well that naturopathy is here to stay, regardless of evidence. This of course gives the Wesley Smiths of the world more legitimacy and increases the chances of people with serious health issues being led to think that naturopathic shite can cure them.

Canto: Well, doesn’t that get back to survival of the brightest?

Jacinta: Maybe, but what about the scenario – and this has been played out – that a seriously sick child has been given a bogus treatment in lieu of real medicine, and has died of something perfectly curable, courtesy of her parents?

Canto: Mmm, couldn’t that be handled case by case? The parents could be up for gross neglect, and the associated naturopath could be had up for bogus claims leading to the death of a minor or something, and be barred from practising… or given some more serious penalty. Anyway we need to wind this up. Is there anything more specific about kinesiology we should be concerned about?

Jacinta: Kinesiology is generally associated with chiropractic, which is about as bad as it gets. As with naturopaths in general, some kinesiacs are more into woo than others, but the AKA website goes on about acupressure and meridians, and no credible evidence has ever been presented that acupressure points or meridional points actually exist. They’re of course part of TCM, along with vital energy and various other concepts and treatments that have no evidence or coherent mechanism of action to back them up.

Canto: You mean rhino horns and the penis bones of dogs don’t cure anything?

Jacinta: Sorry but rhinos are going extinct for an ignorant fantasy, not to mention the 12,000 or so asiatic black bears being kept on farms so that their bile can be extracted for ‘medicine’, which often drives them to suicidal frenzy. Other creatures being decimated by TCM include sharks, seahorses, tigers, turtles and saiga antelopes….

Canto: OK enough, I’m getting depressed. The final verdict on kinesiology?

Jacinta: Well it seems to be just a variant of chiropractic stuff, though probably even more unregulated, with a greater admixture of TCM woo. I have nothing more positive to say about it than that.

Canto: Whatever next…

 

Written by stewart henderson

August 20, 2015 at 10:17 pm