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2010-10-24T06:29:00.000-07:00

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Facts Not Fear For Flu

2010-10-08T04:59:00.000-07:00

As winter ends in the southern hemisphere it is worth looking at the winter flu season just passed and see how our friends the “experts” fared this year.

In May we had dire predictions of a “horror” flu season due to the H1N1 virus. These predictions came at around the time that vaccination of children under five was suspended sue to side effects including seizures and the death of a toddler after being vaccinated.

The government continued to promote the importance of being vaccinated against swine flu due to a much-feared “second wave”. Exactly how you can have a second wave when there was no first wave is another question. Of course the government had paid some $AUD140 million for vaccines which were not being used.

The facts speak for themselves. Figures from the Federal Health department shows that between January and the start of September some 417 cases of H1N1 had been notified. Now to be fair there may be many people with a flu like illness where the test to identify the strain is not done so more people likely had the flu.

And therein lies the first key point. This was just another winter like all others-no horror; no second wave just some people getting ill and the vast, vast majority getting better. Every year some people die with the flu (mostly these people have other illness already) and this year was no different.

Despite all the hysteria from health “experts” and the offer of a free vaccine, only 18% of Australians were vaccinated. The two main reasons were that people perceived swine flu as a mild illness and not a serious threat to their health. The other main reason given was concerns about the vaccine itself.

Here the plot thickens. The program to vaccinate children under age five was suspended due to side effects. A significant number had febrile convulsions (seizures) and there was at least one death. The coroners report ultimately found the vaccine might have contributed to the toddler’s death. Proving causation was never going to be possible. The child was well before the vaccination and died after it. We can draw our own conclusions.

And given the number of hospitalizations and issues with this vaccine, what was the main concern of the authorities? That an “important “ vaccination program was being held up. Never mind that more harm than good was being done.

Regular readers will know my views on swine flu, which are on the record from April 2009. This was always a normal flu like illness and there was no need for panic, hysteria and the waste of billions of dollars. Inquires are being held into the behavior of the WHO and conflicts of interest by those giving advice to governments and also advising vaccine makers.

At no time were the public given the truth. At no time was any useful advice about how to strengthen your immune system given. Basic things like drinking enough water, getting enough sleep, managing stress, eating enough fruits and vegetables. Let alone more specific information about having adequate intake of zinc, antioxidant vitamins, folate and vitamin D.

The web of deceit is starting to unravel. A major analysis published in the journal Eurosurveillance shows the flu vaccine caused more harm than good. For every hospital admission prevented there were two or three hospital admissions due to seizures.

Yet the response of the “experts” remains the same. According to the Australian TGA “the overall risk-benefit balance …remains positive” and the chief medical officer feels that the vaccine should not be withdrawn but that the government would reassess.

There is no point relying on so-called experts or the government. There is no need to get caught up in hysteria. The best way to stay healthy and keep your children healthy is to be in charge of your own health.

Reliance On Drugs HasA Human And Economic Cost

2010-10-01T05:33:00.000-07:00

When too many of us take too many drugs, there are consequences. These are both economic and human. The solution is to use drugs judiciously and not as a replacement for being responsible for what we put in our mouths.

Human inventions are not intrinsically good or bad. It is how they are used which determines this. For example a knife is useful to cut your food but can also be used to stab someone. Fire can warm us on a cold night but has the potential to burn the house down if not used correctly.

And so it is with pharmaceutical agents. They have the capacity to do enormous good when used correctly. However when misused or used inappropriately or when they are not really needed problems can and do occur.

Figures from the USA show that almost one in two Americans take at least one prescription drug per month, an increase of 10% over ten years. A staggering one in five children 11 years and younger were in the same boat. Spending on prescription drugs more than doubled to USD 234 billion over the decade to 2008.

Amongst the commoner medications used were those for cholesterol and depression in adults and for ADHD in adolescents.

British researchers have previously noted that 7% of NHS spending on drugs went on drugs for diabetes. Between 2000 and 2008 the number of prescriptions had risen 50% but costs had risen 104%. This reflects use of newer and more expensive (but not always better) medications. One of these is rosiglitazone.

The fundamental question that never gets asked is whether the best way to manage a problem is with medication? The second question which also is rarely asked is what other consequences might occur if medications are used?

We have just seen the withdrawal of diabetes drug rosiglitazone (Avandia) from sale in Europe and severe restrictions on its use in the USA. A report in the British Medical Journal (BMJ) had earlier called for the drugs withdrawal and questioned whether its use should ever have been approved.

The drug has been shown to lead to an increase in rates of heart attack and strokes in people taking the drug compared to those not. In 2007 a study showed a 43% increased risk of heart attack.

John Yudkin of University College London said in the BMJ “We need to be absolutely certain that our long term treatments for type 2 diabetes are not causing the very harm they are meant to prevent”.

Type 2 diabetes comes about predominantly from people eating too much processed and sugary foods, being obese and not exercising. Logic would dictate that the primary treatments would be correcting what led to the problem. Some people may still end up needing drugs but it would be far fewer and they may not need drugs as potent (or costly) as rosigltizone.

It has also emerged that another diabetes drug, pioglitazone (Actos) is being investigated as it may increase the risk of bladder cancer. It has also been shown that bisphosphonate drugs used for osteoporosis can double the rate of esophageal cancer.

None of this is to say that there is not a role for drugs. However when we are dealing with conditions that come about from lifestyle choices we make, reliance on drugs in preference to making the necessary lifestyle changes are not without other consequences. These examples show that just “popping a pill” may seem an easy option but may not be.

We Need More Fun Not More Fun Police

2010-09-24T02:40:00.000-07:00

The stupidity of government never ceases to amaze me. So far this year we have seen one local government wanting to charge people to exercise in its parks and a councilor in another claim that the City to Surf race should be “run somewhere else” (rather than to the beach).

Now just in time for summer we have Cottesloe council proposing a new raft of laws to make a day at the beach as much fun as a day listening to the thoughts of councilors. As usual this is all done in the name of making the beach safer and claims to be targeting “bad behavior”.

So what sort of dastardly crimes do the law abiding beach goers of Perth need to be protected from?

A few of the activities to be outlawed are digging holes (which are too big), flying a kite, taking photographs, playing with toy vehicles and having a gathering of more than ten people.

Just who will determine when a hole is too big? Will wee see rangers with tape measures deciding whether the hole dug by a five year old meets council standards. And too bad if your family has more than ten members, or if you have a group if friends, who you like to go to the beach with. And naturally any child caught bringing a toy car to the beach will rightly have it confiscated.

Ultimately this is all about petty bureaucrats and small-minded councilors trying to decide what people can do at the beach and raise some revenue into the bargain. The excuse is that the propose laws are in response to incidents. Even if there have been isolated incidents of “problems” due to a kite is banning flying kites for everyone the answer?

Of course not!

The increasing attempts by petty officials and small minded politicians at all levels of government to control each aspect of peoples lives needs to be stopped. Already a protest is being planned for Cottesloe Beach and a facebook group ha started. There are signs that due to the publicity the council is already backing away and is trying to blame some junior official for “misunderstandings”.

Fun and purpose is one of the pillars of DIY health. Petty laws which make it almost impossible to have fun at the beach without tripping over some ridiculous by-law is actually bad for the health of the community.

We need to have more fun, not engage more fun police.

There are enough laws to deal with antisocial behavior by the few. Infringing the rights of the majority with petty, stupid laws which seek to restrict and codify every possible use of the beach is an attempt by the totally humorless to inflict their view of the world on those who want to have fun. It is also a lazy way for governments to try and stamp out the behavior of a few by penalizing the many.

Freedom is one of those intangibles that we can take for granted until it is gone and you wake up one day to find you cannot play with your children at the beach. Health and freedom are related. Attacks on freedom need to be resisted.

Low Libido Can Be An Issue But Is Not A Disease

2010-09-17T03:18:00.000-07:00

The knockback by the FDA of a new drug for female sexual desire again casts a spotlight on the medicalization of life. The drug was knocked back for the simple reason that it had not been found to actually work

Interestingly the comparison is made with drugs like Viagra (sildenafil), of which there are three on the market. Some have claimed that it is discrimination that drugs are made for men whilst women do not have any. Others question the existence of what is described as hypoactive sexual desire disorder.

So lets look at the facts. Tablets such as sildenalil do not actually stimulate desire for sex (libido) in males. They relax blood vessels allowing increased blood flow to the penis. This only happens if a man is actually in the mood or has been stimulated. The tablet does not affect libido.

Hence calling the new drugs a “female Viagra” is wrong as the proposed new drug is designed to work on the brain and affect libido not work on the blood vessels once desire is already established.

The other key issue is whether a low interest in sex is a disease. The fact that it exists does not make it a disease nor does it mean there is something “wrong” with women (or men) who may have a lower interest in sex than others. It becomes a problem it troubles the individual or is a problem in a relationship.

A problem can be real but not every problem is a disease and hence the answer is not necessarily a drug and may lie elsewhere. Worse still, labeling it as a disease, and looking for a drug as the answer, distracts people from the real cause and hence the real solution.

Sexual desire is influenced by a large number of things. Keep in mind that humans are almost unique in nature in that they have sex other than purely for reproduction of the species. Furthermore what constitutes “normal” is impossible to define. Whilst countless surveys are done to determine how often people have sex and their level of interest, all of these studies rely on self reporting and hence people may report what they want to rather than what they do.

Libido is influenced by tiredness, stress, diet, fitness levels, hormones and our emotions to name just a few. Obesity alone has a major impact on people’s sex lives. Obviously how a relationship is going to have a major influence too. At times other issues in life take precedence. When people are focused on work or on raising children, interest in sex can take a back seat. When people reach bed and are exhausted and really ready to sleep it is not surprising that they do not feel like having sex.

There is at times a clash between the mind which says, “we ought to be having sex” and the body which has not got the energy. As a society we also have very mixed attitudes to sex. Bar maids have been arrested for showing a glimpse of nipple yet half the videos watched don the Internet are pornographic. We express concern about teenagers having sex and yet bombard them with sexualized images. Marketers have known from day one that sex sells.

So what are we to do? A low interest in sex is only a problem if it bothers you. If it does then you need to realistically examine what is going on in your life. It may be that you need to change your eating patterns, or get fitter. It may be that you need to get more sleep. It may be that your relationship needs tending. Maybe you need some injection of romance. It may be that at present other things in your life are actually more important.

There is no absolute right or wrong. What matters is honest with yourself (and your spouse/partner) and making changes if you need and want to. Turning aspects of life into a disease and taking a pill is not the solution.

Women Are Smarter Than Governments And Health Experts

2010-09-10T03:13:00.000-07:00

When messages get confusing, people switch off. This has been demonstrated in dietary advice, where it has been shown that the more complicated the diet; the less likely people are to follow it. It has now been shown that official government guidelines on drinking alcohol have little impact on the behavior of expectant mothers.

A study in the Medical Journal of Australia shows that 80% of Australian women consume alcohol while pregnant. The study looked at consumption before and after changes in guidelines in 2001. Prior to 2001, the government recommendation was to drink no alcohol during pregnancy. This was changed to a safe limit of 6 standard drinks per week or less than 2 per day. In 2009, the guidelines were changed back to total abstinence.

What has been shown is that the behavior of women during this time was unchanged. Some 60% of women consume a small amount of alcohol (consistent with the 2001 guidelines), 20% drink less than that and a little fewer than 20% don’t drink at all during pregnancy. Less than 1% were found to consume a level regarded as dangerous.

Much effort and expense goes into developing guidelines. Governments and health experts often wring their hands about people not following their advice

What is really interesting in these figures is that the vast majority (over 99%) of women can figure out what is reasonable themselves. The vast majority of women can work out what is a reasonable and safe amount of alcohol to drink. They are clearly dismissive of scare campaigns about the dangers of even one drink. The reason for this of course is that small amounts of alcohol have not actually been shown to do any damage to the fetus. In turn, the reason for this is that small amounts of alcohol are easily processed by the body ,with no adverse effects.

There are of course, renewed arguments over labeling of alcoholic beverages. Governments and in particular, public health officials, love to be seen as doing something and they particularly love to hector the general public who they generally regard as being stupid. This survey shows that women are actually much smarter than government guidelines and health officials.

Interestingly, at about the same time, another study emerged which suggested that women who drank one glass of wine a day might have children who were better behaved than those who either drank no alcohol or drank heavily. To be honest, I would be very suspicious of these findings. There is no reason why one glass of wine consumed during pregnancy should influence the behavior of a child later in life.

What was really interesting though is that the researchers, despite making this finding, advised women to continue to observe Government recommendations of total abstinence. If the finding is valid, then you think they would be advising one glass of wine per day. If this finding is not valid, then why has it been published at all?

It is easy to imaging the noise that would have been generated had the study shown that one glass of wine per day led to worse behavior in children. This would be hailed as vindication of Government guidelines.

Whilst many in health claim to be guided by science, it is fascinating to see how when the results of their science contradicts their pre-existing beliefs that results can be dismissed.

Rather than being guided by confusing and changing guidelines, clearly women are best guided by their own intuition.

Drug Usage Is Not Black And White

2010-09-07T06:53:00.001-07:00

The airing of the Ben Cousins story recently has certainly fired up passions. It seems everyone has an opinion and so do I. Interestingly within the next week we saw more drug related headlines from another AFL player, Travis Tuck and actor Matthew Newton. Drug problems are not uncommon.

Ben Cousins has been a champion footballer in the Australian Football League (AFL) but his story could equally apply to a baseball, soccer or rugby or basketball player. It is the story of a kid who was thrust into the limelight at a young age and went off the rails and got into drugs. The television documentary followed the path of his journey through rehabilitation.

To be honest there was not a whole lot new revealed in the program. Most of the events had been reported in the media previously. However candid interviews with his family and his father in particular were revealing. In addition Cousins himself was straight up about his addiction.

There has been much debate as to whether the program sent the “right” or “wrong” message about drug use. Did it glamorize the use of drugs or show the downside. Good questions but they miss the point.

The documentary was about the journey of Ben Cousins. It was showing what happened to him. It was not about a message –it was a story. Rightly or wrongly this is a man who managed to combine a successful sports career with ongoing use of illegal substances. This happened under the noses of his club and the officiating league.

During this time he won the Brownlow medal (for fairest and best in the competition) and played in two grand finals. He managed to slip through various tests for substances and despite drug problems being an “open secret” in his hometown somehow nobody at the club seemed to notice. It is fair to say that drug users are good at deception. It is also fair to say that sporting teams do not want to know things about star players that might rock the boat.

This is the key point and it applies across the board. For as long as you are “useful” your indiscretions will be overlooked or excused. Here was a popular and extremely good player at a club looking for (and winning) a premiership. So long as he did his “day job” and kept his drug use discreet, neither the club the league or the fans really want to know. As soon as he ceased to be discreet and the issue was played out in public then there was outrage sacking and hand wringing over the game being brought into “disrepute”.

Much elite sport is played by men aged 18 to 30.This is the same demographic which has the highest levels of drug alcohol and violence related problems. Give some of these young men large salaries, lots of spare time and “hero” status because they can throw or kick leather around a park and you are inviting trouble. When it arrives everyone acts surprised. What is really surprising is that there are not more young sports people going off the rails.

Ultimately the outrage over Ben Cousins is not that he used drugs and “got away with it”. It is that he has dared to state this publically. The reality is that not all drug users are in the gutter, they live among us and we do not recognize them because they do not fit stereotypes. The notion of addiction, which is promoted by governments and health authorities, applies to a small percentage of users. Disturb this image and you get the sort of response Ben Cousins got.

Drug usage is not as black and white as health authorities and governments like to portray it. Some people go quickly downhill. Others function “normally in society. Some use often, some occasionally. Young people are not scared by horror stories because they see a different spectrum of reality day to day.

Honesty rather than lecturing would be far more productive.

Use of illicit drugs can and does destroy lives. So too at times does use of prescription drugs-witness Heath Ledger and Michael Jackson. Rather than demonize people perhaps we need to understand what drives them to make these choices. It is through this type of understanding rather than making the drug the problem that we may be actually able to advance our capacity to help people heal and regain their health and their lives.

Tales From The City To Surf

2010-09-04T02:05:00.000-07:00

The City to Surf run saw over 40,000 participants this year in Perth. I did the 12km run from the City for the first time and was pretty pleased with my effort. Yes with a bit more training I could have sliced a few minutes off the time but the aim is participation and completion. Next year I can aim to beat this year’s time.

Running along there were a number of interesting things to observe. The first and most obvious is that such a large number of people get involved in the run on a Sunday morning and that there is a genuine community feel about it. Authorities often get worried when large numbers of people gather yet here was a huge gathering and no problems whatsoever.

There were people of all shapes sizes and ages. From babies being pushed in prams through to people in their 70’s.Everyone is out to do their best and enjoy the journey. Whilst there are a handful of “professional “ runners at the front the vast majority are people who are running for fitness and enjoyment.

There were a few “casualties” along the way. Not surprisingly these were more towards the end of the run. A few people had pushed themselves a bit too hard and needed to lie down at the side of the road. Some needed assistance from first aid workers.

Little things also caught my eye. A child was holding a sign which read” Go Pop” around the half way mark. A woman had brought a chair and was sitting on the grass watching the runners go by. This is a different form of entertainment no doubt.

Near the base of the second major hill (just near the half way mark) there was a pleasant surprise. A group of people from one of the sponsors was offering high fives to runners going by and had placards with encouraging words. I must say that this was really good. Knowing that a steep hill was looming and getting to that half waypoint where energy and motivation can sag a bit, this sort of encouragement gave me a lift. So a big thanks to the Westpac Bank crew in their red T-shirts.

Much is made of the cost of these events and the disruption. Yes there were many policemen on patrol at closed roads. To be honest this is a better use of their time than standing around with speed radar guns on dual carriageways catching people doing 5kph over the limit (no I have not been caught). This is actually police work which supports the community.

And yes there is some disruption to traffic. Roads are closed and people have to find alternate routes. Given the large amount of warning time in advance this is hardly an issue. Part of the proceeds from the run goes to charity too.

So the councilor who wondered why the run could not be done somewhere else will be pleased no doubt to find the world still spinning.

A large number of people had a run on a Sunday morning, getting some fresh air sunshine and exercise together with a sense of purpose and in many instances connecting with other people too. All of us have covered four pillars of DIY health in one outing. If you then add the fact that everyone was kept hydrated through the event and will sleep well tonight we are up to six.

Not bad for a Sunday morning.

Dealing With Stress

2010-08-24T21:49:00.000-07:00

It is easy to get caught up in what goes on around us day to day and see problems as bigger than what they may actually be. Everything looks bigger from close up and smaller if looked at from a distance.

I have been thinking about this in relation to the issues, which seem to have gotten people “fired up” in Australia (particularly during the election) but in general too compared to what is going on in other parts of the world.

Currently in Pakistan there are 20 million people affected by flooding. Many of these people have lost their homes, their livelihoods and in some cases family members. This figure is close to the entire Australian population and is around 15 times the number of people affected in New Orleans by Hurricane Katrina.

Maybe it is because Pakistan is far away or maybe because it is not seen as “important” but news of this is usually in the middle of the papers with the exploits of sports people or other celebrity indiscretions getting onto page one. The media by and large reflects rather than dictates the mood of the people so this does tell us something about what we see as important.

I was staggered to read (in the Economist Aug 14) that in the last four years there has been 28000 deaths in Mexico associated with drug cartels. Most of these people were murdered. This is nearly 25 times the annual road toll in Australia. All of these people no doubt had families who are affected by this and I am certain the vast majority were young people.

Meanwhile back home the issue, which the Greens are most fired up about, is Gay Marriage. Now to be honest I do not have a strong view either way-it does not affect me. If people love each other then a piece of paper will not strengthen that and if they do not neither will it make them do so. The world will keep turning. Married or not their life will continue.

Many other issues are also given life and death seriousness when in reality they are just about peoples opinions.

Much is made about the increase in mental illness in western countries. It seems increasingly that much of this is worry reclassified as an illness. We are fortunate to have enough to eat and roofs over our heads and by any historic measure, a high level of safety.

This gives us the time to get stressed over who will win the football, or the election. We have time to shop and then stress about paying the credit card bill. We can build a bigger house and stress over interest rates. We have time to get involved in the lives of celebrities whose activities we follow closely and then pontificate on.

Many are whipped up into fear by the latest pronouncement of doom and gloom by some academic who wants more “funding” for their next project. Tales of individuals who are aggrieved over something not going their way also ignite passions and lead people to feel stressed.

Whilst it is true that for each person, that which affects them most, seems the most important, the stress we feel is a product of our mind rather than our circumstances. It is our reaction to events and not events themselves, which are the cause of stress. In western society much of the “stress” we feel is a product of our expectations not being met. The problem is not reality it is our expectations.

In turn we are 100% responsible for our expectations as well as our response to the reality we find ourselves in. This means we have the capacity to change how we respond. It is entirely normal to want things to be “better” and work towards this. Your starting point must be an acceptance of how things are right now. It is only from there that you can go forward.

So rather than stressing or seeking to blame something or someone for any problems you face start with accepting your situation. Then look for a solution and implement it. Sometimes this solution will be to walk away. Always it will involve a choice.

If you want things to be other than they are you will need to do things differently to how you have done them

Politics Or Entertainment

2010-08-17T06:53:00.001-07:00

“There’s only two types of people in this world- The ones that entertain and the ones that observe”
Opening line from Circus by Britney Spears

The Australian election campaign has really shown the truth of these words. In a complete policy vacuum where stage-managed appearances and scripted lines are the norm one bright light has actually stood out for entertainment and indeed thought provoking comment

That is Mark Latham, the former Labour leader turned commentator and part time journalist. Clearly he is in the category of those who entertain. His appearances and words have been as widely reported as those of the two “leaders”. The difference is that Latham is actually genuine. You may not like him or agree with him. You may even feel that his views are colored by spite or other emotion. However what he says he actually believes and he has a unique perspective having played the game of politics.

What is most fascinating is the reaction he generates. Journalists and politicians are “outraged”. His meeting with Julia Gillard was big news. Why? He is entitled to ask the Prime minister a question as a citizen and even more so wearing his “journalist” hat. There was absolutely nothing untoward in this other than he beat the Canberra press gallery at its own game.

Meanwhile his meeting with opposition leader Tiny Abbott was a media event in itself. On Sky news the studio was eagerly anticipating the live “cross” to Latham meeting Abbott. When it happened the camera was on Latham the whole time. So who is actually running for prime minister?

And so what is really aggravating the politicians and journalists is that because he knows the game from the inside he is able to give out trade secrets. When Latham talks about how media events are set up he knows this from personal experience. When he talks about leaks to senior Canberra journalists he also knows from personal experience.

Apparently 1.3 million Australians watched his piece on 60 minutes where at the end he stated that he would not fill in the ballot paper and urged others to do the same. This is the ultimate in not playing the game.

Not surprisingly the media has gone into hyper drive. I have heard more about Latham’s no vote line than about Julia Gillard’s policy launch today. The camps split into two. Those who were suitably “outraged” and those, who were entertained.

It says a lot about this election campaign and the games that are played, that the musings of a former politician can get so much traction. The simple reason for this is that Latham is entertaining. But that by itself may not gather so much attention. The ability to entertain coupled with insights into the political games by a former insider is a potent mix.

Like him or not Latham has nothing to lose by being honest. He is no longer part of the “ game”. Regardless his motives for telling it like it is, he is doing it. Those whose livelihoods depend on the game continuing as is are of course threatened.

In a dull colorless and boring campaign where the focus of each party is not on what they offer the country but to attack the other, the appearances of Mark Latham have been a breath of fresh air. He is a man who has come over from the “dark side” and is now shining a light on political spin.

It is a positive reflection on how fortunate we are to live in Australia that there is so little interest in who governs it and that it probably makes very little difference.

As for his idea on not filling out the ballot paper- it is an idea worth considering.

Pandemic Ends And The Sky Has Not Fallen

2010-08-13T06:36:00.000-07:00

A firecracker goes off with a bang, loud noise and bright light. When it fades such there is no more noise and the last bit of light disappears almost imperceptibly. Then there is nothing again but sky.

The swine flu has run a similar path. It arrived with a bang and lots of noise. This week it faded with the “official” announcement by the WHO that the pandemic has ended. The disappearance was like the firework going out, hardly noticeable. And we are left with sky, which despite the hysterical claims by health officials did not fall.

The whole issue of swine flu has been badly mismanaged from day one. The closing of schools for a week because a child had a sore throat runny nose and a cough was the first obvious sign that a massive over reaction was happening. Other than appearing in Mexico and getting a fancy name, this was always flu like any other flu. Every year some people get the flu and some die with it.

Yet we have witnessed a full scale health scare, which has wasted billions of taxpayer dollars. Governments on the advice of “experts” ordered millions of vaccines and stockpiled anti viral drugs. The vast majority of these were not used, despite advertising campaigns urging people to be vaccinated. Pharmaceutical manufacturers made significant profits.

As it turned out last year was no different to any other year with regards flu In fact not only was swine flu no more serious than any other strain, in most instances the illness was milder. There were fewer cases and less deaths than usual in the southern winter of 2009 and northern winter of 2010.

Some will defend the authorities on the basis of caution in the face of the unknown. This argument falls down, as flu is known. This was just another strain.

The reason most of the vaccines were not used is that most people very sensibly did not want a rushed out and inadequately tested vaccine against a mild illness. It turned out that those who had previous flu shots were more likely to get reactions to the new one. Worse still there has been a high rate of febrile convulsions in children under five having the flu shot this year leading the Australian government to (belatedly) suspend the use of it in this age group. This was after one child died and dozens more were hospitalized after having the vaccine.

Two weeks later this became public and the main concern of health authorities was not that children had been harmed or exposed needlessly to potential harm but that “an important vaccine program” was being disrupted. A report into how this was handled has called for sweeping changes.

There is another sleeper in all this. Serious questions have been raised in Europe and the USA about conflicts of interest with those advising governments also having ties to vaccine manufacturers. The European Commission has called hearings to investigate this. A New York Times article reported over 60% of advisers to the CDC had potential conflicts of interest including being paid by vaccine makers. In Australia questions have been raised about how close the government is to certain vaccine makers.

The fact that swine flu has been a non-event was largely foreseeable. The waste of taxpayers’ dollars and whipping up of fear in the community is not acceptable. I do not see that anyone is being held accountable. At no time did any “official” provide useful information to the public about what they can do to support their own immune system. The only answers to the “problem” were a vaccine, which was not needed, or an anti viral drug, which does not even work.

I wrote about this on May 28 2009 (and subsequently) and have consistently said that this issue has been mismanaged and that there was never any need for fear, panic or waste of billions of dollars. The public response in ignoring calls for needless vaccination and panic has been far superior to the so called ‘experts” who have been running around with the self importance and attention seeking behavior of Chicken Little.

The reality is that the sky was never going to fall. The firework of swine flu has now faded and the sky remains where it always was.

Australian Election - Leadership Goes AWOL

2010-08-08T07:05:00.000-07:00

“And so my fellow Americans, ask not what you country can do for you; ask what you can do for your country” - John F. Kennedy

The late American President said these words half a century ago. The same principle applies in almost any country and its validity has not changed. It certainly should apply in Australia in 2010.

But it does not. Why attitudes have changed so much in 50 years so that today people ask what can the government do for me (or my interest group)? Australia is in the middle of what is the worst election campaign I have seen in my life. The two parties and “leaders” are battling it out to see who can offend the least number of interest groups and offer the “most “ in government largesse.

The aim is to be the government, which offers to do most for you whilst expecting the least is done by you. This is fuelled by an ever-increasing number of lobbies and special interest groups all of who could do a great job if only they had the right amount of funding.

This week the mental health lobby came out swinging on how mental health had been ignored and needed more funding. No mention was made of how this lobby (in my opinion) artificially increases the numbers of people with mental health illness by reclassifying everyone who may have a bit of stress or a bad hair day as having some form of illness.

We are also told health is “underfunded” in a variety of ways. More funding is needed for hospital beds, and for a plethora of “programs”. General practice too is “underfunded”.

Environmental groups, and education groups also need funding. The list goes on. In fact it is hard to think of an interest group, which does not have its hand out for more money whilst claiming the end of the world if they are not adequately “funded”.

Nowhere in this is there any suggestion of people needing to be responsible for their own actions. Nowhere is there any suggestion that answer may lie somewhere other than government funding. Nowhere is it pointed out that the world will keep spinning very nicely even if various interest and lobby groups do not get as much “funding” as they feel entitled to.

Politicians and governments have reached the point of being seen as our “parents” and we behave like children looking to them for protection and provision. The idea of John F. Kennedy that it is up to citizens to contribute rather than take has vanished.

And that is a problem. Put simply government generates no money other than that which it takes in taxes. Government money is our own money funneled back in various ways, minus what gets used up on bureaucracy. Calls for “funding” are people saying, no one will actually pay for the goods or services I have to offer so we will get you to pay via government redistributing money from you to us.

In health the solution is not funding or more hospital beds or more aged care beds. This makes, as much sense as saying the way to stop cars breaking down is to build more repair shops regardless the fact that the reason the cars are breaking down is due to people not looking after their cars.

The solution is people being responsible for their own health. Rather than ask for “funding” for gastric banding surgery, eat proper food instead of manufactured and processed food, and do regular exercise.

Rather than seek more funding for diabetes treatment how about not developing it? Again via eating real food and not overeating. Rather than seek more “funding” for mental health how about accepting that life is not always a bed of roses and not turning every emotion into a disease.

Government is not the solution and will never be. If anything government policies are more part of the problem. Politicians love to be seen as saviors and encourage people to believe they are helpless and in need of the “saving” hand of government. So we get promises to “fix” health (what your government can do for you) rather than the truth, which is that the individual is responsible (what you can do for your country).

Real leaders would say that the solution is not to “fund” more beds but to reduce demand for beds. The solution is not more disease care funding but people being responsible for their health.

In this woeful campaign between two “leaders “ who are followers of focus groups and not leaders in any sense of the word, do not expect the truth of John F. Kennedy’s words to get an airing.

As an individual you can rise above this by simply being responsible for what you do and hence “detaching” from the teat of government.

Who Really Profits From Disease?

2010-08-03T07:22:00.000-07:00

Every so often you suddenly see things, which taken together are another part of the jigsaw.

So it was that within the space of 24 hours I read about a grill in Arizona called the Heart Attack Grill, which claims to serve the worlds unhealthiest food and about calls for more gastric banding surgery to treat obesity.

The Heart Attack Grill “prides itself” on offering unhealthy high calorie foods with names like flat liner fries and the quadruple bypass burger. The place is decked out like a hospital and the waitresses wear skimpy nurses uniforms. There is even a wheelchair to wheel you back out to the car.

Interestingly the sign on the door says “Caution this establishment is bad for your health”. You can not be more blatant than that. Anyone who goes in knows what is on offer. Over 90% of diners are tourists. This shows that people do not eat there regularly.

With no advertising the grill has generated huge publicity on the backs of the, predictable, calls for it to be closed down. Apparently the owner has plans for more. Nurses, doctors and other members of the health lobby have picketed the grill, which has been accused of profiting from obesity, heart disease and diabetes.

Really?

The other item was the call by Associate Professor John Dixon, the head of obesity research unit at Melbourne’s Monash University for bariatric surgery to be standard treatment for people with a Body Mass Index (BMI) of over 40 and for those with a BMI over 35 with diabetes.

He claimed that General Practitioners (primary care physicians) should refer more people for surgery and not pursue lifestyle measures or be deterred by the 12% re operation rate. He failed to mention the longer term complications such as fractures and kidney stones.

He did declare that he had consulted for several companies with interests in bariatric surgery.

So who is actually profiting from obesity, diabetes and the like? A grill selling clearly labeled foods to people who would see a visit to such a place as a one off fun night out or the people pushing surgery and drugs which they are paid to do or prescribe, in preference to obvious lifestyle measures which they are not earn money from?

Pharmaceutical companies also profit handsomely from diabetes. The drug Avandia has generated billions in sales yet it now has been shown that those taking the drug for diabetes have higher rates of heart attacks then those not on the drug.

So not only does the company and other parts of the medical establishment profit from the treatment of diabetes it may well further profit from the treatment of problems caused by the initial treatment.

This adds to the already expensive “disease care” costs facing western societies.

So in actual fact it is the medical industrial complex which profits from obesity, diabetes and other lifestyle related conditions, rather than an over the top grill. This is never more clearly demonstrated than in the call of the Monash Professor, who is paid to consult for companies with “interests in surgery” and pushes expensive surgery in preference to inexpensive dietary change and exercise.

Things are not always as they seem.

Inventing Disease

2010-07-30T02:41:00.000-07:00

With the huge amount of research that surfaces each day, it is not surprising that the quality varies considerably. Sometimes, you actually have to wonder whether the researchers are having a joke at our expense. Dubious research coupled with the tendency to disease mongering and the creation of new conditions can lead to hilarious outcomes.

If this story had appeared on April first, it could easily be dismissed as an April fool joke. However, as it appeared at the end of June, it seems these researchers take themselves seriously. With straight faces, they warned that Australian teenagers are becoming text addicts and in turn, risk a “range of serious mental and physical disorders from depression to repetitive thumb syndrome”.

To help legitimize this nonsense, new terms have been created. “Textaphrenia” is defined as hearing texts arrive when they haven’t and constantly checking to see if a message has arrived. “Textity “is the anxiety felt when they haven’t received a text or are unable to send texts. Post traumatic text disorder are injuries that occur when texting such as walking into things and feeling depressed when people don’t contact them. Binge texting is sending lots of texts. One can only wonder who pays for this sort of research.

This sort of research can be easily dismissed as absolute nonsense. Clearly, texting, which is a relatively new phenomenon by human existence standards, can, like anything, can be taken to extremes by some individuals if they chose to do so. There is no disease entity involved in this. Unfortunately, creating terms like the ones above, allow people to make excuses for their behavior. One wonders if somebody crashes their car while texting will be able to claim that they were suffering from one of these text related conditions and offer that as an excuse.

Furthermore, it continues the trend to medicalise human behavior. Texting is a form of communication. In exactly the same way some people talk more than others, some people will send more texts than others. Some people have brown eyes and some have blue. None of these represent abnormalities or disease processes. Some people will over do activities be it texting, eating, drinking or any other form of human past time.

The solution to this is not to create fancy new medical terms and pseudo diseases. The answer will certainly not be in developing medications to control these non-existent diseases. The continued medicalisation of life is an invitation to people to not be responsible for their actions. The solution is in fact for people to take ownership of their behavior. If they send too many texts, then the simple solution is to send less. If you walk into walls while texting, then the solution is to look where you are going if you are not able to multitask.

Life can be actually fairly simple when researchers are not involved.

Spending On Disease Does Not have to Keep Rising

2010-07-11T01:43:00.000-07:00

You would need to be living under a rock not to know that health (disease) care spending is continuing to increase. The total spending in the OECD is increasing faster than economic growth and inflation in the OECD.

The USA spends the most at around 16% of GDP nearly double the OECD average of 8.3%. This average has gone up from 7.3% in the 1990s . Governments are generally responsible for half or more of this spending. Virtually all the focus at a government level is on how are we going to pay for more disease care in the future.

A different question would be how can we keep healthy so as not to have to spend so much. There are two aspects to this. The first and (dare I say obvious) one is people actually being healthier. With three quarters of spending on “health” being spent on preventable lifestyle related conditions there is plenty of scope . For example 80% of cases of stroke come about in people who are overweight or eat poor diets, smoke or do not exercise. Strokes are extremely costly both in dollar and human terms

There is another aspect as well. One of the big costs in the system is pharmaceuticals particularly those which are “lifelong” treatments. You would think that there would be a interest in making sure that the money was well spent and that there was value, once again, both in dollar and human terms.

Statin drugs, which are used to lower cholesterol, generate billions of dollars in sales on the basis of reducing heart disease. Yet there has never actually been any evidence, which shows that cholesterol in the bloodstream is the problem.

Furthermore there has been a trend to place more and more people on these drugs as a form of “prevention”. Yet a major analysis has shown that for people without heart disease there is no decrease in mortality in those with risk factors who take a statin. Fully three quarters of the people taking these tablets are in this group.

Basically millions of people are taking an expensive drug, which is not actually doing them any good. Questions have also emerged about a study in 2008, which showed benefit from one statin in reducing heart disease given that nine other trials found no such benefit. These focus on the independence of the researchers.

Meanwhile an expensive diabetes drug (Avandia) is under question due to evidence that those taking it had higher rates of heart attacks and strokes than those not taking it. These two conditions are more common in diabetics and one of the aims of managing diabetes is to reduce these conditions. Again you would think that this would raise alarm bells in medical and government circles.

There are more and more examples of this emerging with long term drug use. Medications are trialed over short time periods and then used over long periods. Problems not apparent after two years might become apparent after ten years.

Our reliance on pills is costing us in both dollar and human terms. Every person taking a tablet they do not need is risking side effects for no benefit not to mention enduring cost to their hip pocket. Every time a use for a pharmaceutical is widened to capture more people being in a “risk” group the more this cost increases.

It is time we rejected unnecessary use of pharmaceuticals and were far more questioning of the cost benefit equation in the ones we do use.

Facebook and Bikinis

2010-07-02T03:27:00.000-07:00

Facebook is an interesting beast. Over the last year or so I have grown to over 1000 friends some of whom I actually know, most of whom I do not know personally and some of whom I have actually got to know which has been great.

The other interesting thing as the number of friends grows is the invitations to events, causes, groups and pages. The range of these is incredibly diverse. In turn it got me thinking, what does publicly joining a group, cause or page say about the person. It may say a lot more than what is contained in the bio or even what appears on the wall.

Exactly how we get these invitations is not absolutely clear to me. The diversity of what I get invited to though is enormous. Recently I have been invited to like wrestling girls as well as peace in the Middle East. Both have their supporters and although they are poles apart obviously different people felt both might be of interest to me.

Sometimes I click through to have a look at the page in question before forming a view. Other times I “judge the book by its cover” in deciding whether to join, like or ignore. In some respects it is a click of the mouse. In another, it is a public announcement about my likes, interests and even beliefs.

This came home the other week when I “liked” a draw Mohamed page and drew the ire of someone. Now I am happy for people to follow the religion of their choice and absolutely respect their right to do so. However there is no reason why other people cannot have a laugh, be it about religion or anything else.

The interesting thing about offense is that it can actually only be taken not given. Whether or not a person takes offense is a choice they make. It is not a function of what is said or done as nothing causes equal “offense” to all people. Those who choose to take offence will generally blame the other party rather than accept ownership of their own feelings.

The other interesting phenomenon is that after the mouse is clicked that may be the last I see of the group or page. Whilst I can search and find groups I have joined unless I can remember what I am looking for it will be difficult to find.

So what am I do with the invitation, which got me thinking about this whole issue? It is an invitation to like the page “I love sexy bikinis”. It was sent by a friend and promotes a retail website selling, well, bikinis. To be honest they look pretty OK. If the page was “I love pretty landscapes” or “I love stunning architecture” would that be different?

All three are about something, which is visually appealing. If I like the architecture or landscapes no one would bat an eyelid. If I like the bikinis will there be a range of comments from the nudge nudge variety to the morally outraged?

In liking such a page what am I saying publicly? The answer of course is that I like the look of women in bikinis. This puts me in the company with 90% or so of the male population and a high percentage of women too. Serious swimmers do not wear bikinis. They are, of course, worn for appearance not functionality.

So do I publicly declare my like of bikinis or not? You will have to check my Facebook status to find out.

Collateral Damage In The War On Cancer

2010-06-29T06:34:00.000-07:00

Since the war on cancer was declared by then president Nixon in 1971 much effort has been devoted to the war. So how are we doing? In 2007 there were 12 million new cases of cancer reported world wide and 7.5 million deaths.These numbers are projected to rise to 27 million new cases and 17.5 million deaths by 2050.

These figures do not suggest that what we are doing is working a s well as it might be. The other figure which, does not get quoted much is the collateral damage which is done in the war. Hang on a minute, what is collateral damage? Surely screening for and treating cancer is all good even if it doe not always work.

There is a view which is promoted in the media and by doctors(particularly those involved in cancer screening) that screening is all good and that early detection is important. There is no argument that early detection is better than late detection. There is also no doubt that some people have had their lives “saved” by early detection.

Do we know how many people are in this particular boat? Do we know how many people had unnecessary procedures including biopsies and surgery not to mention needless stress because screening tests picked up cancers that were not actually there? Do we know how many people have early cancers which f not found would not actually develop and lead to a reduction in life expectancy?

Figures are starting to emerge. The British Medical Journal published figures on mammography. The difference in deaths in women aged 40 to 55 that can be attributable to mammography screening is 0.06%. Looked at another way for every woman who would otherwise not have found the cancer and died, 1610 women need to have tests. In addition to this ten women will undergo surgery, which will provide no benefit to them, only potential complications.

With prostate screening the situation is even worse. For every cancer successfully detected and treated early, 48 men will have unnecessary surgery, which can lead to urinary incontinence and impotence in one third of cases. Another review suggested that screening led to no decrease in death rates. The inventor of the PSA test, which is used for screening(but was not developed for that use) described prostate testing as like flipping a coin.

The positioning of cancer screening as saintly leads to criticism of anyone who questions the current orthodoxy. Keep in mind that there are considerable vested interests invested in screening programs and those advocating screening may have a conflict of interest, which would not be acceptable in any other field.

Every person who has surgery or other unnecessary procedures is collateral damage in the war on cancer. Some will say this is a reasonable price to pay. Others may not see it this way. The key point is that you can only make a decision on how you want to proceed if you know all the facts.

A Week Used To Be A Long Time

2010-06-25T18:42:00.001-07:00

It is an old adage that a week is a long time in politics. With the world speeding up it seems like a day is now a long time. It is highly unlikely that Wednesday morning that many Australians would have thought there would be a new prime minister within 24 hours.

The fall of Kevin Rudd is quite remarkable. Twelve months ago he was riding high in the polls and at one point enjoyed record high approval. This is a first term government, which came to power after over 11 years in opposition.

Certainly the popularity of politicians goes up and down. Polls, which seem to dominate all thinking these days are necessarily done on small numbers of people and the results extrapolated. Often they are close to the mark but as all the politicians know there is only one poll that really counts.

Clearly the labour party formed the view that they were likely to lose those years election with Rudd in charge and replaced him with his …deputy.

This raises the real question of style versus substance. Were people turning “against” the prime minister because of the policies of his government or him personally? It is worth remembering that as his deputy, new Prime Minister Julia Gillard was involved in policy making. So it is not likely that a new face will bring about huge change in policy. One of the key issues has been the mining profits tax and I wrote about the connections between wealth and health previously.

So is the issue the message or the delivery of the message. Are the governments’ approval ratings falling because people do not like what they are doing or is it simply that what they are doing has not been “sold” in the right way.

Julia Gillard will, like all new leaders, have a honeymoon period. Many will like to see her succeed because she is the first woman to be Australian Prime Minister and this will in itself provide a boost in the polls and an air of goodwill, which will color people’s opinions and also media coverage.

Ultimately the problem though facing many countries is that there is a focus on personality rather than policy and a fixation on polls and the 24-hour news cycle. To grow an apple tree you need to pant the seed and tend it over many years before it grows and provides fruit. Expecting fruit after three months and declaring the tree a failure (and ripping it out) if that doesn’t happen would be ridiculous.

Equally with government policies, which have, long-term effects, judging policy success in a short time frame and then acting on that may make as much sense as ripping out the tree. Of course bad policies should be dropped as would trees, which are not growing be removed from the orchard.

With an election due within nine months it will be interesting to see whether we see changes in policy (particularly the unpopular mining tax) or simply a change in selling the message or perhaps a bit of both.

Most interesting will be the response of the people.

Relationships Do Not Have To Be Complicated

2010-06-22T06:26:00.000-07:00

Relationships form one of the pillars of DIY Health. There are many different relationships that we have and over the last week we have seen examples of how the way we conduct these this impacts on people, for better or worse.

There are two separate events, which caught my eye; resignation of the CEO of David Jones department store after allegations of sexual harassment, and the furor over allegedly racist comments by a former footballer. Both say something about our relationships.

Firstly were the comments made at a private function by a former footballer Mal Brown who allegedly made references to Aboriginals and cannibals in jest. Not surprisingly this made the news for a few days and led to the usual screaming from those with a vested interest in doing so.

Now I was not at the function, so do not know the context of the comments. However following media reports millions of people became aware of the comments of one person instead of the small number in the room. More interesting are the claims that one person’s remarks are widened out to suggest it represents “systemic racism” either in football or society in general.

Of greater significance is that the man who made the comments has a long track record of playing and coaching Aboriginal footballers and has probably done much more to help their advancement than many of those now screaming out in “horror”. A sign of maturity in race relations will be when jokes whether bad or good are seen as jokes rather than put into a political context. Laughter is one thing we all have in common as humans.

The resignation of David Jones CEO Mark McInnes again highlights how traits, which serve people well, can lead to their downfall. There is a long long history of leaders be it in business or government having multiple affairs, relationships, mistresses or whatever term was popular at the time. This goes back to the days of Caesar and continued through to Bill Clinton. “Leaders” in other fields have a similar track record.

In this particular case the man has resigned and is forgoing something in the order of $16 million in lost entitlements compared to seeing out his contract. There is no way a fine of that magnitude would be imposed by a court. Furthermore nobody is disputing he was extremely good at his job.

None of this excuses behavior, which is unacceptable and he has paid a high price. Equally one can also wonder if the behavior is shaped by the fact that other women may well have warmly received or even sought his attention. It is likely that some did. It is also likely others did not but were not prepared to speak out. There will undoubtedly be more stories emerge over the next week or two

The problem is that often the exact same drive and personality traits which led to success and rising up the power ladder can send you right back down again. A football coach who calls a spade a spade may go far on the playing field but come unstuck at after dinner functions. A CEO who charms women does well in running a retailer but comes unstuck from his private dealings with people if he does not learn where to draw the line.

Relationships are often made more complicated then they need to be. They are never helped when people who are in no way affected jump in with opinions or interpret behaviors through their own biases or worldview.

The old golden rule of do onto others as you would have them do onto you does not even quite work in the politically correct age. You need to do onto others, as they would have you do onto them. For that to occur we need to be honest and open in our dealings with people. We can not expect others to be mind readers. We need to tell them what we do and do not accept and we need to act on that accordingly.

Maybe relationships are not that difficult after all.

Be Questioning

2010-06-15T06:24:00.000-07:00

A survey of Australians shows that church attendance has fallen about one third over the last 16 years. A number of other “religion” parameters such as belief in heaven and god have also fallen although running in parallel with this is an increasing interest in spirituality, separate from religion.

This trend is part of a broader trend in society away from “authority” figures and institutions in general and to a greater desire to find ones own way rather than be told which way to go. We see this in declining church attendance but also declining regard for judges, police politicians (of course) and dare I say even doctors.

Ultimately the problem we have is that people have used authority badly and come to feel that it is the position they have which confers importance upon them rather than position being recognition of what they bring to it. In other words putting a robe on me does not give me moral authority if I do not have it without a robe. If a person is corrupt, putting them in a police uniform does not change who they are. Yet we see time and again the excuse of position being offered when people are caught out.

There is no doubt in my mind that the response to child sexual abuse by the church has contributed to its loss of credibility. There has been more energy expended trying to defend people and position than trying to resolve the issues.

In other fields similar problems emerge. Reports of two undercover policemen arresting and charging a skimpy barmaid for showing too much buttock will leave many wondering why the police are not spending their time investigating murders and robbery. A similar thought goes through my mind every time I cruise by two policemen under a shady tree holding a speed radar.

The medical profession is not immune to this trend and is also guilty of undermining public trust by its own actions. Reports of researchers and doctors being paid by pharmaceutical companies for research which invariably is favorable to the sponsors does not help credibility. Neither does beat ups like swine flu.

Despite overwhelming evidence that this is not a major threat, health authorities are at it again with claims of chaos and horror to come. This is after a vaccine, which was not needed, was rushed to market and then withdrawn from use in children under five following an unexplained death. Official pronouncements of safety do not sound good in these circumstances. Little wonder that peoples confidence is shaken.

Meanwhile we are constantly told that the whole reason for vaccination is that people are protected against the illness they are vaccinated against. This flies in the face of the actions of the WA health department after a case of measles was found. A frantic search was done to find all possible contacts. If the herd immunity principle works, then why the panic? Interestingly one of the three cases was a paramedic who you would assume was vaccinated.

A two page circular to doctors gives “useful “advice like conducting an examination in a room which can be left vacant for two hours and avoid “suspects” using the waiting room. And who are these suspects? People with a fever ,cough and sore throat. The average doctor would of course not see many of them in winter would they? Apparently people born before 1966 are automatically immune!

Now measles is not a pleasant illness and vaccination has contributed to its decline. However generations survived it in much lesser circumstances than we enjoy today. If the whole purpose of mass vaccinations is called into question when one case is found is it any wonder that people become questioning.

Wealth and Health are Connected

2010-06-11T22:44:00.000-07:00

Whilst being rich does not of itself guarantee a long or happy life and many people with little by way of monetary wealth live a long and happy life wealth and health are linked.

As nations become wealthier the overall standard of health rises. We have seen over the course of the twentieth century that as nations industrialize, standards of living improve and so does health. This is not due particularly to medical science and owes very little to high technology medicine.

It comes about through people having clean water, better overall hygiene and sanitation, better protection from the elements and of course access to enough healthy food. The last one can go the other way as we see with problems of too much of the wrong sorts of food being consumed leading to a whole different set of health problems.

The other aspect that is important in health and is pillar eight of DIY Health is fun and purpose. As humans we need to be doing something that we feel matters and that we enjoy. As nations become richer the diversity of opportunities increases exponentially. Once we are free from having to spend much of our time looking for food or defending our territory we can focus on other things.

This may be a job, running a business, creating works of art travelling or a myriad of other things. The key things from a health perspective is that we enjoy what we are doing, that it has some challenge and that we feel there is a purpose. These three components are what the University of Pennsylvania has described as constituting authentic happiness.

Equally, we all need a certain amount of money to live. I am not talking about living in a palace or flying first class but enough to be comfortable and do most of the things we would like to do. People who are successful usually become wealthy because other people are attracted to the value they create. This can be in business or in the arts or any field of human endeavor.

When people have made an effort and created value it is fair and proper that they be rewarded for it. Furthermore, often these people create wealth for other people too either in the form of paid jobs or investment opportunities. Once again this is right across the board with regards human activity. Many who are successful increasingly put back into their community in a variety of ways.

The current debate about the mining tax in Australia highlights the passions aroused when those who create wealth and opportunity for themselves an others find themselves subject to arbitrary government rule changes. Governments by their nature can never create wealth or add value. This can only be achieved by individuals, acting alone or with others, in some form of business.

Different countries have prospered because of different industries. All countries, which have prospered, have done so because individuals and businesses were prepared to take risks in the hope of reward. To attack the reward after the risk has been taken will naturally arouse anger. I am not aware of any other country, which deliberately set out to weaken the business sector, which had been its most successful. Australia’s most successful industry is mining.

Governments argue that the taxation money can be spent in the community. Sadly governments of all persuasions have a bad record of efficient use of funds. Suffice to say the current one is true to this pattern. Excessive taxes and government interference in the economy leads to increased unemployment.

The best way to strengthen the community and for people to prosper is for people to have purpose, like a job or business, and the opportunity to invest their monies. Diminish this and you diminish the community and the nation.

When the wealth of the nation is collectively affected, the health of the nation will also be affected. It is little wonder passions are running so high and across so many levels of Australian society.

Human Emotion Is Not A Disease

2010-06-08T07:30:00.001-07:00

One of the things one tends to do when in another city is use public transport. And so it was that I was waiting for a train at Sydney Town Hall Station when the billboard caught my eye.”7 out of 10 Australians will suffer a mental health illness” was the headline. Below the headline was a diverse looking group of people with thought bubbles above their heads.

Amongst the thought bubbles were things like, I am stressed at work, I am grieving for my mother who died, I have mortgage stress and I feel anxious at times. The billboard was promoting a charity, which amongst other things provides support for people with “mental health problems”.

There is an increasing tendency for a variety of medical groups, patient support groups and charities to make problems look bigger than they are so that they can get attention or raise money. To do so however, they reclassify normal parts of human emotion as an illness to boos the numbers and create a sense of crisis. In turn those who create the crisis stand ready to solve it with donations from the public.

If it is not a mental health illness to feel happy when you win a lottery why is it an illness to feel sad when a loved one dies. If it is not an illness to feel nervous before performing on a stage, why is it an illness to feel anxious sometimes? Stress in relation to work or finance is a normal response depending on the circumstances and is not an illness.

In a similar vein eating disorder “experts” are warning that anorexia nervosa is more prevalent than being reported. Part of the basis for this is that ninety per cent of teenage girls have allegedly been on a diet. The experts warned of an “alarming” number of young people developing eating disorders as they battle obesity.

Being on a diet is not the same as anorexia and people “battling” obesity are unlikely candidates for anorexia which in fact has nothing to do with food and is all about control issues. However “alarming numbers” and “experts” makes for great headlines, as did the claim that one in 10 women will develop an eating disorder.

One question though. How did they define eating disorder? Depending on the definition you could widen it to nine or even ten out of ten women.

Meanwhile it has been shown that Australians are being prescribed antidepressant medication for reasons other than those for which the drugs have marketing approval. This is particularly the case in the elderly. In the USA increasing prescribing rates for antidepressants over the last decade has not improved the overall mental health of the populace.

So here is the problem. Feeling stressed or down or a bit anxious is not the same as a mental illness. Conditions like anxiety and depression represent one end of a spectrum of human emotion and behavior. Labeling every emotion as a disease is good for sales of medications, for groups seeking to raise funds and for academics pushing research agendas.

It is not good for people. Reclassifying normal human emotion and experience as a disease portrays people as victims in need of the support offered by those raising the monies or selling the medication. As soon as you are not a victim you are in control of your own destiny and may not need the “support”.

None of this is to deny that some people have genuine mental health illness and need support and in some instances medication. It is to say that it is easy to reclassify human emotion and behavior as an illness and that doing so can be very profitable.

With Tests And Treatments Less Is More

2010-06-04T05:57:00.000-07:00

In the previous blog I wrote about problems with long term use of medications particularly those used for lifestyle related conditions. It looks like The American Medical association agrees with me. The association’s Archives of Internal Medicine Journal has highlighted the often unpublicized downside of tests and treatments in a recent edition.

In an editorial titled “Less is more: How Less Health Care Can Result In Better Health” the spotlight has been turned on how extra tests and un necessary treatments not only do not help but can cause significant harm. The fractures and diarrheal illnesses associated with long-term proton pump inhibitors (used for heartburn) were one of the cases highlighted. According to Dr Deborah Grady of the University of California, San Francisco “There just seems to be this assumption that the more health care you get, the better”.

This is an incredibly important issue. The Archives Journal will have a regular “Less is More” feature looking at where treatments have expanded to the point where harm outweighs benefit. Doctors and patients have become conditioned to the notion that if tests are good, more are better and that pills are the answer for just about everything. Yet there is never such a thing as a free lunch. All pills have side effects. These can be justified when the benefits outweigh the risks and when no other treatment is available. When simple changes in lifestyle will have the same effect though they cannot be justified. The issue of cost is a whole other component of this.

Tests are also seen as wonderful because of their capacity to find “unexpected” serious illness such as cancer. Tests are fallible though and many people go through further tests and even surgery because of a finding in a test which may in fact be meaningless but “once found must be acted on”. Mass screenings add to this problem. Issues with PSA testing led the tests inventor to describe PSA testing for cancer as being like flipping a coin. The benefits of mammography screening have been significantly overstated.

So what drives the test and pop agenda? There are two main drivers. One is litigation and the use of defensive medicine. Ordering unnecessary tests on 1000 people will not get a doctor sued, regardless the cost and inconvenience but the one person where a diagnosis is missed may well sue. The other is commercial and vested interest.

Obviously the pharmaceutical industry has a legitimate interest in selling its products and is clever at marketing. It also drives a lot of research. If a study is done looking for a use for a drug there is a fair chance it will be found. Extending the number of people classified as needing treatment (for example by lowering cholesterol target levels) boosts sales.

Whole industries have sprung up behind screening too. Those involved in the mammography business dismiss any criticism of mammography, as an attack on women, usually. Unnecessary surgery on breasts is not seen in the same light.

There is no point saying that there is an across the board clear cut answer. And herein lies the real issue. One size fits all models do not fit all. Attempts to screen or treat everyone the same has led to this problem. Over emphasis on guidelines and protocols stop doctors (and patients) considering the individual circumstances of each case. Well meaning scare campaigns convert everyday bodily functions into danger signs of cancer leading to a race to exclude what was never there.

The answer then is in fact simple. Focus on being healthy rather than enter the obstacle course of avoiding disease. Have faith in your own body and what it is telling you. It knows more than most tests. Ask your doctor about the downside of tests and side effects of medications. Take the non-pharmaceutical option first. Do not buy into scare campaigns or disease mongering.

Long Term Drug Use Can Have Unexpected Side Effects

2010-06-01T07:18:00.000-07:00

Much is made of the fact that pharmaceuticals are tested before being released. Trials are done to assess whether the drugs work and to assess the side effect profile. Many drugs never make it to market because in the trial process either they are not found to so much or there are significant other problems, which outweigh their benefit.

This process is a useful one. However it also has limitations. Over the last few weeks we have seen data emerge about long term unexpected problems with widely used drugs. Statins and proton pump inhibitors are in the top five for widely used drugs in many western countries. They are also amongst the most costly to the health system. Statins are used to “treat” cholesterol and proton pump inhibitors are used for ulcers reflux and other stomach acidity problems.

When trials are done they are conducted on relatively small numbers of patients for a relatively short period of time. At tops it may be a few thousand people and often for less than two years. Indeed it may be so many hundred people for so many months. It should not come a s a surprise then that less common problems or those which may take many years to show up will not be picked up in these trials.

When the drugs are used by millions of people for many years new problems may emerge. For example an effect, which occurs one in every 100,000 people, may not be seen in a trial of 5000 but there may be 20 by the time 2 million people have used it. Of course effects, which take ten years to show up, will not be seen for at least that time.

So after nearly 20 years of statin use we are seeing that there are increased rates of liver dysfunction kidney failure, cataracts and myopathy (muscle damage) in those taking long-term statins. The increase may be as high as eight fold. These figures come from studying 2 million people over a six year period. The findings were published in the British Medical Journal.

Meanwhile the FDA has called for labeling changes on proton pump inhibitors after finding an increased rate of fractures in people using them long term. It has also been found that long-term users have much higher rates of clostridium difficile infection causing diarrhea.

It is not surprising to me that when you interfere with the gut there will be consequences. The stomach has acid for a reason. Block it and you will affect absorption of food and other gut functions. The higher rates of diarrhea suggest that the bacteria are better able to survive in a less acidic stomach. Bone fractures suggest the absorption of minerals is being affected. There may be other direct effects on bones too, which have not been determined.

Does this make these drugs dangerous? No it does not. What it shows is that long term use of medications have unexpected consequences. In also shows we do not always know the long term safety of drugs when they are released.

Most importantly it tells us that reliance on drugs for lifestyle related conditions is not a free lunch. The notion that it is easier to take a pill than to change our eating patterns (for example) may seem fine in the early days. After the unexpected long term problems arise it may not seem like as good an idea.

The bottom line is that lifestyle related conditions require lifestyle solutions. Some people may need medication but this should be used for as few people as possible and for the shortest possible time.

Children Do Better In School With Regular Exercise

2010-05-18T06:50:00.000-07:00

The human genome (our genes) has changed very little over the last 10,000 years. How we live our lives has changed dramatically over that time and particularly in the last 50 years. A day in the life of a child growing up in the 1920’s would be completely different to one growing up the 1960’s and would bear almost no resemblance to a child growing up today. Yet a child growing up in the 1620’s may have had a similar experience to one in even the 1820’s.

The two biggest changes are of course what we eat and how much movement we get. This affects adults as we see with rates of obesity and other lifestyle related diseases. It also impacts on children and can have unexpected consequences. In turn people then tend to look everywhere for the answer rather than where it actually lies.

The most “visible” affect our children of a diet high in processed foods and a lack of activity is the increasing rate of diagnosis of ADHD. The improvements seen with putting the right fuels into little bodies and allowing them to run around like, well…children is often dramatic.

There are more subtle effects too. A report presented to the American Heart Association showed that children who are fitter do better in school. Assessments on test scores in math’s science and social studies were made in year 5 and followed up in year 7 in a West Virginian county. The children who did best in their test scores had the highest levels of fitness. Those who improved their fitness, by and large improved their scores over the two years. This does not mean they were Olympic athletes. It basically meant they did some regular sport or physical activity. Another study in California on high school students found exactly the correlation.

Showing the practical application of this, a school near Chicago has made gym class the first session of the day to “kick start” the brains. The Napperville School also has bikes and balls in the classroom to keep the children on the move. According to the University of Illinois, children do 10% better at problem solving after a 30-minute stint on the treadmill. Exercise makes the brain “ready to learn” and it is good for attention.

The results speak for themselves. Reading and mathematics scores are up significantly. Exercise has got to be better for children than Ritalin and of course there are other benefits as well.

A study looking at children with genes “associated with obesity” found that in the group which did regular exercise, the gene did not express itself. In other words even if one has genes, which may predispose to obesity (and remember our genes have not really changed in 10,000 years for most of which time obesity was not a problem) then regular exercise overcomes it.

This fits completely with the growing understanding that genes are like light switches. Presence or absence means less than whether they are switched on or off. And what influence whether genes are switched on or off? Our lifestyles and in particular stress, diet and exercise.

So the answer to better grades is the same as the answer to obesity and to a large degree the answer to attention problems. The answer is not complex. The answer is not in a pill. The answer is regular exercise and healthy eating patterns.

Healthy Bones Need Sunshine And Exercise Not Pills

2010-05-14T21:18:00.000-07:00

One of the reasons that “healthcare” is so expensive is that the expensive option is usually researched more and pushed more than inexpensive options. Falls, particularly in the elderly are a major cause of illness and can at times be the trigger for admission to a care facility for someone who previously lived independently. This is not just because of the fall as such but is compounded by a hospital stay, which is always debilitating.

Governments, are often interested in ways to prevent falls and hence save themselves some dollars. We have also seen the creation of osteoporosis as a disease to be treated with the notion being, that doing so prevents fractured bones. There are a number of drugs, which are used to “treat” osteoporosis. Indeed the widespread use of hormone replacement therapy, which has now been discredited, was justified on the basis of preventing osteoporosis.

Osteoporosis is a “thinning” of the bones as we age. Like many aspects of the body there is change over the years. However it is not a function of age alone. It is a function of how we look after our bones along the way. The condition, like many in medicine, is defined statistically. In much the same way as someone is the shortest in the room, someone will have the least “dense” bones.

Of itself it is (with exceptions) a painless condition which of itself (again with exceptions) does no harm. Problems arise because of fractured (broken) bones. However this can occur in any age group including children so is not confined to the elderly.

So if our aim is to reduce fracture rates, then we should be interested in ways to prevent falls. Placing a whole lot of people on drugs does not do this. The best way to prevent fractures is to prevent falls. The best way to do this is through regular exercise so that muscles and coordination remain as good as they can be. Recent studies have shown that older people who participate in martial arts classes or regular dancing reduce their fall and fracture rate. Both are obviously forms of exercise. In addition to this they both, in different ways, emphasize co-ordination and balance. These are important in preventing falls.

Furthermore if we are really interested in our bones then we can be doing things to care for them. Adequate intake of green vegetables for calcium and minimizing sugary foods (which leach calcium out of the bones) is important. Regular aerobic and resistance exercise keeps the bones and muscles strong. The other key component is vitamin D, which is free form the sun.

One of the tragedies of aged care is to see elderly people denied fresh air and sunshine. Rather than giving them tablets for their bones, how about letting them sit in the sun for 15 minutes or so per day so they do not become vitamin D deficient.

So rather than see loss of bone strength as a disease needing pills, we need to see it as a consequence of not looking after our bones. Whilst sooner is better, it is never too late to start caring for your bones with simple measures as we have seen above.

Cancer - What If You Have A Say In It ?

2010-05-11T06:46:00.000-07:00

It is amazing how discoveries, which are simple, do not make big news. If a pill which reduced breast cancer by one third was released it would be big news. There would be massive demand and the company, which made it, would see profits and the share price rocket.

There is of course no pill, which does this. The same effect can be achieved, by eating less, exercising more, and having only moderate alcohol intake. Regular exercise alone leads to a halving of lifetime risk of breast cancer. Does it really matter if the way to reduce your chance of getting breast cancer by one third is by taking a tablet or doing other simple things? Apparently it does.

Whilst this finding, which came from The University of Milan, made some newswires it was hardly the front-page story that the release of a pill would be. Why is this? In my opinion there are two reasons.

Firstly we have become conditioned to look for technological solutions rather than simple ones. In the long and thus far unsuccessful “war” on cancer hundreds of billions of dollars have been spent looking for new breakthroughs. If the solution is something we sort of knew all along and is not a “breakthrough” then people tend to switch off. We also tend to think, “it can not be that simple”. When answers are obvious or right in front of us we tend to be dismissive, as we have become conditioned to look for the complex.

There is a second reason and this highlighted in some of the reaction to this. A spokesperson for a British cancer charity said their agency was very careful about issuing similar lifestyle advice. Ian Manley from Breast Cancer Care told Fox News “We would never want women to feel responsible for their breast cancer”.

How exactly does this help women? If there are things that they are doing which makes it more likely they get cancer then surely taking responsibility and doing something different would be the way to go. We are not talking force fields which mean you can not possibly get cancer but a one third reduction in risk is certainly worthwhile. Many in the health arena are paranoid about what is called “blaming the victim”. This essentially portrays anyone who has disease as an innocent bystander who is totally helpless and has been struck at random by forces completely beyond their control.

What about if we rephrase this as, “the actions of an individual lead to certain consequences”. Hence if by eating certain foods, being overweight and not exercising you have significantly increased your chances of getting cancer then those are choices you have made and cancer may be one of the consequences.

To use an analogy, if you stand in the middle of a freeway your chances of getting hit by a car are much greater than if you stand on the sidewalk. On the road the cars may avoid you and it is possible to be hit by a car, which leaves the road and hits you on the sidewalk. However you know where the odds of getting hit are greater. If you deliberately do certain things which increase your chances of getting cancer (or any disease) then it not really a random action beyond your control if that disease eventuates.

The great thing about being responsible for your health is that it puts you in charge. You can make the changes and in turn change your odds of “getting hit”. It is a no brainer to walk on the sidewalk rather than down the middle of the road. Doing regular exercise, maintaining a healthy weight, eating mainly “real” rather than processed food and moderating alcohol intake are collectively the same no brainer when it comes to breast cancer.

Disease Is A Profitable Business

2010-05-07T02:44:00.000-07:00

Sometimes useful insights come from unexpected places. Fortune Magazine publishes an annual report on Americas top 500 companies. Included in this is an overview of business sectors and how they have fared the previous year. Not surprisingly, 2009 was not a great year for many businesses.

There are of course exceptions. To quote Fortune, “For the drug industry it is as if the recession never happened”. Earnings in the pharmaceutical industry were up by one-third last year. Even sales of Botox came in at $1.3 billion; slightly down on 2008. A numbers of reasons were given for this. The most significant one in my opinion was that the industry is credited with the ability to raise prices even in tough times.

Given that this all occurred against the backdrop of major debate over health reform, lack of insurance cover for many, and the costs of healthcare in general, makes it all the more remarkable. So why is the pharmaceutical industry able to raise prices and make money when times are tough?

There are a few reasons for this. It is held that people are more likely to get sick in hard times, although this has been strongly disputed. Medications are seen as essential so people may cut back on other items before pills. However given that much of the cost is borne by insurers this is not the whole answer either.

In my view the reason is simple economics 101-supply and demand. There is an increasing demand for medications and this allows the suppliers a greater degree of price control than in areas where demand for product is less. Doctors, many of whom unfortunately see pills as the answer to most problems, drive much of this demand.

This was illustrated perfectly by a letter I got from a cardiologist in which he extols primary care physicians on the importance of treating diabetics with high doses of statin medication together with at least two blood pressure medications. As usual this advice is based on “evidence” which comes from trials. Whether or not pharmaceutical manufacturers funded these trials is not clear.

The letter did not mention weight loss, exercise or stress management. It also did not mention the study earlier this year, which showed once again that weight loss leads to lower blood pressure. The lead author of this study concluded, that it was important for people to know that they can try diet instead of pills and get the same results.

Other studies have shown reduced rates of heart disease and stroke in people who ate more foods containing vitamin B6 and folate. Those who ate more processed foods and foods with added sugar had higher rates of heart disease. Olive oil reduces inflammatory activity, again reducing heart disease as we see in those following a Mediterranean diet.

People see the world through their own eyes. Unfortunately doctors, in many instances have become conditioned to see pharmaceuticals as the answer to lifestyle related conditions. For some people there will be a role for pharmaceuticals. However the best solution to lifestyle related conditions are lifestyle changes.

These will not boost the profits of the drug industry though.

Improving Hospital Food

2010-05-04T07:07:00.000-07:00

As an amateur chef, I like to watch some of the cooking shows, which are so prevalent on television these days. Putting the right fuels in the body, is so important for good health, yet it is sometimes the perceived difficult to do this. It is always good to see chefs who use real food and teach us that cooking is simple, fun and that using good produce is not expensive. Of course the end result is a meal that we would all like to eat.

Some celebrity chefs have branched out and taken up broader issues related to food and its role in our lives. Jamie Oliver is probably the chef who has been at the forefront of this with his Ministry of Food and Food Revolution. He has ventured into areas where hardly anyone knows how to cook and taught them simple healthy recipes. He has also tackled school canteens in the UK and more recently the USA.

This is all good TV and sells books-fair enough. If people neither watch his shows or buy his books the message does not spread. A bit of publicity either favorable or the “get out of our town” variety also helps this process.

Now another chef has taken up the issue of hospital food which, by and large, does not provide either good nutrition or even taste to people who are sick and in need of good nourishment to aid their recovery. Many elderly people are malnourished as it is, due to not eating enough fruits and vegetables and often relying on packaged foods. The situation in aged care facilities is generally little better. When in hospital, it is an opportunity to provide them with some good nutrition. This opportunity is almost always wasted.

Heston Blumenthal whose Fat Duck restaurant was named third best in the world will team up with The University of Reading and the Royal Berkshire Hospital to find ways of making meals more flavorsome and nutritious. Whilst there is no need for Michelin star foods or fusion dishes on hospital menus, there is much that can be done to improve the quality of hospital meals. When a meal is appetizing and flavorsome, we are more likely to eat it. Of course, when we do the meal needs to provide our body with the nourishment and fuels we hope.

Of course providing a large number of meals simultaneously is not logistically simple and there will be a range of issues to address. However once there is a will, a way will be found. The first aim of the collaboration is simply to improve the flavor of simple meals like Shepherds pie.

My late mother spent some weeks in hospital after a hip fracture and the food she was served was awful. You cannot repair a house without the right materials,so how we expect the body to repair when it is not provided with the right nutrition is beyond me.

The body needs the right fuels at any time but arguably more so when ill. This move in the UK will hopefully generate plenty of publicity and start people down a similar path in other parts of the world too.

Taxing Cigarettes Is Reasonable - Be Honest About It Though

2010-04-30T01:54:00.000-07:00

The Australian government has increased the tax on tobacco and announced changes to labeling laws, which will mean that from 2012 cigarettes will need to be sold in plain packets without colors or brand logos

Cigarette smoking is, after obesity, the second largest cause of preventable disease and premature death in Australia. Until fairly recently, it held the number one spot, and in many countries still does. The tax increase will add $2.16 to a pack of 30 or about 7c a cigarette. This is not a huge amount but may well encourage some to stop burning their money.

However, the government does not expect huge reductions in consumption as it is counting on an extra AUD $5 billion in revenue over the next four years. A statement said it expected consumption to drop 6% and that 2 or 3% of smokers would quit based on the price hike. The revenue raised will be used to fund hospitals and $27.8 million will be spent on anti smoking programs. The move has, of course been welcomed by the public health brigade on the basis that it will save lives. No doubt they are already devising ways to use the extra “funding” that is so beloved of those in public health.

The issue of packaging is interesting. Youth workers are not convinced that teenagers will be put off experimenting with smoking if it is in plain wrap. Equally It is unlikely manufacturers would invest so much in branding if it makes no difference. However how are we to explain teenagers using marihuana or other illicit drugs, which do not come in, branded packages? The tobacco industry will get little sympathy. However that does not mean that the move will have much effect or has much basis other than allowing the government to “look to be doing something”.

I have no issue with an increased tax on cigarettes. As I have written previously smoking is a choice people make and they can choose to stop if it gets too expensive. Governments see smokers as a soft target and a group who wont get much sympathy. It can be argued that by putting the tax money raised into hospitals it is a form of “user pays” albeit a clumsy one.

I have an issue with dishonesty. This move has nothing to do with health. It is a revenue move. This is patently obvious in that the projections are for a significant increase in revenue. If there were a serious drop off in smoking revenue would be static or decline. Governments can be expected to dress up any tax hike (justified or not) and use spin. But what excuse do the public health people have?

The public health crew does not want to bite the hand that feeds them so they peddle the government line that these moves are about health whereas in fact they are not. They also tend to see being “anti” the tobacco industry as somehow an achievement of itself. Nothing like having an enemy to make yourself look like a hero.

The bottom line is that some people may, of their own volition, choose to stop smoking as a result of the tax increase. The increase is a reasonable revenue move by a government searching for dollars to fund its promises.

Can we just be honest about it, please?

Swine Flu- One Year On And Still A Storm In A Teacup

2010-04-25T02:20:00.000-07:00

It is just on one year since the world first heard of swine flu. It is still extraordinary that a mild flu like illness has led to such a completely over the top behavior from “health officials”.

The program to vaccinate children aged between six months and four years has been “temporarily suspended” by the state of Western Australia. This was after at least 60 cases of adverse reactions including fever, vomiting and febrile convulsions. A number of children had to be admitted to hospital. One child remains in a critical condition. The number of reported cases is likely the tip of the iceberg and there may be hundreds if not thousands of children who have had milder reactions that are not reported.

An urgent meeting of the Therapeutic Goods Administration (TGA) has been called to investigate the matter. The Australian Chief Health officer who two weeks ago sent a letter to doctors urging them to vaccinate, today said doctors should stop vaccinating children under five immediately. This response has been swift and is to be commended. There have been suggestions that these reactions have been known about for two weeks and it has been “kept quiet”. Hopefully this is not the case.

The recommendation is that everyone else can continue to be vaccinated. The reactions have been to the “seasonal” flu vaccine, which as usual has three strains. This year one of the three is H1N1 or swine flu. The chief health officer has said that it remains safe for children to have the swine flu vaccine by itself.

Confused?

Here are some facts. The vaccine is tested on a small group of people and an even smaller group of children. If there is a one in 5000 reaction this may not show up in a trial of 200 but there will be 20 cases by the time 100,000 doses have been given. In 1976 a mass vaccination campaign resulted in more deaths from complications of the vaccine than of the virus. This was with a strain similar to H1N1. Clearly it is this component which is the problem.

From the outset everything to do with swine flu has been rushed and corners have been cut, based on the fear of this virus. The estimates of swine flu have been wrong from day one. The 2009 southern winter and 2010 northern winter have been the mildest, in terms of flu, for many years. Predictions of millions of deaths were ridiculously wrong and deaths were less than usual. Every year some people die in relation to flu. Most of these have other illnesses and there are a small number where there is overwhelming infection.

The USA, UK and many European countries slashed their orders for vaccines and still had many doses to spare. The Australian government is sitting on a huge stockpile of vaccines. The notion that the only way to protect yourself from flu is to be vaccinated continues to be promoted with no regard given to the fact that a competent immune system is your best protection from flu or any virus. I am yet to see any advice from health authorities on ways to strengthen your immune system.

I am not into conspiracy theories so do not see swine flu as a government plot in collaboration with the vaccine manufacturers. It is my opinion that conspiracy is not the correct interpretation of events when incompetence or stupidity would be an equally valid explanation.

This is also not a debate about vaccination per se. In the same way that if a drug is withdrawn from the market, it is about that drug, not drugs as such.

Swine flu has been a textbook health scare. The threat was way over stated and the reaction was way out of proportion to the threat. Now we have the situation where those who got it wrong are too attached to their position to admit error. The continuing push to vaccinate on the basis of fear is wrong. If even one child dies or sufferers serious harm based on a program that was not needed, then this is not acceptable.

The issue is not about the rights or wrongs of vaccination in general. It is about whipping up fear and telling people that only a vaccine can protect them from a mild illness.

The authorities got it wrong. It is time for them to fess up. Ongoing attempts to reassure the public about the safety of a vaccine, which is unnecessary, will only serve to further undermine confidence in vaccination and in health advice.

No,Prime Minister,People Need Sleep To Function Effectively

2010-04-20T06:57:00.000-07:00

It is fair to say that many government decisions are not particularly good. There may be an obvious reason for this emerging. Australian Prime Minister Kevin Rudd is “unapologetic” about his staff working long hours and there being a high turnover rate of staff.

Apparently staff can start at 4.30 am and still be on the go at 10pm.Seven day weeks are not unusual. Mr Rudd claimed a year in politics is like a dog year, seven years crammed into one. He claimed that people expected their government and politicians to work hard.

It seems the PM is unable to differentiate between quality and quantity when it comes to work. Furthermore he also seems to be unaware of the health effects of long hours and its impact on decision-making and the impact of high turnover.

Any human resources manager will tell you that staff turnover places a huge burden on business. There is loss of corporate knowledge, and the time taken to get a new staff member up to speed can be some months. All the while productivity suffers. This is quite aside the monetary costs of paying people out and the costs of recruitment. In business these costs affect profit whereas in government it is just borne by the taxpayer.

It gets worse. Sleep deprivation affects both health and productivity. NASA studies have shown that after 20 hours continually awake your brain is affected the same as with a blood alcohol reading of 0.05%. This is the cut off level governments set in most countries for drink driving. At this level you are not fit to drive. So how can you run the country?

In addition to this lack of sleep contributes to an increased rate of high blood pressure and heart disease. People who do not get enough sleep are more likely to be obese. When they do finally drive home, obviously there is a greater chance of a road collision and injury to them or someone else. Lack of sleep contributes to stress and in turn this can increase the likelihood of getting cancer five fold over a ten-year period.

For governments who claim to be concerned about health and wanting the population to be healthier this is a strange way to act. However even if we totally ignore this (and one wonders what the Health Minister would say if a public company forced employees to work these hours) there is another aspect.

Experiments have also been done on productivity and sleep. Sleep deprived people are less likely to work co operatively with others, are more irrational and more prone to emotional outbursts. Has anyone ever seen the behaviour of a tired child? Well it is the same in adults.

People want government to be effective. This is measured by outcome not hours spent. Indeed what we are seeing is that the modus operandi of government leads to poorer results by making its employees less healthy and getting them to work when their brains are far past their best for the day.

I would not want to be operated on by a surgeon with a blood alcohol level of 0.05% or equivalent in sleep deprivation. I do not want decisions made about the governing of the country by people with a blood alcohol of 0.05% or the equivalent in sleep deprivation.

The final irony is that the hard work keeping everyone up was on … health reform.

Parks Are For Exercising Even If It Wears Down The Grass

2010-04-16T03:04:00.000-07:00

It is always amazing how little things can make a big difference. You would think that with all the talk about problems with obesity and people being too sedentary that all levels of government would be taking steps to encourage people to exercise. At very least you would not expect them to put up barriers.

Sadly you would be wrong. The City Of Stirling (in West Australia) wants to charge personal trainers up to $50 an hour to use parks and reserves. Two bizarre excuses were offered. One was that the council must charge trainers because of the wear and tear on parks. The other was that parks are not provided for businesses to get a “commercial gain”.

What a load of rubbish!

Parks are actually designed to be used. They are not ornamental. The whole purpose of having public parks is so that people can use them. Large grassed areas are ideal for running, throwing a ball or doing all forms of healthy outdoor activity. The “wear and tear” line reminds me of the lady in a Fawlty Towers episode who had difficulty hearing but when asked about her hearing aid said she did not use it because it ran the batteries down.

We have parks but we do not use them because it wears the grass down! Even if there is some truth to this, all levels of government are encouraging people to be more active and public parks are provided for…public use. Every year we pay rates to councils and basically all they do is collect the rubbish once a week and water the parks. If maintaining public parks in the face of public usage is too hard for the poor dears then they need a reality check.

The second excuse is completely self-serving. Most trainers are small business people. Most do not charge huge amounts of money. It is also a fact that the presence of a trainer will encourage people to exercise and push themselves a little bit. Exercising in a group is popular as it provides a social benefit as well as the fitness side. The fact that the trainer provides a service to those people exercising does not mean they are getting a “commercial gain” from the park, they are earning a living by providing a service to people who live in the area and pay rates to the council to maintain a park for public use.

One trainer, is not wearing down the grass, it is the collective use of all the people exercising. Presumably this council hopes that its charge will discourage trainers. In turn that means it hopes ratepayers will not exercise in the park and not wear down the grass. One can assume it hopes they will stay inside watching TV instead.

Rather than discourage trainers, if governments were serious about health they would subsidize trainers at every park so that more people would do regular exercise. Some of this money could be diverted from funding of elite athletes. Some could come from the health budget.

With a healthier population, there might be just enough savings from the health (disease) budget to pay for grounds maintenance.

Pharmaceutical Influence Is Changing Shape

2010-04-13T07:05:00.000-07:00

The links between doctors and the pharmaceutical industry are coming more and more under the spotlight. To be upfront, I have over the years been given various pens, coffee mugs, and have been to sponsored dinners. Over the past few years I have deliberately stopped going to these and have not regularly seen reps since 2005.

It always struck me that these promotions were advertising and that it was up to me to decide whether the claims were valid in much the same way, as I would assess claims made about products advertised on TV. The media has tended to focus on these gifts as the main game.

What has become clear is that pens, mugs and dinners are not the main game. The big issue is payments to doctors as consultants and speakers. Pfizer has reported that in the last half of 2009 it paid $US20 million to doctors and medical professionals for consulting and speaking. A further $US15.3 million was paid to academic medical centres and research groups for clinical trials. Other companies are also disclosing payments.

Some states in the USA now have laws covering gifts given to doctors from pharmaceutical companies. Various universities and medical schools have implemented disclosure policies. Harvard Partners Healthcare put a cap on how much doctors can be paid to sit on boards.

Institutions, which employ doctors, are able to put conditions on employment. Doctors in private practice are of course not bound by such conditions. Consequently there is a trend to get local doctors to give talks. The payments for this can be lucrative with reports of payments of tens of thousands of dollars.

None of this is “wrong” as such. Speakers are paid in all forms of industry. Companies are free to promote their wares and pay people to endorse them. Many sports people earn more from endorsements than they do from their chosen sport. So is it a surprise that some doctors can earn more from “endorsements” than their practice?

The short answer is no. However there is one key difference. When you see and add with a celebrity you know they have been paid to advertise the product. When doctors talk about drugs it is presented as clinical information. It is known that pharmaceutical companies seek out “opinion leaders” in medicine so that their names can be quoted to other doctors. “Specialists”, who, rightly or wrongly, are deemed to know more about particular areas of medicine, can influence primary care physicians.

I do not believe any doctor will say things at a talk, which they do not believe. The point is that they are selected because of their views. A doctor advocating lifestyle treatments rather than drugs probably will not be invited to speak. It is more about what is not said. A talk on diabetes sponsored by a drug company will of course focus on drug treatment rather than diet and exercise.

Bottom line is that millions of dollars would not be spent if there were not some return to the company. This matters because the costs of drugs are generally borne by governments and insurers rather than the individual. Hence unnecessary use costs everyone.

As the rope tightens around this method of promoting pharmaceuticals another subtler one is opening up. This is payment by pharmaceutical companies to patient support groups. In some instances pharmaceutical grants have been used to set up patient groups. Australian figures show several pharmaceutical companies donated over $1 million to assorted health groups including the Heart Foundation. The Australian Lung Foundation was set up by a grant from a company that makes a quit smoking drug. Guess who may have funded the establishment of Impotence Australia.

Once again none of this is “wrong” or illegal. However might your view of a news story quoting a health group be affected if you knew who had funded them? As with the doctors it is not about paying people to say things they do not agree with. It is about finding people who agree with you and then having them promote your line “independently”. Similar to celebrity endorsement, this is patient endorsement.

Many patient support groups have a “saintly” air about them and claim that they are all about advocating for the people who have a particular disease. Fair enough. It also means they can have an interest in “disease mongering” and encouraging people to see traits or minor symptoms as part of some disease or syndrome. This builds the number of people they “represent”.

This leads to the medicalizing of life. In turn there is increasingly a drug to treat this medicalized life. These drugs are sold for a profit by the same pharmaceutical industry, which supports these groups in spreading the word.

If we take three steps back, it may become apparent that there is something not quite right with this picture.

Being Human Is Not A Disease

2010-04-09T07:55:00.000-07:00

Humanity has a breadth and depth to it. We are not all the same. It is interesting then how some differences are accepted and others are not. It is particularly interesting how some differences are increasingly been made into diseases. The medicalization of human behavior is a real trend. If a human trait can be reclassified as a disease, then suddenly there is the potential to “treat it”, especially with a pharmaceutical agent.

Let us look at a ridiculous example. Height can vary considerably. Whilst there are genetic causes at the extremes of the height range, the vast majority of people are either to the taller or shorter end of the spectrum. It is not considered a disease to be five feet high even though this is at one edge of the range.

So why is it then that with behaviors we are increasingly regarding those towards one edge of the spectrum as having a disease? ADHD is a classic example of where particular traits have been reclassified as a disease and the people, mainly children, involved have been put on drugs. Attention spans like everything else vary, but this is not to say those at one end of the scale have a disease, particularly when these children usually have other talents which the school system may not recognize or reward. Even allowing for the fact that some children may have difficulty with sitting still, that does not make it a disease.

Shyness is another human trait. Some of us are more outgoing than others. In the 1990’s this was reclassified as Social Affective Disorder and people were treated with antidepressants. This has fortunately gone out of vogue. If shyness is a problem to people then there are ways of dealing with it; it does not make it a disease.

In a similar way the concept of depression has been expanded to include everyone who feels down. If it is not a disease to feel happy after winning the lottery, then it is not a disease to feel down, for example, after a death of a loved one or relationship breakdown. Whilst some people do have genuine depression, many others now come under this banner for basically having human emotions, which are reclassified as a disease.

We saw in the 1980s the reclassification of menopause, which is a normal part of life, as a disease. Many women were placed unnecessarily on hormone treatment, which was found to cause more harm than good. Some of the issues surrounding clinical trials, which supported hormone treatment, are still being investigated.

Some men at times have difficulty getting an erection. This is not new and is not a disease but was reclassified as one and named erectile dysfunction. Sure if taking a tablet helps you and you want to take one, then do so, but do not call it a disease. The latest attempts will be to make premature ejaculation and jet lag into diseases. Neither is. The first can be distressing and can be dealt with. The second is the obvious result of our ability to move time zones more quickly than our body can cope with. Calling sex addiction a disease is just making excuses for people who choose not to control their behavior.

The bottom line in all this is that a drug looking for a disease always accompanies the reclassification of a human trait, emotion or tendency. If people want to use pharmaceutical or even illicit drugs because it makes them feel a certain way, or allows them to do something they might not otherwise do (remember the songs written in the 1960’s under the influence of substances) then the rights or wrongs of this can be debated.

However let us not use the label of disease to justify our actions and certainly let us not reclassify normal parts of life as a disease especially if the main reason is to boost the sales of pills.

Prostate Testing Is Not Black And White

2010-04-06T04:53:00.000-07:00

Prostate testing remains controversial. In one camp we have those who are pushing for more testing so that more cancers can be detected. This group feels that prostate cancer is under diagnosed and under treated. In the opposing camp are those who feel prostate testing is not helpful as a screening (as against a diagnostic) test and feel that too many men have unnecessary biopsies and surgery with all the associated risks and possible complications. Interestingly, in this latter group is the inventor of the test.

Whilst stories of men who had their life “saved” by having a PSA test make the headlines, stories of men who have incontinence and impotence after unnecessary surgery do not.

What is the average man to make of this? The issues are not straightforward.

The PSA test measures a protein in the blood, which comes from the prostate gland. Like with all tests there is a statistically defined normal range and this increases with age. There is also a sub set of “free” PSA versus PSA bound to another protein.

In an ideal world a raised PSA would diagnose prostate cancer. It does not. The level can be raised for a number of other reasons including benign enlargement, infection and can be raised by some over the counter medications. The PSA can also be normal even if cancer is present. In medical terms this test is classed as having a high” false” positive and negative rate.

It gets more complicated. There are two types of prostate cancer. One form which is fatal and the other is not. In simplest terms it has been regarded that all men will eventually get cancer cells in the prostate if they live long enough. They will die with not of the cancer. Hence the finding of prostate cancer in someone of 70 is regarded as less serious than in someone of 55. Age whilst a guide, is again not an absolute determinant of the form of cancer. The PSA does not give us any clue either.

The final complication is that in many instances we do not know if treatment makes a difference. In other words in many cases we do not know if a man who has undergone surgery and radiation and lives would have lived just as long without treatment.

There are conflicting trial results too. An Australian study claims that Australian men are under diagnosed and under treated. This is based on the fact that 60% of biopsies were positive for cancer compared to 30% in the USA. It also found that when radical prostatectomy was performed that on 5% had “insignificant “ cancer compared to 25% in the USA. This could also be interpreted, as showing that there is better case selection for surgery in Australia.

Once again it would be simple if the finding of cancer and treatment meant a better and longer life. A large American trial over ten years showed PSA screening did not reduce death rates in men over 55. A European study showed a small decrease in death rates. For every 48 operations there was an increased survival of one. This means 47 men had surgery, which can cause incontinence and impotence for no net gain.

The Australian study is being promoted by the Urological Society, which advocates PSA testing for all men over 40. It is worth remembering that their members earn a living from biopsies and surgery. This does not make their advice wrong but they have a vested interest. Other Australian groups recommend screening after 60 or no screening at all.

The tests inventor, Richard J Albin went public saying he never intended the test to be used as a screening tool and claims the original FDA approval was based on it detecting 3.8% of Prostate cancers. Whilst the case rate of Prostate cancer in the USA is 16% there is only a 3% death rate from it.

So to get back to our question of what are we to make of this? The simple answer is we do not know. Those who claim to have the answer need to be treated with great skepticism. Those who claim they are about “saving lives” need to be treated the same. Those who downplay the not insignificant costs in human terms of over treatment are not doing us any favors.

Ultimately the decision needs to come down to the individual based on his circumstances. Factors like family history and symptoms need to be considered. If a PSA is done and is raised it should certainly be repeated before further action is considered. Men need to be aware that it is not black and white; that a positive test may mean nothing and a negative test does not mean absolutely no cancer.

Whilst it would be nice to be able to offer a simple one size fits all advisory, I do not believe this is possible. Hence beware of those who do particularly if they stand to gain monetarily from it.

Chocolate Is Actually Good For Your Health

2010-04-03T05:57:00.000-07:00

Easter Sunday is the day when everyone can indulge his or her love of chocolate without feeling guilty-and rightly so. Chocolate is universal. It is said that nine out of ten people say they like chocolate and the tenth is lying.

So why is there guilt about chocolate, and do we need to feel guilty? Simple answer -NO Chocolate is not intrinsically bad for us. At levels of cocoa of 70% it is actually good for us. What applies to you will depend on how much you eat and the quality of the chocolate.

So lets look at the “health benefits” of chocolate. The good feeling you get is not imagined. Chocolate contains a phyto-nutrient, which is an endorphin. The “high” from eating chocolate can be similar to the high runners get. It comes from the endorphins (the bodies natural happy hormone). Chocolate is virtually an antidepressant. Is it any wonder people turn to chocolate when they feel down? A Swiss study showed that eating 40g a day of dark chocolate lowered stress hormones in the bloodstream making people more resilient to stress.

Research has looked at the health benefits of dark chocolate and the results are impressive. A Swedish study showed that after a heart attack, those who ate chocolate at least twice a week had a three fold increase in survival over an eight-year period. Meanwhile a Canadian study showed a decreased risk of stroke in those who ate chocolate once a week compared to those who do not.

The benefits come from the flavinoids in cocoa, which are a potent anti oxidant. These flavinoids have also been shown to protect our genes (DNA) from oxidative damage. This potentially makes chocolate an anti-aging compound.

Chocolate is viewed with suspicion because it tastes so good. As a “pleasure” it has been seen as sinful. There are also linkages between chocolate and that other great “sin” of humanity-sex. Hence, the association of guilt.

Dark chocolate has lots of minerals including potassium, zinc, copper, chromium and magnesium. Many women turn to chocolate if they have pre menstrual symptoms. This is related to low magnesium. Again the body knows what it needs.

Cocoa is rich in antioxidants (10g dark chocolate has the same amount as a cup of green tea). The glycaemic index (GI) of chocolate is 40. Polyphenols in cocoa can reduce LDL, which is the “ bad cholesterol. There are also good fats in chocolate.

Now this is all well and good, you may say, but you can get the most of the same minerals and antioxidants from other sources. This is where the extra dimension of chocolate comes in. Fun is one of the pillars of DIY Health. Apart from providing goodness for us, our food needs to give us joy. Chocolate scores ten out of ten on this one.

So as I said above, there is no need to feel guilty about eating chocolate on Easter or on any other day. This does not mean a bar a day and yes you can get all the above nutrients from other sources, perhaps without the same amount of enjoyment. The best is 70% cocoa and organic is great if you can get it.

As part of a balanced DIY health program chocolate hits the spot.

Happy Easter Enjoy!

Being Healthy Is More Than Just Not Getting Sick -Focus on Being Healthy

2010-03-31T07:04:00.000-07:00

Over the last 30 years we have seen the rise of preventative health. Some recent studies shine a spotlight on this and raise good questions. A US study questions the cost effectiveness of certain health programs. In Germany it has been suggested that many “preventative” health programs may do more for doctor’s wallets than patients.

A UK study has shown that simple lifestyle changes would reduce rates of bowel cancer far more than screening programs (testing blood in the stool. Mass skin cancer screening in Australia has seen the ratio of spots removed per cancerous spot go from one in four in 1980 to one in thirty today.

The issue with most public health and preventative health campaigns is that are focused on trying to detect or prevent specific diseases. There is rarely an emphasis on keeping people healthy overall.

Now, lets be clear, it is better to find disease early than late. However this is not the same as not getting disease and certainly not the same as focusing on being healthy. If being healthy becomes an obstacle course, then in avoiding one obstacle we may run straight into the next.

There are unintended consequences of this “disease specific” approach For example; skin cancer campaigns that urge people to stay out of the sun may be partly responsible for a staggering increase in vitamin D deficiencies. This may be causing more cancers (bowel and breast for example) than it is preventing. Vitamin D deficiency is also possibly linked to diabetes

Since the late 1970’s, there has been a big push to reduce fat intake. This has come about because of concern that cholesterol in the blood stream leads to heart disease. Interestingly, the original study (Framingham), which sparked this whole reduced fat movement, never actually concluded that circulating cholesterol levels were the problem. It was always to do with the build up of cholesterol plaque in certain artery walls and even more to the point, the rupture of this plaque. The reasons why this occurs in certain individuals and not others, has always remained a mystery.

Indeed, there are populations around the world who have very high levels of cholesterol and very low levels of heart disease and vice versa and up to 40% of people with heart disease have none of the “common risk factors”.

Nevertheless, the “fat is bad” mantra gained traction.

The proverbial baby has been thrown out with the bathwater, as many people may not get enough good fats. Omega 3 and omega 6 are called essential fatty acids because the body can’t make them and needs them. Also in a push to lower fat intake, consumers sought out low fat foods. What people didn’t think about was these foods were very high in carbohydrates (sugars) in general and refined carbohydrates in particular. Not only those, but also these foods do not provide much nourishment and often leave you with the munchies two hours later.

If the body gets excess calories it will store them. It can’t store them as sugars, it stores them as fat, so regardless of how many low fat foods a person eats, the excess calories are converted to fat. The gradual result of this over 25 years has been an increase in the rates of obesity. People have been eating less fat but guess what happened? They have been getting fatter.

The next knock-on effect has been an increase in the rate of diabetes. Obesity has skyrocketed since the mid 1980’s - all this under the watchful eye of the public health and preventative disease authorities. By focusing on trying to prevent one illness, a whole range of other effects was overlooked. The messages are not bad or negatively intended in any way, but too narrow in trying to stop one particular disease.

The solution of course is to focus on being healthy rather than trying to prevent specific diseases, especially when trying to prevent one disease can lead to getting another. This is the essence of Do It Yourself Health

The best way not to get sick is to be healthy.

Fitness Is Important Regardless of Your Day Job

2010-03-26T06:39:00.000-07:00

Politicians can be criticized for many things. Being fit and healthy is not usually one of them. The general view of the lifestyle of the average politician would be one of too many meals out perhaps accompanied by a bit too much alcohol. Regular exercise is not often associated with politicians. Now, this is of course a generalization. There will be those who are watchful of what they eat and some maintain a fitness regime.

Australian Federal opposition leader Tony Abbott is a rare breed amongst politicians in that he is a fitness fanatic. He competes in iron man events and triathlons. He is in extremely good physical shape for his age and is getting known for photos in his Speedos. This is a rare look for any politician.

Now I am fairly fit and a couple of years younger than Mr. Abbott and have no desire to emulate his efforts. It is not necessary to do as much exercise as he does to be in good health.

It is interesting to see some of the reaction to this. Obviously political opponents want to score points so it can be argued that making jokes about media pictures of Mr. Abbott in his “budgie smugglers” as his bathers are colloquially known is fair game. Equally is the jibe that the public may be tiring of seeing photos of him in bathers on the beach.

There has been another criticism which is a bit stranger particularly sitting against the backdrop of ongoing discussion over health care reform. He has been criticized for spending too much time keeping fit rather than being at work. Now I do not know exactly how many hours per week he spends on his exercise regime or doing his day job. The Federal Treasurer was quoted as saying” I do not know where he finds the time …”.

Jokes aside, there are serious issues that emerge from this. Firstly no matter what your day job is, looking after your health is vital and keeping fit is a key part of this. We all have 24 hours in the day. Some of us prioritize exercise and others do not. Some of us are efficient in our tasks, others less so. Some people, not just politicians, wear the hours they work as some sort of honor badge- it is no such thing.

Excessive hours at work are not good for health as it makes your life unbalanced. In addition to this, the longer one works without break the less productive one becomes. On top of this exercise helps mental clarity and helps you sleep better. Hence a fit person will often get more done in less time that someone who is not fit. Of course exercise helps you maintain a healthy weight and reduces your risks of disease such as heart disease and stroke to name but two.

So with all the arguments over “health “ reform and ways to pay for more disease services, which are required because many people do not exercise, it is in some ways refreshing to have a political leader who is leading by example when it comes to health. A politician who is showing that health is not about hospital beds but about looking after yourself.

Being fit is not grounds for bring elected.Like all politicians he needs to be judged ultimately on policies and how well he does his day job. Criticisms of his exercise regime particularly in an environment where governments are concerned about the spiraling costs of the consequences of not exercising are ridiculous.

Weight Loss Does Not Come From A Pill

2010-03-23T07:15:00.000-07:00

The weight loss drug Sibutramine, better known as Reductil had its license suspended by the European Medicines Agency (EMA). The agency recommended that the drug should neither be prescribed by doctors nor dispensed by pharmacists. The reason for this was that a trial of 10,000 people followed for six years showed an increased rate of heart attacks and strokes in the group taking Reductil compared to a control group. The EMA has concluded that these risks outweigh the benefits.

Whilst the drug remains licensed in other countries at this stage, the end cannot be far off. Even if other government agencies do not follow suite, the manufacturer may well pull the drug off the shelves on potential liability grounds. This trial result would make a liability action difficult to defend.

This drug will not, in my opinion, be missed for the simple reason that it does not do much. Those taking it lose only marginally more weight than those taking a placebo and the effect is not long lasting.

This drug now joins a list of other weight loss drugs, which have been taken off the market because the risks were greater than the benefits. At the same time the race to find a new pharmaceutical agent for the “obesity” crisis goes on. There is a cash prize on offer. It is estimated that Americans spend $59 billion each year on weight reduction products and services. Only a small part of this is spent on pharmaceuticals.

There are currently three new drugs lining up at the FDA for regulatory approval. Apparently they have shown “promising” results in one-year trials.
Whilst that is fine, a one-year trial will not show risks, which might appear after three to five years. The trial, which has led to the decision on Reductil, was done over six years.

Here is something to think about. If it was not a pill that caused you to become overweight, why would you expect the solution to be in a pill? The basic fact is that we put on weight when our energy intake (calories) exceeds our energy expenditure. Now, I know the calories in, calories out idea are not popular in some quarters. It is true that some people have different metabolic types and do better with some foods than others. It is also true that to reduce weight, combinations of foods, times when you eat, and your emotions play a part.

The bottom, line though is that whilst there are a vast number of roads to travel, the final common pathway has to be an alteration in the energy equation. This is not medicine; this is a basic law of physics and cannot be gotten around.

Therefore lets be honest about weight. The problem is not your bones, your genes, your family, the take away shop down the road, your job or any one of a thousand other excuses. The problem is the energy equation of energy taken in compared to energy used up. When you bring it back to basics the solution is simple. It is to change your eating patterns. It is about putting the fuels into your body that it actually needs. It is about reducing processed foods and eating more real foods.

What you have created, you have the power to change-if you want to.

Immunization Debates Generate More Heat Than Light - We Need Facts on Vaccinations

2010-03-19T01:01:00.000-07:00

Unless you have been on mars for most of the last twelve months you would have heard about the H1N1 virus also known as swine flu. In response to the perceived “killer” virus, governments around the world ordered mass dosages of a vaccine against the virus in a bid to save the populace from the terror of flu.

As things turned out there was no threat and many governments in the northern hemisphere have scaled back their orders considerably. In fact latest figures from the USA show that this flu season has been particularly mild with far less cases than usual. The Australian government was not able to cut back its order and hence has a lot of vaccine in storage. It is looking to get rid of this by another scare campaign about second waves (which is tricky when there was no first wave).

Through all this though there has not been any questioning of the basic assumption that giving people a flu vaccine protects them from flu and that in turn they and society benefit. Many countries have annual flu vaccination programs for those over 65. Some of these have been going for many years.

It was with some interest then that it emerged recently that there is not actually any evidence to show that this does any good! The well-respected Cochrane collaboration released a report, which looked at 75 studies over a 40-year period. The conclusion was that “The available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines in people aged 65 years or older”.

In simple terms after 40 years we do not know if giving people over 65 a flu vaccine does any good or any harm. Now to be fair there is nothing at all to suggest that there is any harm done even though the safety of its use has not been proved. Also it could be that nobody was able to find the evidence of benefit even though it may be there.

However after 40 years and 75 studies on a commonplace medical procedure you would expect evidence of benefit to be apparent. The assumption that because it involves vaccination it must be good is not a scientific position but one of faith. Interestingly it is exactly the type of criticism that is leveled at those opposed to vaccines by health authorities and doctors. Unfortunately “debates” over vaccination generate heat and no light as positions are entrenched and facts are of little interest.

Some drugs are more useful than others. Those, which are shown to be not useful, go out of use. Medical procedures too, become superseded. There is no reason the same logic should not apply to vaccination. Those, which are shown to be useful, should be continued. Those where there is not shown to be benefit should not.
Last year serious questions were raised over the papiloma virus vaccine (marketed as the Cervical Cancer vaccine) as how long it lasts in the system is unclear and by giving it to 13 year old it may have worn off by the time they need protection. Also there is the lingering question about whether the body will in most cases clear the virus anyway.

An Australian report showed that after the introduction of the Chicken Pox vaccine there was an increase in the rate of hospitalization of the elderly with Shingles, which is caused by the same virus. This led a call for another vaccine program. Whilst there was a reduction in cases of chicken pox, in children this is hardly a massive achievement as it is essentially a minor childhood illness (yes there can be complications but this is rare).

The bottom line is that this matters. Governments spend large sums of money on vaccine programs. There is in many instances some compulsion about being vaccinated and penalties for not doing so. This does not occur with any other area of medicine. Assessments made on the basis of facts, not pre conceived notions, faith in vaccines, or opposition to vaccines, is what is needed. Those, which are shown to have benefits outweighing risks, are worth doing. Those where this is not the case, are not worth continuing.

Vaccination is a medical and public health issue. It is not a sacred cow. Programs need to be assessed, criticized and changed or stopped if not found to be of benefit. Justification on the basis that vaccination, of itself, is good is no better an argument than vaccination, of itself, is bad.

Parenting Is About Using Judgement Not Protocols

2010-03-16T07:36:00.000-07:00

One of the important contributors to a child’s health, both physical and mental is a reasonably stable environment. This for various reasons is not always possible and humans are fairly resilient. When one looks at the requirements people have to go through to be approved as adoptive parents and applied this to parents in general there would be very few children born.

Departments of child services or child protection are there to step in and protect children if they are deemed to be in danger for some reason and that it is deemed unsuitable or unsafe for the child to remain with their natural parents. These children are then placed in foster care. Again there are certain criteria that people have to satisfy to be selected as foster parents.

A row has broken out in my home of Perth this week about a prospective foster family who has been told they cannot fulfill such a role. This family has 11 children of their own and told The West Australian newspaper that they saw fostering as part of their Christian duty and an opportunity to put back into the community. There are reportedly 3238 children on the emergency waitlist for foster placement.

The reason this family was told that they are not suitable is because during the interview they admitted that occasionally smacked their own children. They indicated that they would not smack a foster child in their care.

Now I will put three things on the table. I do not think smacking is the best way to discipline children and I have on very rare occasions smacked my children. I have never met the family in question.

In some countries smacking is against the law .It is not against the law in Australia. According to the Department of Child Protection, if one of the children in the house were to be smacked then this would traumatize the foster child.

What are we to make of this? If there are over 3000 children awaiting emergency placement then clearly there are more children that prospective foster families. Being a foster parent is possibly the hardest gig. They are not your own children and you have not adopted them as your own. You are charged with raising them for an unspecified period of time under the watch of a government department. These children necessarily have issues otherwise they would not be in foster care.

This does not mean that there should not be a vetting process and that any family that puts their hand up gets selected. It does mean that commonsense rather than political correctness needs to rule the day. If a parent is honest enough to say they occasionally smack their child, does this automatically make them a bad parent? Is this worse then sending a child to their room for two hours or grounding them?

And here is the key thing. Being a parent requires the use of judgment. You need to judge situations and respond at the time in the way that seems best. In doing so there is a chance with hindsight that your judgment call may not have been the best one. This is thing that government departments and the people who inhabit them cannot abide. And why is this?

It is because when you make a judgment call you are taking personal ownership and responsibility for what you do and the consequences. You are not hiding behind a committee decision or guidelines or protocols, which are supposed to be able to second guess, in advance every nuance of every situation. You are making a decision and in so doing must take responsibility for that decision.

The same thinking is behind equating an occasional smack with child abuse. By making everything the same, there is no need to make judgment calls on individual situations with the inherent need for personal responsibility and the possibility of being wrong. Of course such an approach diminishes the severity of real abuse but can be easily placed in protocols.

A family with 11 children is fairly easy to assess for parenting skills. Look at how the children are turning out. Talk to their school, the local community maybe employers of the older children. The proverbial proof of the pudding is in the eating. If these parents are capable you will see it in their children.

This of course requires judgment and individual responsibility, something that is anathema to government departments who whilst charged with protecting children, have 3238 awaiting care but bask in the glow of protocols, which “protect” children.

Health Reform Is Not More Services - It Is People Being Healthy

2010-03-13T03:51:00.000-08:00

Health reform is on the front page in Australia, again. Prime Minister Kevin Rudd revealed a plan for the Commonwealth Government to take over the funding of public hospitals from state governments. Prior to being elected in 2007 Mr Rudd promised to fix the health system and stop the “blame game”.

Funding of the health (read “disease” system in Australia is split between the two levels of government. In simplest terms the Commonwealth raises tax dollars. It then gives the states a pot of money under the Australian Medicare agreement, to run the public hospitals. This allows Canberra (the capital) to blame the states for not wisely spending the money they have and allows the states to blame Canberra for not providing them enough money to do the task.

Strange anomalies occur. For example, if you get a prescription from a doctor in a private practice and get it dispensed at a pharmacy, the Commonwealth will in part pay it for. If you get a prescription at an emergency department and it is filled out there, it is paid for by the state. See a specialist in their consulting room and it costs the Commonwealth. See the same specialist in a clinic and he will be paid by the state. This has also led to attempts by both levels of government to try to push costs on to one another. For example hospitals now send people home with little or no medication whereas previously they got two weeks worth. This “pushes “ the cost of tablets onto the Commonwealth.

These discussions about funding cause the eyes of the average person to glaze over. The dollars involved are astronomical. The Treasury’s Intergenerational report suggested that spending on “health” would rise from 15% of Commonwealth outlays to 26% by 2050. Type 2 Diabetes is estimated to increase six fold by 2033. It is already estimated that obesity costs Australia $56 billion a year.

As usual all these arguments centre on how to pay for an inexorable increase in demand for services. The issue is the same in the USA and all western countries. Australian Health Minister Nicola Roxon told Fairfax radio taxes might need to rise, as “ …we have to be able to fund delivery of services into the future”.

Has it ever occurred to any of these bozo politicians that the solution may not be in trying to fund more and more services? Has it occurred to them that the solution may be in finding ways to lower the need to provide services? Are they aware that 75% of spending on services is already for preventable lifestyle related conditions, which are preventable, or reversible with simple changes to how people live their lives?

Or is it better to promise to fix people and hence make themselves look important. Oppositions always promise to fix health. When in government they find that they cannot do this. I doubt it comes as a surprise.

Western Medicine is great at acute care. If you break your leg, I do not believe that herbs or meditation will fix it. However Western medicine does chronic disease very badly. It offers expensive pills and technology when lifestyle changes are what are needed. This is why our disease systems are unable to cope with demand. They are not suited to the task. Hospitals are not the answer to diabetes obesity and other lifestyle related chronic diseases or the consequences thereof. Hence our systems are struggling. More of the same will not be the answer.

The answer lies in the hands of individuals who can choose to be healthy rather than wait for the system to “fix” their disease. In this scenario the disease systems will easily be able to cope with the demand for what they are good at, treating acute illness and injury.

Fitness of Nations - How is Government Money Best Spent?

2010-03-10T07:35:00.000-08:00

It was interesting to see an editorial in the Vancouver Sun Newspaper questioning the spending of Canadian taxpayers money on Olympic sports. The Winter Olympics were a great success both in a logistical sense for Canada and in terms of medals. The Canadian Olympic Committee (COC) asked for an additional $11 million per year on top of the current $47 million.

The paper suggested that the COC had wanted to act quickly whilst the glow of success was still fresh in people’s minds. The same situation has occurred after summer Olympics in Australia and I suspect these issues come up in other countries too.

The paper noted that several medal winning athletes had said they could not have succeeded without funding. It then made the key point “…we have been buying medals. We know now that we can do it. But should we do it? Maybe the money should be spread around to give kids across the country more chances to ski, skate, hockey, curl and even bobsleigh.”

Last year an Australian Government report suggested funding for Olympic sports are reduced and monies directed more to sports with greater participation. It has been estimated that each Olympic gold at Beijing cost Australia about $15million.

Not surprisingly this call brought howls of protest from Olympic officials and athletes who not only do not want funding cut, they want more funding. One former medalist was quoted in the paper as saying how disappointed she would be if youngsters were not able to achieve their dreams because of lack of funds.

Now it is great for people to have dreams and go for them. However why should certain dreams be supported by taxpayers and others not be? If your dream is to be an Olympic athlete then significant money may be directed your way in terms of training and other support. What about if your dream is to be a musician or to be a scientist or anything other than an Olympic athlete, you have to manage on your own. Keep in mind also that Olympic medals are actually won by individuals not countries, even though medal counts are done by country.

More importantly is the issue of how government money should be spent. Given the demands on “health” dollars from lifestyle related conditions such as diabetes, obesity, heart disease and even forms of cancer, all of which are in part improved or reduced by exercise, is pouring millions into elite sports a good investment compared to putting money into facilities for more people to do sport and exercise. There is not a “trickle down” effect of fitness.

There is another aspect to this, which I saw at close quarters last year. The Australian Institute of Sport (AIS) is the training ground for Olympic athletes in Australia. On a Tuesday morning tour at around 10 am there were two six year olds doing gymnastics. I asked the guide why they were not in school? Apparently they have a compressed school day of four hours from 11 till 3 sandwiched between training for six hours per day. The families are moved to Canberra so that the children are not separated from parents. The children are “picked “ as young as three for their potential in the sport.

Exactly when do these children play and whom do they play with? What if their potential is not as great as the talent scouts thought? If certain Key Performance Indicators are not met then they will be ejected from the institute. The Australian community pays for this. I know some countries are much worse than this in their quest for gold but this does not make it any better.

Putting six year olds in an institute away from their friends and robbing them of a childhood is close to child abuse in my book. The carrot of a gold medal does not change this.

If individuals want to pursue dreams, be it sport or anything else that is great. If they are able to get external support, that is great too. Governments have a responsibility to the entire community. With 75% of the disease burden being lifestyle related conditions do we really want to buy gold medals for a handful of people or do we want to use money to build facilities and provide support in communities so more children (and adults) can be physically active and encouraged to be.

How many sports balls could be bought and how many community fitness trainers could be employed for a year, for the cost of a gold medal. Being active is vital for good health. Nations will get healthier if more people do a bit of sport or exercise than if a few do a lot.

The benefits of regular exercise are many and varied. You only get the benefit if you do it. Governments, which are supposedly interested in the health of the people they serve need to think long and hard about the best way to spend their dollars.

Weight Watchers and McDonalds - An Unusual Pairing in Weight Loss

2010-03-06T18:08:00.000-08:00

The famous golden arches have been in the news this week and as usual attracting a degree of criticism. Questions have been raised about McDonalds sponsorship of the Winter Olympics and also a deal struck with weight watchers.

It is worth getting something on the table straight up. McDonalds is in the business of selling fast food. They have a legal and legitimate right to do so and to promote and advertise their products. They are entitled to offer sponsorship dollars in return for publicity.

Each individual person has a choice as to whether or not they choose to go to a McDonalds outlet and if so what menu items they choose.

The issue surrounding the Olympics is the usual gripe about an “unhealthy” product being seen alongside sports, and healthy athletes. It is fairly unlikely that the competitors at the Olympics eat much fast food from any company so they can hardly claim that any medal won was a tribute to the foods advertised. In turn it is drawing a long bow to suggest that viewers will draw that inference. Essentially this is awareness advertising and creating “warm fuzzes” so consumers look more fondly on the company, whether they buy the products or not.

The real question that arises is whether the organizers of the Olympics should accept such sponsorship? In my view there is no reason why they would not. Being sponsored does not imply support of the sponsor-it is the other way around. People can argue that there is endorsement by association. That is possible but even if it is the case-so what?

The key issue is that like all fast food, the issue is not its existence but how people use it. If someone goes to McDonalds once a month or so then really that is not a problem. Whilst I would not recommend it, and I am not a customer, I have no issue with people who go from time to time. Health problems arise if people eat fast food frequently. The product per se is not the problem; it is how people use it. That is a function of the individual not the company. When asked if you want to supersize or would you like fries you are not obligated to say yes. You always have a choice.

The second story is more interesting. In New Zealand (and Australia later this year) three menu items will bear the weight watchers logo. No doubt there has been a fee paid by McDonalds for this. Previously the company paid the Heart Foundation over $300,000 to put the tick on seven meals.

The Weight Watchers website advises people to avoid fast food, including warnings about salt, fats and additives. At the same time Weight Watchers logos will be seen on mats and menu boards in McDonalds. The three meals, which have earned the logo, are a wrap, chicken nuggets and a fish dish. All have around 400 calories.

What are we to make of this? The meals have to meet certain criteria to have received weight watchers endorsement. McDonalds have responded to previous criticisms by broadening their offering. Equally it is a strange pairing to have people on a diet go for fast food with the support of a group like weight watchers.

A few questions arise. Will the dieters order the weight watchers approved meals? Will they take their children and what meal will they have? Will people be full after these meals or might they go back for more?

Smart companies spot market trends and look to cater to them. Generally businesses are much smarter than “non profit” organizations for the simple reason that they have to be to survive. If there is demand for healthier food then smart businesses will respond to this. By the same token, smart consumers will know when they are being “taken for a ride”.

In my opinion those who genuinely want to lose weight will not benefit by going to any fast food outlet even if there are lower calorie options available and regardless of whose “endorsement” it has. If you want to have the occasional Big Mac then by all means do so and enjoy it-just do not make it a regular occurrence.

Pills Are Not The Answer to Better Health

2010-03-02T01:37:00.000-08:00

In what could almost be a man bites dog story, Australian researchers have criticized Australian doctors for not prescribing enough pills. The study released this week surveyed 322 General Practitioners (family physicians) looking at their management of patients over 55 with risk factors for cardiovascular (heart) disease. Each doctor filled out a survey on 15-20 consecutive patients. The total number of patients was 5293, of which 29% had established heart disease and 22% had risk factors.

The authors concluded there was “substantial under treatment of patients…” and that “ We recommend that GPs … ensure that high-risk patients receive evidence based pharmacotherapy”. It may not come as a surprise to find of the eight authors, five have been paid, in various ways by pharmaceutical companies and two are employed by a pharmaceutical company. Only one of the eight has no financial ties.

Now I have no issue with people earning a living and no issue with the pharmaceutical industry promoting their wares. However, I do have an issue when the only recommendation to reduce the chances of people getting heart disease is to use more pills.

Treatment of risk factors is a favorite in the pharmaceutical industry as it is lifelong therapy and a “no lose” situation as it is not the disease being treated, In other words treating risk factors means you get credit if the event does not occur and can claim to have done your best even if it does

Nowhere in this piece is a recommendation that there might be other ways to reduce the risk of disease. There is no recommendation that GP's advise patients about the importance of eating more fruits and vegetables. There is no recommendation that the doctors talk to their patients about weight reduction.

There is no recommendation that people be advised on the importance of Omega 3’s. There is no recommendation that exercise be considered. There is no recommendation that stress be looked at or managed. The fact that just following a Mediterranean diet results in a 10% drop in mortality from cardiovascular disease and cancer did not get a mention either.

In other words the whole solution is to put more people on more pills in the hope that if enough people take enough pills that all would be well with the world.Call me one of the “bad” doctors if you like, and I am sure our researcher friends would, but I do not buy this. Conditions like heart disease, strokes, diabetes, obesity and many others are not due to a shortage of circulating pharmaceuticals in the blood stream, they are a consequence of the choices we have made over an extended period of time. The solution then is to make the changes in our diets and daily life not just to pop more pills. After doing all this, there will still be a role for some pharmaceuticals in some people, but far less than is currently suggested be prescribed.

Meanwhile, just to show that not all research is a way to sell drugs, a study in the European Heart Journal has shown being happy can reduce heart disease by around 40%. The connections between the heart and happiness are legendary and like many things, which are part of human existence; there is a basis which science has not caught up with yet.

To get the benefit, people did not have to be happy all the time and it did not matter if they had down periods. What mattered is that they enjoyed life overall and had some fun. This could be as simple as listening to music for 15 minutes or walking in the park, anything which you enjoyed doing. This is Pillar 8 of DIY Health 101.

Advising people with their lifestyle choices and the importance of some fun in their lives is a much better role for doctors than dishing out pills even if that makes me a bad doctor in the eyes of certain researchers and their bosses.

Swine Flu - The Threat That Never Was and Six Ways To boost Immunity

2010-02-24T05:56:00.000-08:00

For reasons that are beyond me, health authorities will not admit that they got it wrong with swine flu. In some respects this is happening on the quiet as many countries have slashed their orders for vaccines and you hear less about it. In the northern winter predictions of countless deaths have of course not materialized.In fact the flu season has been no worse than usual.

Dire predictions of swine flu at the winter Olympics were made. Not one single case has occurred. In the southern hemisphere we are preparing for the next winter, still four months away. This will be the second winter with H1N1.You would think that people who claim to be “of science” and who criticize other practitioners for being “unscientific” would use the facts from last winter and apply them. You would be wrong.

The facts are that the H1N1 virus was no more severe than any one of the usual flu viruses both in terns of numbers of cases and severity. Some people get severe symptoms with flu, some people are hospitalized and some die. This happens every year. The predictions of both cases and deaths from H1N1 were so far wide of the reality as to be laughable, if so much effort, time and money had not been wasted.

If any further proof was needed that the last winter flu in Australia was mild it came in the profit result of listed medical centre company, Primary Healthcare. In its half yearly result the company noted that attendances at general practice clinics had been flat. One reason for this cited in the half yearly report was the “lack of a flu epidemic compared to last year”.

Not only was last years flu season not worse than usual it was milder than the previous year, resulting in less visits to the doctor.

People can get things wrong. We all do. We can learn from mistakes. So what are we getting from the health department in Australia? Recognition that they were wrong? Advice to treat this winter like any other? No, we are getting dire warnings for this year.

The threat of a second wave has been raised. How can you have a second wave when there was not a first one? There is the threat that the virus will morph somehow. It was not serious last year, but somehow it will change this year and be the killer that we were all supposed to be afraid of.

To that end the Chief Medical Officer wrote to all Australian General practitioners urging them to vaccinate everyone against H1N1. It also tells us that the government will be spending more health dollars on a campaign to inform the public of the importance of getting vaccinated.

It admits that most of the 20 million vaccines bought by the Australian government have not been used. It also does not mention the spending on anti viral drugs which have been shown not to work, but that is a whole other story.

Now here is the really interesting part. Nowhere is there any mention of what the individual can do to support their immune system. There is no mention of the importance of things that make a real difference to your immune system such as

1) Eat a balanced diet with adequate fruit and vegetables as well as sources of essential fatty acids such as fish, olives (or olive oil), linseed or nuts.

2) In addition to this many people may benefit from vitamin supplements, particularly antioxidants such as vitamins A, C and E, which help the immune system. Zinc, Vitamin D and Folate supplements are also helpful.

3) Regular exercise has been shown to boost the immune system.

4) Make sure you get enough sleep, as this is the bodies recharge the battery time

5) Drink 30-35ml/kilo of water each day.

6) Most importantly examine your workload and stress levels and take steps to reduce them before they reduce your immunity to illness.

The notion that only a vaccine can protect you from the flu is wrong. According to the product information the vaccine has a variable, albeit high percentage “take” and of course it does nothing against other viruses. Your immune system is there to keep you healthy. All it needs is for you to care properly for it.

Do not get caught up in hysteria about killer flu. Do not be swayed by alarmist predictions. Be responsible for your own health.

The best way not to be sick is to be healthy.

Learning From Falling - Personal Responsibility Versus The Nanny State

2010-02-22T05:55:00.000-08:00

Anyone who has learned to walk has fallen over. The way babies learn to put one leg in front of the other and keep balance is through practice and the neural feedback that comes from falling down. The brain fairly quickly learns what does and does not work so that the baby learns how to walk.

Without the feedback of falling we would never learn to walk. As we go through life we may fall down doing other things and learn from this too. This is both literally in learning various sports, including monkey bars as children and metaphorically when we “fall down “ in exams or in business. In fact no one who has succeeded at anything in life has done so without falling down, usually many times. Those who learn from their falls get stronger and better at what they do. They are not fearful of falling, as they understand it is part of the process of life and learning.

Try playing any football code without falling over. Try learning any snow sport without falling over. You cannot do it. This last week we have seen the Winter Olympics and there have been many falls. Australian Torah Bright fell on her first run at the snowboard half pike, got up and then nailed a perfect run on her second attempt and received the gold medal.

This, get on with it attitude, was sharply contrasted with the events in a British town which in the same week banned contestants from running in the annual Shrove Tuesday Pancake race. The event has been held since 1445. In 2010 health and safety council officials in St. Albans, Hertfordshire decided that any person caught running would be disqualified as conditions were unsafe and someone might … fall.

One contestant was quoted in the Daily Mail as saying “I have been disqualified from a running race for running”. Now if the ground is wet, and let us remember that February is winter in the UK and it is known to rain, then this has been the case since 1445.

No doubt the council officials will cite legal concerns as the reason as well as concern for injury. And therein lies the problem. Firstly, no one is forced to run in this race and anyone who does will be aware of the ambient conditions. The fact that any legal system would allow a person who has chosen to run in a contest and falls over to “blame “ the council is ridiculous and is something that governments in a number of countries need to address.

The second issue is that health and safety has gone from being a good idea to nearly a cult with some in officialdom who see it as their role to save everyone from every possible form of hurt, no matter how slight. Yet it is not possible to protect people from themselves and worse still, attempting to do so robs those people of the opportunity to learn how to manage risk themselves.

Closer to my home, a former mayor of Cottesloe bemoaned that all the fun had been taken out of playgrounds which needed to be risk free and hence provided no challenge to children. The po-faced reply from the town CEO was that playgrounds needed to conform to Australian standards. How are children to develop motor skills without some form of challenge? This again is all about legal issues and nothing to do with what is best for children.

Like all things in life there is a happy point in the middle. It is not about leaving babies unattended by fires in the hope that they will learn that fires burn you. It is also not about stopping adults from making a choice to move along a road on foot at a speed, which they feel they can manage.

The notion that adults can be protected from all risk is not only wrong but also not achievable. The notion that children can be protected from falling is also wrong and not achievable. Worse than that it is counterproductive. Governments complain about childhood obesity in one breath and make outdoor activity boring for children in the next.

What is the answer? With children it is about teaching them to manage risk in exactly the same way as they learn to walk. Falling at times will be part of this. In adults it is about taking back responsibility for our behaviors. If I fall over while running then that is not the fault of the person or entity that owns the piece of ground, it is mine.

Those of us who feel that the state has gone too far in seeking to control all aspects of life need our voices to be heard.

ADHD Drugs- Children Do Worse at School When on ADHD Drugs

2010-02-19T00:38:00.000-08:00

Every once in a while a study emerges that fundamentally changes a particular aspect of medicine. A long term study which shows that the assumptions underpinning a particular course of treatment, are shown to be wrong. One example was the Women’s Health Initiative in 2002 that changed our view on hormone replacement therapy for women. It had been assumed for close to 20 years that the benefits outweighed the risks. Then a long-term study showed the exact opposite and almost overnight the routine recommendation to menopausal women to take HRT was changed. Today it is only used where the benefit to the individual can be assessed as outweighing the risks.

This week the same fundamental overthrowing of assumptions has happened with Attention deficit Hyperactivity Disorder (ADHD). For the last 25 years we have seen a significant increase in the number of children diagnosed with this condition and an exponential increase in the use of drugs to treat it. These “stimulant” drugs such as Ritalin and Dex-amphetamine are amphetamine derivatives and are potent. They have been known to have significant side effects particularly affecting the heart and cardiovascular system. Their use has generally been defended on the basis that the benefits outweighed the risks.

One of the main perceived benefits has been improved academic performance. Paradoxically, the use of stimulant medication seems to tranquilize to some degree children with ADHD making them more docile and more attentive in class settings. In turn it has been assumed that children treated with the drugs would do better in school than those that were not medicated.

The study released this week from the well-respected Raine Foundation is the worlds first long term research into drug use in ADHD. The children were followed for nine years. The results showed that not only did the medicated group not do better than the non-medicated group; they did worse by a factor of ten fold! Children who had been medicated had a ten fold higher rate of being identified by teachers as performing below average for age then those who had never been medicated.

The other justification for medication has been improved behavior in the child. The study showed no significant improvement in the medicated children. Their behavior was no “worse” but not better. There was a slightly increase likelihood of depression in the medicated group.

So essentially the two reasons that have been used to promote the use of stimulant medication in children have been shown to be fundamentally wrong. The strength of this study is that is long term (9 years) .It is often easy to show benefits from medication in the short term for a variety of reasons including the placebo effect. Long term is where the truth comes out

Furthermore, the children who had been medicated had a significantly higher diastolic blood pressure, which was not a short-term effect. The drugs are known to elevate blood pressure whilst in the body but it was thought that this wore off. This study showed that medicated children had ongoing higher blood pressure even after the medication was ceased. This potentially increases their risk of hypertension and heart disease in adult life.

So what does this mean for parents whose children are on these medications? The short answer is that one should be looking at getting them off. This needs to be done in consultation with your doctor. Importantly each case is different and there will be some cases where for various reasons the benefits are judged to outweigh the substantial risks. However we will expect to see a drastic reduction in the use of these potent drugs in our children.

In an upcoming piece I will outline other ways to manage and deal with behavioral issues in children.

Alcohol and Drinking Age-The Answer is to Set The Right Example

2010-02-15T21:54:00.000-08:00

Alcohol is in the news fairly regularly. It is both the most widely used and most problematic of all the substances that we use. The thing about alcohol that sets it apart is that there is not only a safe level, but also arguably there is a level of consumption with health benefits. Modest consumption of red wine is good for the heart. Used correctly it is a social lubricant and a pleasure to enjoy. However, the problems caused by misuse of alcohol dwarf that of tobacco and all illicit drugs combined.

The problems caused by misuse and overuse of alcohol affect not only the individual through diseases including liver failure, dementia and some cancers but also others. This includes family and friends who may be subjected to violence or abuse. It also can affect total strangers if people drive under the influence of alcohol or are involved in violence in say hotels or nightclubs. Ultimately many deaths are directly attributable to the misuse of alcohol.

Now here is the thing. Alcohol itself is “inert”. In other words it is not the alcohol that is the problem. It is how people choose to use it. To use an example a knife is inert. It can be used to cut your food or it can be used to stab a person. The knife is the same. What is different is how it is used. In the same way that I have previously written about smoking as a choice, so too is alcohol use. The notion of the helpless addict is not correct and worse than that this thinking reinforces the idea that people are not able to change their behavior.

The latest call in Australia is to lift the drinking age to 21 from the current 18. There is a fundamental flaw in this thinking, which is that young people will not drink alcohol if they are under age. They already do. Lifting the legal age will not change this. Worse still it just criminalizes behavior clogging up police resources, and courts, which have better things to do.

What is needed is to teach young people about the proper use of alcohol. In this regard European cultures like the French and Italians do much better than Anglo Saxon cultures. Alcohol is seen as part of social occasions and the young are introduced to small quantities. They observe their elders enjoying a social use of wine, mainly, with meals. The way children learn most is through copying adults. This can be for better or worse.

Simply banning use has not and never has worked. Prohibition in the 1920s did not result in people not drinking. It resulted in profits for criminals. Telling people aged 18 that they can fight in wars and can vote but can not drink alcohol is ridiculous. More to the point it will not solve the issue of problem drinking as those who want to drink will do so anyway. It also assumes that it is just young people who misuse alcohol-and it is not.

We teach our children many things including how to use knives responsibly. We do not ban them from using knives till a legally set age. We let them ease into use at the age appropriate for the child. We guide them carefully until they can manage by themselves If we want to reduce alcohol miss-use in our young people we need to teach them responsible use via the same principle as we teach them to use knives.

This in reality means setting a good example.

Do as I say, not as I do, will not cut it.

Childhood Obesity - Small Changes Make a Big Difference

2010-02-12T02:40:00.000-08:00

Childhood obesity has been put front and centre with Michelle Obama. An ambitious goal to eliminate childhood obesity in a generation has been made. There is an old quote attributed to Michelangelo that it is better to aim too high and miss than to aim too low and hit.

There is no particular reason why this goal cannot be achieved. The “Let’s Move” campaign actually is focusing on a range of initiatives. It is getting government agencies coordinated and working in collaboration with business and the media. Sports stars have volunteered to help spread the message.

Success will of course come down to individuals and families making changes and accepting responsibility for what they do. However it has been shown that simple things like repainting crosswalks helps encourage children to walk to school hence providing some exercise. Giving parents useful information about foods and dispelling myths about junk food being cheaper will also help. The support of three major suppliers of school lunches to reduce fat and sugar in their products will help too. A positive approach rather than the usual handwringing will make it far more likely that there will be success.

Health habits start in the home. A new study has demonstrated that little things make a big difference. A study of over 8000 preschool age children showed a 40% lower rate of obesity in families where three simple things were done,

1) The families ate dinner together at least five times a week
2) The children got at least 10.5 hours sleep each night
3) The children watched less than two hours television each day

These three things combined almost halved the rate of obesity. None are difficult and none are expensive. We also know that getting it right in preschool age sets the basis for the school years so this is actually the best time to act.

Meanwhile at the other end of the spectrum a study was released supporting gastric band surgery for teenagers. The study compared weight loss in 25 teenagers on a weight loss regime compared to 25 who had surgery after two years. The faults with this study are numerous including the small numbers and the short length of time. Seven of the teenagers required further surgery. The biggest issue is that a company, which makes the bands, funded the study and worse still two of the authors are on company advisory boards so are not independent.

It is already emerging that there will be long-term complications from gastric banding surgery including kidney stones and brittle bones. Interfering with the bodies absorption of food has major ramifications, most of which have not been thought about because they do not happen straight away. With teenagers who are still developing, the long-term issues are completely unknown.

The best quote on this came from AMA Vice President Steve Hambleton who said, “We should not be outsourcing self control to a surgical procedure. It means we are not doing anything about the problem, just treating the symptoms.”

I could not have put it better. Nobody is born obese. It comes from actions taken after birth. Hence the individual can change those actions. Support such as that outlined by the First Lady will assist.

Putting the right fuels into your body in the right amounts is a key part of Do It Yourself Health. It is within the power of everyone to do this.

Health is Your Responsibility

2010-02-09T06:14:00.000-08:00

Children are taught from a fairly young age about the need to take responsibility for their actions. The classic tale is of Billy and Johnny standing next to a window, which has, had a brick thrown through it. An adult finding this asks who did this? To which Billy replies “ I did but only because Johnny told me to”.

Whilst Johnny may well get reprimanded for telling Billy to throw a brick through a window, Billy will be punished and told very clearly “just because Johnny tells you to do something doesn’t mean you have to do it. If Johnny told you to jump off a cliff would you do it?” The answer to this is of course no.

So the child learns that despite being egged on by peers, he needs to decide his own actions and not seek to blame others for his actions. Parents and teachers are charged with the job of teaching children about taking responsibility for their actions so that they can grow up to be responsible citizens.

It is therefore somewhat bizarre to see how often adults do not only use a variation of the excuse above but that adults are actually encouraged to use this excuse. I am of course referring to advertising. Who encourages adults to use the Jonny told me excuse- public health advocates.

The recent Health Reform Taskforce in Australia again raised the issue of ”banning” junk food advertising. This has been mooted before and is leapt on with glee by public health advocates who argue that it is an essential part of the battle against obesity.

Now wait a minute. How exactly does an ad make you obese? Apparently people are influenced by the ads and then go out and buy (and consume) foods, which are not good for them. Apparently if the ads were not there people wouldn’t do this.

Translated this is health officials telling the adult population that they are absolved from the responsibility of what they out in their mouths by being able to say “the ad told me to”. What must the average five year old who has just been sent to their bedroom for misbehavior make of this?

The other line run is that advertising in children's viewing time should be banned as children pressure their parents into buying the foods advertised. Hello!! This is little Jonny in reverse. It is now assumed that parents are so inept that they can’t decide what grocery items to buy. Being a parent means making decisions-some of which children may not like.

The bottom line is that the only person responsible for your actions is you. This is actually very empowering because if there is an aspect of your life that you are not happy with, you have the absolute power to change it.

It starts with you being responsible for what you do.

Expensive Pills are not the Answer

2010-02-05T02:10:00.000-08:00

Whilst the health agenda in the USA has captured most of the headlines, the same issues are confronting other countries too. The central issue remains how to pay for the services, which are expected to be needed by an ageing population with a shrinking taxpayer base.

In Australia a tax review has just been completed and the third inter generational report was handed down. This looks at projections for the next generation.

One of the snippets from the tax review caught my eye. It claimed that the cost per head of pharmaceuticals in Australia had trebled in twenty years from around $200 per head to over $600 whilst in the preceding twenty years it had remained stable. This was put down to the development of “blockbuster “drugs.

The cost of drugs in Australia is much less than in the USA due to a system called the Pharmaceutical Benefits Scheme, which in simplest terms makes the government the “sole “ buyer of drugs that are listed on the scheme. So where is most of the money going?

By far the biggest spend is on cholesterol lowering drugs (statins) which accounted for AUD $1billion in 2008/09. Other biggies were reflux drugs and blood thinners at around AUD $200 million each and a common antidepressant at AUD $100 million.

The next question is what are we getting for our money? Life expectancies have continued to gradually increase over the last century by about one quarter of a year per year. This rate has not accelerated over the last twenty years. Rates of heart disease and reflux have not plummeted.

Given the amount expended on pharmaceuticals you would think that questions about benefits would be asked. By this I do not mean clinical trials, which shows that the drug “works”, I mean questions about benefits to society in terms of longevity or better levels of health. There seems to be silence on that front.

It actually gets worse. An Australian review showed that average cholesterol levels in the population had fallen 0.2 units in twenty years. This is despite a trebling in the use of statin medications since 1997 at significant cost, to “lower “cholesterol.

In the whole “healthcare” reform agenda there are always arguments about how we are going to afford the cost of disease. There are never any questions asked about ways to reduce spending on disease by people being…healthier. When one looks at the “conditions” treated by the most expensive drugs they are mainly lifestyle conditions and the cleverly coined term “risk factors”.

In other words we are treating with expensive tablets that which we have brought about through our habits be they dietary, exercise or other. Logically then, if it was not a pill that caused the problem, why is a pill the answer?

What is needed is a change in the way we look at health care. Our current systems are disease systems. The cost comes from treating disease. There is little or no support for or investment in people being healthy. A genuine health system would be looking to keep people healthy rather than pick up the pieces after they have become sick.

As individuals we need to be responsible too. Around three quarters of spending on disease is for diseases that come about not through random action but by our daily actions. We need to be responsible for our own health. Eating the right foods, being active, drinking water, managing our stress and getting enough sleep are not expensive and not difficult.

Given that “lifestyle” diseases are the major “cost” to the disease system, the solution lies not in more expenditure on treatment but in real prevention.

The best way not to be sick is to be healthy.

Smoking is a Choice not an Avatar

2010-02-02T06:03:00.000-08:00

Here is something obvious-smoking is not good for you. This has been known for probably the best part of 50 years. No one in western societies who has started smoking since the mid 1970s can claim that they were not aware of this. Advertising has been virtually abolished and the packs carry warnings and sometimes pictures of diseases related to smoking such as lung cancer.

Rates of smoking have declined significantly from over 70% of adults in the 1950s to 20% or less today. Australian figures for teenagers show rates of around 5% which augers well for the future.

However despite all the information available about the problems associated with smoking some people continue to choose to smoke. Now I would encourage all of those people to quit, but some will choose not to-and that is their right. This fact though is unable to be accepted by those in public health who feel that everyone should act only in a way that is good for them and bring an almost religious zeal to their application of science.

This has led to increasingly bizarre claims, the latest of which involves the movie Avatar. One of the characters in the movie smokes. This has seen calls for the movie to have warnings about this or even a higher rating and accusations that the movie is pro smoking.

Really?? Now lets compare Avatar to another recent movie, It’s Complicated. In this there is a scene where two of the lead characters get drunk and another where two lead characters get stoned on a marijuana joint. Does this make the movie pro drunkenness or pro illicit drug use? Of course not. The film has the same classification as Avatar in Australia (although different in the USA). Was the movie Inglorious Basterds pro Nazi because some of the characters in the movie were Nazis?

Of course not and the fact that one character in a movie smokes does not make a movie pro smoking. Interestingly there has been no reaction from the holier than thou brigade to the scenes in It’s Complicated. If seeing one movie will lead to a flood of new smokers why will another not lead to the same outcome with alcohol and marijuana? Are not all three health issues?

Here is the bottom line. Cigarette smoking is a choice some people make. It is not a disease. The medicalizing of smoking with stop smoking pills together with labeling people as addicts dis-empowers them from taking charge of their health.

The choices we make are our responsibility.Blaming a movie for them is saying that we are absolved of the responsibility for our decisions because we have watched a movie.

The only person responsible for your choices is you.You have the power to make the best choices for you and in turn you will reap the benefits.

Swine Flu - Learnings From the Non Event of 2009 Swine Flu

2010-01-28T21:57:00.000-08:00

There is an old adage that those who fail to learn the lessons of history are doomed to repeat them. Whilst H1N1, also known as swine flu, is so 2009, there are lessons to be learned from it.

How did the story unfold? A “new” strain of flu emerged in late April. Other than that it came from Mexico (originally) and was associated with pig flu, there is nothing notable about another strain of what is a very common virus. Yet the “authorities” went into hyper drive. Predictions of thousands of death and millions of people being infected were made.

The chief Medical Officer in the UK suggested that there could be 65 000 deaths. Comparisons were made with the “pandemic” of 1918. Similar dire warnings were made in other countries. In Australia children with a runny nose were placed in quarantine and whole schools closed.

The WHO got into the act with its own dire predictions. Pandemic 6 was quickly reached. This sounds scary but means only that the virus has infected people in two WHO regions. All that takes is for a person with the virus in the USA to go to Europe and someone get it there –seriously scary. To combat this dire threat, governments around the world ordered mass doses of vaccine.

As the months went by the reality diverged further and further from the fear campaign. Deaths were not only way lower than predicted but lower than occurs with seasonal flu. The virus was milder than many other flu strains. There were no mass graves. Economic activity continued as normal.

Despite overwhelming evidence that they got it wrong (same as they did with SARS, Avian Flu, Mad Cow Disease and many others) the authorities have clung to their story.

In December we had USA officials urging everyone to get a vaccine in case of a second wave. It is hard to have a second wave when there was not a first one.
In Australia a similar line has been run although advertisements (paid for by the government) urging everyone to have a vaccine have disappeared.
Australia ordered 20 million vaccines. At least 75% of these will never be used. Many governments have now (quietly) slashed their orders. Glaxo (a vaccine maker) reported sales to governments of $US 1.36 billion in the December quarter. Meanwhile most countries claim their “health “budgets are struggling.

On the positive side, The Council Of Europe is investigating what Wolfgang Wodarg (head of health at the council” called “one of the greatest medical scandals of the century”. In the USA a report has shown that 64% of advisers to the CDC on vaccines had potential conflicts of interest (ties to vaccine makers).

Through all this, not once has there been any “official” advice to the public about things that you can do for your immune system. Simple things like drinking adequate water, doing regular exercise, getting enough sleep, having adequate levels of zinc vitamin and antioxidants (to name a few), eating fruits and vegetables and managing stress.

Of course not, that would be too simple and mean that you have looked after your own health rather than rely on government to “save” you from the latest crisis they have conjured up.

I do not expect the authorities to learn their lesson. They have a vested interest, either financial or perceived importance, in dreaming up health scares.
For those of you who are into do it yourself health there are simple lessons

1 Look after your immune system (see key points above)
2 Do not buy into hysteria and outlandish claims regardless of who makes them
3 Do not be “sold” a solution when there is a free one available
4 Be questioning of information from health authorities.
5 The best way not to be sick (from any cause) is to be healthy
6 Be responsible for your health and have your own DIY Health Plan

Watch out for the next health scare. It will emerge and will follow the same pattern as all the previous ones. Next time step back, do not get caught up and have a quiet chuckle.

Relaunch - Commentary on Health Issues

2010-01-28T05:49:00.000-08:00

With the advent of a new year and the blog coming up for its first birthday in February, it is time to relaunch the blog page. When I started this last year there was no website so this was the vehicle for all articles. With the launch of the website at www.drjoe.net.au last September there has been duplication between postings in the site and on this blog.

Starting this week, the blog will be where I comment on health topics and give my opinions on matters to do with health and other issues that affect our lives. The website will be home to health information and tips on how to be DIY Healthy. Given the nature of health topics,at times there will still be some overlap.

This will make the blog more of a true blog in some respects. I would like to thank all of my readers and hope that you will contribute comments and ideas on postings here.

Australia Day

2010-01-25T20:00:00.000-08:00

Today is Australia Day. January 26 1788 is when the first fleet arrived in Sydney Cove to establish a British colony in Australia. For the first century and a bit Australia was a collection of separate colonies and in 1901 the colonies came together to form a federation.

Like many countries some of the behavior of early settlers was with hindsight not all that it could have been. Equally it is easy to be judgmental with the benefit of modern life and the knowledge we have today that was not available to our ancestors of over two centuries ago.

It is interesting that during the last 25 years Australia Day is being recognized and celebrated more. It is now celebrated on January 26 rather than on the nearest Monday. The flag is much more visible and ,dare I say, respected than in years gone by.

Australia today has become very diverse and cosmopolitan. Migrants have come to Australia from right around the world seeking a new life in “the lucky country”. With the exception of the actions of a few individuals, Australia remains a tolerant place where diversity is respected and people from any background are welcomed.

Australia Day then is less about remembering the landing of a boat 222 years ago but more about celebrating a country which today enjoys a high standard of living, where opportunities exist for all who want to succeed, where the climate is pretty good all year round, where people do not take themselves too seriously and where a people live in peace and by any global scale, prosperity.

Equally,remembering and learning from history is important as is recognizing the efforts,struggles and sacrifices of those who came before.

I am certainly proud to be Australian. Happy Australia Day to all.

Depression-Alternatives to Antidepressants in Managing and Avoiding Depression

2010-01-20T07:33:00.000-08:00

Once again a large question mark has been thrown over antidepressants. A major analysis of previous studies shows that the effect of Selective serotonin reuptake inhibitors (SSRI’s) is no more than placebo (a non active sugar tablet) in mid and moderate depression. It is only in severe depression where the drugs do more than placebo.

This backs up a previous large analysis in 2008, which showed the same result. These analyses have looked at both published studies and also unpublished data submitted to the FDA. Their have also at times been allegations that studies, which showed little benefit from the medications, were at best not published and at worst suppressed.

What is interesting is that, of course most people who take antidepressants feel better, but in mild and moderate depression, it is the taking of the tablet rather than the tablet itself, which has the effect.

The rates of diagnosis of depression have increased considerably over the last two decades. Between 1995 and 2005 the number of Americans prescribed an antidepressant doubled and those being treated took more tablets. Some say this comes from better recognition of the problem. Others feel that it reflects a medicalizing of normal human emotion. However there is no data at all to show that the population is better off for taking all these pills. Around US$1billion is spent on promoting SSRI”s each year with the proportion devoted to direct consumer advertising quadrupling between 1999 and 2005.

The de-stigmatizing of mental health has been a good thing. Mental health issues are no less real than any other. However, it has also led people to feel that having a bad hair day is somehow the same as having depression. I am staggered by the number of people who feel that because they are facing challenges in their life, they feel like they have got “a bit of depression”.

So what are some simple things that can we do to reduce the likelihood of feeling depressed and improve our mood if we are low?

1 Exercise. Regular exercise can reduce depression by around one third. Even regular housework (20 minutes per week) has reduced depression by 20%.

2 Eat real food. Higher rates of depression are found in people who eat lots of processed food whereas those who eat “whole” foods (fruits, vegetables, fish, nuts etc) had lower rates.

3 Get enough Vitamin D. This can be from a bit of sunshine eating oily fish (e.g. salmon or tuna) or supplements.

4 Drink Green tea.

5 Manage your stress. For example take a walk in the park or listen to music. Meditation or yoga is also good.

For those seeking a natural option instead of tablets, the herb St Johns Wort has been consistently shown to be as effective as drugs and has minimal if any side effects.

When “bad” things happen it is as normal to feel down, as it is to feel happy when “good” things happen. To feel down after a relationship breakdown or job loss is no more abnormal than to feel happy after winning a lottery. There is a range of human emotion and feeling-all of which are valid.

Life has its ups and downs. Often when you are feeling down there is some lesson in life to learn. It is from the hardest times that comes the greatest growth. Some people may need an antidepressant for severe depression. For most of the rest the answer will lie in resolving the issue(s) that trouble you rather than in a pill.

Benefits to You of Regular Exercise

2010-01-13T20:10:00.000-08:00

One of the simplest ways to stay healthier for longer is to be regularly active. In some respects it is amazing that we need to be reminded of this. Up until fairly recent times being active was not optional-it was necessary for survival.

Our ancestors would only be able to eat if they caught or gathered food, both of which require exertion. Even after the advent of commercial agriculture most forms of work were physical. On top of that to get from A to B required physical effort.

If we examine our daily routine, it is remarkable how much the requirement for physical activity has been removed. Simple domestic tasks like washing the clothes the dishes have been automated. Even one generation ago you needed to get up out of the chair to change TV channels and get out of your car to open the garage door. You can even get pre chopped up vegetables!

It has been estimated that the amount of calories “not used” up in a year due to labor saving devices could be as much as 2kg of weight. By the end of 10 years that’s 20kg by eating exactly the same as you might have done 30 years ago!

Two common questions about exercise are, is it too late to start and when will I find the time. Great news then on both these fronts. A recent Israeli study showed that life expectancy in 85 year olds increased when they were active for 4 hours per week. There was a benefit even if they had not been active before this. In addition they reported feeling less down and had greater confidence in tackling everyday tasks.

At the other end of the spectrum a Norwegian study showed that women who exercised regularly in pregnancy avoided having babies with excessive birth weight, which is a plus for mother and baby. Not surprisingly there are plenty of studies around showing benefit to people at all ages.

So you are never too old or too young to start.

Lack of time is the number one excuse given for not exercising. A recent survey across many countries showed that the average time spent each day watching TV was at least 3 hours. That is 21 hours per week or nearly one whole day out of every week!!

For a reasonable exercise program you need 30 minutes 4 times a week or a minimum of 2 hours. A bit more is better but 2 hours per week is a start. This is 10% of average TV time. Put simply there is time there if you choose to look for it.

And herein lies the key. Exercise will happen and you will get the benefits when you choose to do it. This is really simple. There is no need for government programs, no need to wait till tomorrow and no need to spend a single cent. You can start walking today. If you haven’t done much for a while start at a low level. Just go around the block. After a week or two go around a bigger block. Gradually expand the distance. Increase your pace if you want to.

If you don’t like walking you can swim or bike ride, if you want to invest some money join a gym or get a personal trainer.Get involved in The Weekly Fitness Challenge. There are many choices. Please add your ideas below.

The single most important choice is choosing to be active regularly.

Be a better you in 2010

2010-01-07T01:57:00.000-08:00

Can you believe its already 2010. “Happy New Year to you”. One of the customs of the New Year is to do new years resolutions. Many people will have resolutions to do with their health. Unfortunately some of these will be the same as last years and maybe some years before that too. The problem being that by middle to late January great intentions fade and we revert to usual patterns.

The two commonest new years resolutions we make are to lose a few pounds (or kilos) and to get fitter. The problems arise in two ways. Firstly, our beliefs. What we believe is a function of our collective past experiences. This includes both the results of our previous actions but also our observations of what other people have done. If we have tried to get fit in the past and haven’t then our belief system will tell us it can’t be done. The same applies to changing eating patterns.

So lets say we start out with some ideas about exercise and healthy eating. If we believe that our ideas can be brought to reality, we will set about doing them. If we believe they are not possible, then it is likely that the idea will go no further. There is a third option which sometimes is the default one where people set out to do something but deep down don’t really believe they will succeed.

Many people fall into the third category as described above where they set out on an exercise program or to improve their diet, and despite good intentions deep down, they don’t actually believe that they will succeed. This is usually based on past experiences.

Yet if you look around, people have done it and there are countless stories of success. This means it can be done. In turn this means that for you to succeed the first step will be a change in your beliefs and mindset. As Henry Ford said, “whether we believe we can or we can’t, we are likely to be right”. This is therefore a choice you make as to what you choose to believe.

Secondly there is a lack of a plan. The resolution to “get fit” or “eat better” is noble but vague. A plan to work out for 30 minutes, 4 times a week with the time and place written in your diary is specific, measurable and much more likely to be acted on. Likewise a plan which says I will eat two extra serves of fruit and vegetables and stop eating potato chips is specific and measurable. So is I will drink water instead of soda.

The twin problems of beliefs and lack of a plan can be overcome. You may need to work at them, as it may be a new experience. That’s fine. Nothing that is worthwhile comes without effort. Equally it is effort (note not struggle!) that brings rewards.

The third component is knowledge. There is no shortage of how to books out there yet as has been said if all we needed was how to books everyone would be rich and of ideal weight. What you need is a guide to better health complete with tips, simple ideas and knowledge that is easy to understand and easy to apply.

Believe that you can, have a DIY Health action plan that you follow and start 2010 with a gift to your self of the best guide to health- Dr Joes DIY Health. ( available at http://www.drjoe.net.au )

Please add your comments and thoughts below.

Changing your mindset is the first step to being a better you.

Dr Joes DIY Health Guide to Christmas

2009-12-21T05:45:00.000-08:00

At live presentations this month I have been asking the audience “Who is looking forward to Christmas”? A number of hands go up. The next question is Who is looking forward to Christmas being…over? A second set of hands goes up.

If I asked a group of year one school children the same questions all hands would go up the first time. The reason that some of us look forward to Christmas being over is of course stress.

It is a slightly sad reflection on society that so many people see Christmas as a stressful time. Yet as I have said before “stress is not about events themselves but what we make of them”

At one level Christmas is a day of the year like any other. At another it is a day of celebration of the birth of Jesus Christ. At a third level it is a secular celebration with gifts and get togethers. Finally there is the “festive season” which can start in mid November involving a series of events at which one may eat and drink.

The biggest stress issues around Christmas are weight gain from overindulging, bank balance loss from overspending and anxiety from interacting with those who you would prefer not too.

So this year rather than Survive Christmas why not enjoy Christmas. There is much that can be done to make sure you enjoy Christmas based on the 8 Pillars of DIY health.

1 Each day spend 30 seconds to take 3 slow deep breaths do this at least 4 times a day. This will reduce stress.
2 Drink water. Before you go to a function have a glass or two of water. Keep yourself hydrated. If at a party alternate water with alcoholic drinks.
3 Finger food is notoriously high in calories. Eat a carrot or other piece of vegetable before you go out. This way you will not be as hungry and hence you will eat less.
4 Keep active. Do some walking or other exercise everyday (or at least 3 times a week).
5 Don’t be the last to leave. You need your sleep.
6 Realize you have choices about whom you see and what you buy. Your stress levels will be a function of your choices not the “world out there”. Be honest with yourself and others about what you can and can’t reasonably do.
7 Buy your Christmas presents with cash. That way you know you can afford them and you won’t stress about the credit card bill in January
Only buy gifts for people you really want to give one to.
8 Christmas is a time for goodwill to all but if you really don’t like spending
time with certain people (even if they are your family) then it may still be better not to. Be polite but firm in declining invitations. Make sure you spend time with those you really care about If there is “no way out” then say to yourself “this too will pass” as often as needed. It will pass and by adopting this approach you will not stress.
9 Christmas day lunch is a meal. If you are having people around you don’t need more food than if they were coming any other day. If it’s a big gathering have everyone contribute a plate. You don’t have to eat till you feel like you will “explode”.
10 For some the preferred option is to “cancel” Christmas and just go to ground and emerge again on December 27.
11 Have fun. Children enjoy Christmas. There is no reason adults can’t do the same. Allow yourself to be a child again. Pop crackers enjoy unwrapping presents and playing with the wrapping paper.
12 Consider having some “purpose” around Christmas. Maybe do some volunteer work? Perhaps reflect on what you can do to be a better person or how you can contribute to your community.

For virtually everyone there was a tie when Christmas meant fun. Somewhere along the line this has been lost for some of us. This year ask yourself what needs to happen for me to enjoy Christmas as much as when I was six years old? Then go and have fun.

Cholesterol- a different view

2009-12-16T07:07:00.000-08:00

Here is something that you may not know. Cholesterol is found in every cell in the human body, all 60 trillion of them, as it is part of the cell membrane. It is also the base component for a number of hormones. Some of these hormones are involved in regulation of fluids and salt within the body. Others are involved with energy pathways and glucose metabolism whilst the third group are the sex hormones (estrogen, progesterone and testosterone).

So how did a molecule, which is actually essential for life, become public enemy number one? Good question. It basically goes back to the 1970s and various studies which looked at factors contributing to coronary artery (heart) disease. To cut a long story short, the idea took hold that cholesterol is bad therefore the levels in the bloodstream needed to be reduced. This was later modified to allow for lowering “bad” cholesterol (LDL) but not “good” or HDL cholesterol.

It wasn’t till the late 1980s when the first statin drugs appeared that the big push to lower cholesterol really took off. This of course was encouraged by the pharmaceutical industry, which makes billions of dollars from the sales of statin drugs.

However circulating cholesterol has never and will never be the problem. The problem is plaque (which may include cholesterol) building up on the artery (blood vessel) wall. This is why some people with high levels of cholesterol never have heart problems (including some French and Italian populations with very high levels) and as many as 40% of those with heart disease have none of the “official” risk factors including raised cholesterol.

The real cause of vascular disease (including heart disease) is slow inflammation. In this setting cholesterol may contribute to plaque on the vessel walls, which narrows the bloods vessel restricting (or stopping) blood flow but is not the primary cause.

Recent studies have now shown that lowering cholesterol does not equate to lowering heart disease. Two drugs were compared. What was shown was that whilst one group of people had their cholesterol lowered more than the other there was no difference in rates of heart disease.

Lets get back to our original question about cholesterol as public enemy number one. In the 1970s it was observed that LDL (bad) cholesterol was raised by saturated fat. It was (and still is) assumed that saturated fat is bad because it raises LDL and in turn LDL is bad because it is raised by saturated fat. This is a circular rather than cause and effect argument.

Hence it became case closed that cholesterol was bad and anything, which raised it, was bad and hence lowering it was good. A bit like in George Orwell’s animal farm “for legs good two legs bad”.
Now what is interesting is that statins seem to be associated with lower rates of heart disease. However these new trials, which used non-statin medications, might be suggesting that the primary benefit of statins may not be lowering cholesterol but some other effect.

There are many scientific studies, which raise questions over the widespread use of statin medications. This is from the perspective of side effects and costs but mainly questioning the assumed benefits. Not surprisingly the manufacturers fund most of the studies supporting statins. Like many pharmaceuticals, there is a role but not as big a one as they end up with.

So what is the bottom line here? Essentially cholesterol has been made into an ogre, which it is not. In the process billions of dollars worth of drugs have been sold for far less benefit to many of those taking them than the pharmaceutical companies would have you believe.

For the individual interested in their own health the solution as usual is simple. Eat mainly food which till recently was growing or moving around. Make water your main beverage. Minimize processed and packaged foods.

This together with the other 7 pillars is your best way of staying healthy and in turn not getting sick.

Medical Screening- More Not Allways Better

2009-12-09T06:35:00.000-08:00

There is a great line in the movie Men in Black when Agent K (Tommy Lee Jones) is telling soon to be agent J (Will Smith) about aliens on the planet which until then J had no knowledge of. It goes like this - “ 1500 year ago people knew that the earth was the centre of the universe, 500 years ago people knew the earth was flat, yesterday you knew there were no aliens on earth what will you know tomorrow?”

Now I am not entering into a discussion about aliens but the real point is that our knowledge changes. This mainly happens through trial and error and also through creative genius. The medicine man in the seventeenth century applying leeches didn’t think he was doing the wrong thing. He was going with the knowledge of the day.

Today science is able to make greater progress than in centuries gone by. However it remains an extension of trial and error. The simple reason for that is that science is an extension of our senses and capacity to interpret what we find. Before the invention of microscopes we couldn’t see bacteria-it didn’t mean they weren’t there. Before the electron microscope we couldn’t see our genes (DNA) –again it didn’t mean it wasn’t there.

Science then is limited by the five senses and an assortment of aids such as microscopes. More importantly scientific discovery is a reflection of our capacity to “understand and interpret” what we find. Ultimately what we “know” today may be found to be totally wrong tomorrow. This is how knowledge advances.

The recent furor over cancer screening fits into the above scenario. In the USA new guidelines for mammograms now recommend that it be done two yearly starting at age 50 rather than annually starting at 40(this now matches Australian guidelines) .The new guidelines comes from looking at the actual results of the screening program. New guidelines are also being considered for cervical cancer screening. Prostate cancer screening remains highly controversial as to what is best.

It is easy to paint all cancer screening as “saving lives” and dismiss the problems. However screening can lead to unnecessary procedures (including surgery) and stress for people who have false positive results (results which show an abnormality but where the person has no disease). Also we are seeing that some very early “cancers” might not actually develop and some resolve themselves.

Now none of this is to say that screening is not helpful. It is to say that what we “knew” ten years ago may no longer be relevant. It is also important to note that the loudest arguments against change usually come from those who are doing the screening. They necessarily have a vested interest, which may be financial or reputational. The medical industrial complex has spawned industries around screening and follow up treatment.

Sadly this debate may get tied up in arguments about payments and “rationing”. More tests have been seen as being only positive. The reality is that indiscriminate testing has downside. Whilst it is easy for a person to say “my cancer was found and I don’t care how many other people had needless tests and stress to allow this”, that is only one side of the issue, albeit the only side that gets much airtime. Furthermore real questions can now be asked as to whether all these cancers would have progressed anyway. In other words it may not be the screening that “saved all the lives.”

As our knowledge grows and more importantly our capacity to understand what we “see” grows there will be changes in what is regarded as best medical practice. These should always “challenge “ current ideas and generate debate. Clinging to what has been done before when new knowledge supersedes it is the modern equivalent of insisting the earth is flat.

A weighty issue- time to think differently

2009-11-30T05:58:00.000-08:00

Here we go, another piece on weight-hasn’t it all been done to death? Well maybe its time to look at it a different way. I have written previously about the importance of putting the right fuels into your body and how this means you will feel better and probably eat less.

There is no question that carrying excess weight is not healthy for a number of reasons. The question is what constitutes overweight? This article (see link) looks at some of the politics of obesity. It describes the background to the Body Mass Index (BMI), which derives from work done in the 1940s by insurance actuaries and work on “normal “ weight from the 1830s. The arbitrary cutoffs came from the International Obesity Task Force. All this seems a bit out of date and perhaps of questionable relevance today.

What is so special about a BMI of 25 as against 27? Many sports people are classed as overweight because they are muscle bound. Arnold Schwarzenegger was “obese” when he won Mr. Olympia. Many football players would also be technically overweight. The BMI also does not include a differentiator for men and women.

A recent study has followed over 11,000 people for 12 years and found those who were technically overweight (BMI 25-29.9) had lower death rates than those with a “normal” BMI (18.5-24.9). Now I am always suspicious of studies but whenever there is one, which challenges conventional wisdom, I am more interested. Whilst research is presented as “scientific “, to publish findings, which are against the herd, mentality is difficult.

There has been a whole industry set up to deal with the obesity “epidemic”. This includes countless jobs for health officials to set up taskforces and attend meetings. The pharmaceutical industry has tried to get on board, although with limited success as some “weight loss” pills had to be taken off the market. More recently weight loss surgery has been a winner for surgeons.

To get a drug to market requires years of development including trials to establish that the drug works and that the side effect profile is acceptable. New surgical procedures are not subject to this. The long-term effects of weight loss surgery may be only just becoming visible. Two recent reports show
increased rates of fractures and kidney stones for people in the years after surgery.

It does not surprise me that when you interfere with the absorption of food that there will eventually be consequences. Belatedly a study is being done to see if there actually are long-term benefits from weight loss surgery.

The central question in all this is what constitutes overweight and obesity. We can probably all spot it when we see it but can we define it? More importantly can one measure be applied to all people in all circumstances – the answer to that one is no.

Like most things with the body there is a “right” level above and below which there are health issues. With weight there is a level, which will impact on your health. That level may not be a BMI of 25. The likelihood is that the “correct “ BMI for most people is somewhere between 20 and 30.The other likelihood is that there are much better markers for health issues than the BMI.

As I say in my book, Dr Joes DIY Health-Putting you in charge of your health, focus on eating food that until recently was moving around or growing somewhere, food that your ancestors from 100 years ago would recognize as food, food that if not eaten would have to be thrown out next week. Following these simple guidelines will make it far more likely that your weight will be in the zone that is right for you.

http://www.ipa.org.au/publications/1409/big-fat-beat-up

Swine flu-Chicken Little Rides Again

2009-11-21T23:17:00.000-08:00

In the story of Chicken Little, it was Chicken Little’s view that the sky was falling. She, of course became very fearful of this and was able to convince others that this was the case. All those who believed it became fearful too. There are two endings to this story, a happy one where Chicken Little and friends are saved and a tragic one where Foxy Loxy eats them all.

The moral of the story is don’t believe everything you hear. Chicken little jumps to a conclusion, whips up others into fear and hysteria, which plays right into the hands of the fox that uses the hysteria to his advantage.

Whipping up fear, which can be used to advantage is sadly seen in health matters. Some expert has a view that the sky is falling and countless deaths will occur. In most instances the people running the scare have a “solution” of sorts, which either involves them, making money or wielding influence/power.

In the book Scared to Death by Christopher Booker and Richard North health scares are brilliantly defined as having four components:
1 The source of danger must be universal so anyone can be affected.
2 The danger must not have appeared in the current form before (even though it may have appeared previously.)
3 Whilst the scientific basis of the scare must be plausible there must also be an element of uncertainty to allow for alarmist speculation.
4 Societies response must be disproportionate.

Ladies and gentlemen I give you swine flu, a classic health scare where alarmist speculation about a virus has led to a massive over reaction. A lot has been written and said about H1N1 virus over the past 7 months.

However this article from the New York Times (see link) perhaps best sum up the situation. We have two polarized groups. There are those who desperately want a vaccine, as they are fearful of the H1N1 virus and those who are fearful of the vaccine itself. In amongst this are conspiracy theories with a fair amount of disinformation and a thriving industry.

Of course there is also a silent majority who wonder what all the fuss is about.
Yes there have been deaths associated with the H1N1 virus. There are deaths every year associated with the flu. Yes some previously healthy people for unknown reasons will succumb to overwhelming illness. The vast majority either has a mild illness or no illness at all.

Through all this I am yet to hear anyone in officialdom suggest that a healthy immune system is the best way not to get ill. I am yet to hear about the ways to strengthen your immune system.

Advice like put the right foods into your body, a balanced diet with adequate fruit and vegetables as well as sources of essential fatty acids such as fish, olives (or olive oil), linseed or nuts. Advice like taking vitamin supplements, particularly antioxidants such as vitamins A, C and E, D. Folate and zinc which help the immune system.

Advice to get enough sleep, as this is the bodies recharge the battery time and drink 35ml/kilo of water each day. Advice to lower your stress. This will significantly help the immune system.

No, we get a diet of fear, which increases people’s stress, and a line that there is nothing you as an individual can do, only a vaccine can save you. In turn you are encouraged to look to the medical industrial complex and government to save you in your hour of need. This is not the way to go if you want to be in charge of your own health.

Here is the bottom line. The sky is not falling. The H1N1 virus is a mild strain at absolute worst and there is no need for mass panic or the mass over reaction we have been subjected to.

The best way not to get sick is to be healthy.

http://www.nytimes.com/2009/11/10/health/10klas.html?th&emc=th

Getting real about our children

2009-11-16T06:05:00.000-08:00

The adage about our children being our future remains true today. So that being the case what are we doing about the health of our children? Statistics suggest that 25% of Australian children are overweight or obese. Figures from the USA are comparable and many European countries like Greece Portugal and Spain are in the same boat.

The figures from Greece are the most interesting as they reveal one of the key reasons we have this problem. Between 1982 and 2002 there had been a trebling in the number of overweight Greek 12 year olds. During this time there had been a move away from the “traditional” Mediterranean diet and an embracing of processed high sugar foods. The traditional diet was based on vegetables fruit, unrefined grains olive oil for cooking with a bit of fish nuts poultry and eggs thrown in. There was not a lot of red meat consumed and virtually no refined sugars. This diet provides lots of nutrition and is not calorie dense.

Contrast this with a diet of hamburgers, soft drinks, biscuits and other processed foods which make up, a “typical” western diet. This is the exact opposite - calorie dense with not much nutrition. If you then add into the mix that many children are not physically active, spending hours in front of screens, we can see why children like adults are getting heavier.

There is much hand wringing going on about childhood obesity. There is no shortage of opinions on how to “manage the crisis”. As is usually the case, calls are made to ban advertising of “junk foods” and for government to provide “funding” for various programs. Of course this funding goes mainly to program providers, often the same people who are arguing for funding for such programs.

Then there are the ridiculous suggestions like banning children under two from watching TV. Not only is this pointless but how on earth would it be implemented? The most bizarre one recently was for lap banding surgery for children. Not only is this completely the wrong approach to take with children but no one has considered the long term effects on their growth if one interferes with food absorption.(It is emerging that long term issues with bones and kidneys may follow lap band surgery but this takes years to appear).

In amongst the nonsense, there is a shining light. A school in Queensland (Australia) has won an award for teaching children how to grow and cook fresh food. Angela Skerman,the teacher in charge of this was quoted as saying "There's a lot of benefit of getting children to go back to the basics and being able to grow their own food and see the relevance and importance of eating seasonal produce rather than things that have been held in a fridge for eight months “

In my view this sums it up. Rather than berate children and parents about all the wrong things they are supposedly doing or treat them like imbeciles who will do anything just because it was on an ad, teach useful skills and provide useful information. This is best done at a grass roots level.

The two key ways to help our children with their eating is to teach them the basics and the connections between nature, what we eat and our health. The other key is to lead by and set a good example.

A giraffe in a plane

2009-11-05T06:14:00.000-08:00

It is amazing how new learning’s come at the most unexpected times. Last Saturday I had a new lesson in relaxation, pillar 6 of DIY Health, at the local markets. Now Saturday can be fairly busy in our house.

There are two and sometimes three sports and most weeks it is the day for food shopping (unfortunately in Perth we are very restricted in when we can go shopping), as there is no time during the week.

Anyway we were due to start at 9am with basketball for my son. We arrived a bit before 9 and by the designated start time there were only three of our team and none of the other team and no referee.

This seemed odd. At five past I felt it was time to ask the question at the reception desk. Apparently the other team had forfeited at the last moment and the rest of our team who had arrived two minutes before us had been “headed off at the pass” and had gone off for a refreshment.

There are two choices one has in this situation. One is to get stressed, the other is to accept what is and move on to the next thing. We chose the latter.By late morning it was time for the weekly food run. We go to the local supermarket for non-perishables and to the local markets for fruit and veggies, bread and produce from the continental grocer. Now the markets are not flash (as my daughter reminds me) but the produce is good, fresh and actually cheaper than in the supermarkets.

Our last stop was to be the continental grocer as it was on the way back to the car. On the way we noticed the face painting for children was set up next to the grocer (it is usually at the other end) and you can guess what became the added stop.

Despite it being a busy lunchtime there were no takers for face painting. My daughter wanted a swan. One of the painters was trying to “sell” the idea of a painted giraffe in a plane. She had been practicing this but had no takers. “Dad “ she asked “would you like a small giraffe on a plane on your arm?” With a bit of encouragement I agreed.

On sitting down the painter said to me this is a good thing to relieve stress. This seemed an odd description of an adult having a picture painted on his arm. Then as I sat watching her paint, the penny dropped. I had been pretty much on the go all week and through Saturday. This was a chance to not only sit down but also watch an artist in action.

As the aviator giraffe formed on my forearm, I was relaxing as just watching her paint absorbed me and I stopped thinking about the other things that still needed to be done that day. It was also just “fun”. At what age did I become too old to have a fun painting on my arm? It was cute and colorful.

Watching a giraffe in a plane being painted on my arm had brought me into the present moment, allowed me to sit down and to be a kid for a while. I got up more relaxed than when I sat down. The opportunity to relax may present itself in unexpected ways. Be open to them and when they arise take the opportunity to do something that a serious adult would reject but a child would see as fun.

A Glass of Wine is OK

2009-10-28T06:57:00.000-07:00

One of the reasons that public health messages struggle to get through is that they are presented as very black and white, a bit like in George Orwell’s Animal Farm -“four legs good - two legs bad”. Yet with virtually all matters of health it is not that simple. There is usually a right amount. Too little or too much is a problem.

Even essentials like air and water come under this rule. If you breathe too quickly you get anxious and light headed. There is a “right” amount of air that the body needs. Too much water can be a problem as is too little.

Most public health messages are based on the tobacco principle. Tell people its bad and don’t allow any wriggle room. It is fair to say that tobacco is not healthy in any amount (although like with all poisons less is better than more). However with foods and alcohol the situation is not as clear-cut.

Now the problems associated with alcohol abuse and misuse, dwarf the combined problems from all illicit drugs. The problems include violence, road trauma, relationship breakdowns and of course numerous health problems from liver disease through to dementia. These are problems from excessive consumption of alcohol.

Yet consumed in smaller quantities these problems do not occur. Furthermore it is likely that the consumption of red wine is actually good for our hearts. This idea has been around for a while but has struggled to get much coverage as the public health people are terrified that if the public are told that a glass or two of wine is healthy that they will drink much more than that.

The really interesting thing is that those who drink harmful amounts of alcohol are not wondering about the health effects of their behavior, be it good or bad, and no one who doesn’t like wine will suddenly start drinking it for medicinal purposes.

So lets just stick to the facts. It has long been observed that the French have lower rates of heart disease despite eating diets higher in fats compared to Anglo-Saxon countries. Attempts to explain this have always come back to the consumption of red wine. This has been documented many times. There are a few mechanisms-the main one being Resveratrol. There are some “cardio protective” effects from this including an increase in HDL or good cholesterol.

Resveratrol is now marketed as a supplement and this likely has some benefits. However, it is also likely that the benefits from red wine are not just due to Resveratrol and that there are other bio-active compounds working in with it. Reducing nature to one working part will generally mean something is left out.

So what is the take home message in all this? A glass or two (1-2 for men 1 for women) of red wine a few days a week is not only not bad for you but probably good for you. Is this a reason to take up wine? —No. Is more better? —No it’s worse.

Can you enjoy a glass of wine with your meal and not feel guilty? –absolutely.

If it wasn't a pill that caused it...

2009-10-19T07:09:00.000-07:00

It is reported in The New York Times(see link) that 3 new diet drugs are lining up for regulatory approval. It is estimated that Americans spend $59 billion annually on a range of weight reduction measures from diet books to stomach surgery.Yet as the paper reports only a very small amount of this is spent on prescription drugs.

There are two main reasons for this. Number one is that they don’t work particularly well and secondly there is a track record of diet tablets being taken off the market due to safety concerns. The new drugs have shown some “positive” results over a one-year trial. This is not a long time though and the safety issues with previous drugs only became apparent after they were used by a much larger number of people.

Given the huge potential profits it is easy to see why the pharmaceutical industry may be keen to get involved (the drugs are owned by biotech firms looking for a pharma partner). This is despite sales of current weight loss pills being small and the safety/liability issues. There is also the FDA concern of them being used “recreationally” by people who are not overweight but say want to drop one clothes size.

Here is something to think about. If it wasn’t a pill, which made you put on weight why do you, need a pill to reverse the process. It is always interesting to hear when people say diets didn’t work. Diets have no moving parts .The only way it can “work” is if the individual sticks to it.

Now herein does lay the issue. Many “diets” are considerably removed from what people normally eat each day. Hence the change is too hard to sustain. Even when people stay the course for long enough to reduce weight, they then revert to the previous eating patterns, and not surprisingly this takes them right back to where they started.

Whilst this should not come as a surprise it usually does.

So is there a solution? Of course there is. It starts with taking personal responsibility. You must accept that it is your own actions, which have led you to this place, and that it is only your own actions that can take you to a different place.

The solution is to change your eating patterns. It is no use repeating the same thing and expecting a different result. You need to change the way you relate to food . For example, if you comfort eat then recognize this and deal with the underlying issue. If you have a sweet tooth (like I do) accept this and allow yourself some small treats rather than going without for so long that you end up binging.

Keep at the front of your mind this simple concept. The body stores energy it does not use up as fat. The only way to reduce weight is to use up more energy each day then you put in. This gives you two dials to adjust. Use more energy by being active and consume less energy(calories).

Do not go hungry. Choose foods, which provide nutrition without excess calories. In simplest terms this will be whole food. Food that till recently was moving around, or growing somewhere.

Cut down on processed and packaged foods. Drink mainly water. For sustainable change these must become what you do daily not just a “diet” for a few weeks.

It has been done, it can be done and you can do it if you so choose.

http://www.nytimes.com/2009/10/17/business/17obesity.html?_r=1&nl=todaysheadlines&emc=a6

Live Better for Longer

2009-10-09T01:46:00.000-07:00

Two interesting pieces recently on longevity caught my eye. It was reported in The Lancet (link 1) that life expectancy is continuing to increase and that a large number of babies born this century will live to be a century.

I was first shown statistics like this in 2003 at an anti aging conference in Singapore run by The American Academy of Anti-Aging Medicine (A4M). The statistics showed that life expectancy in the developed world has been steadily increasing at the rate of one quarter of year per year (1 year each 4 years) since the late 1800s and that the graph was not plateauing. These latest findings confirm this.

Many reasons are cited and not surprisingly there will be many lining up to take the credit. It is due to a combination of many factors. One of the main ones is that average life expectancy is strongly influenced by childhood deaths. As these have bee reduced significantly the average has gone up. Better food, sanitation and living conditions have helped too. Modern medicine has had a role but less than it might claim.

Life expectancy still differs in different countries. Japan has one of the longest life spans and it is thought that half of its 80 year old women will make it to 90.It is also estimated that in very near future the number of people over 65 will exceed the number under 5.

The second article (link 2) looks at the effects of recession on life span and shows perhaps surprisingly that bad economic times correlate with greater increases in longevity. In other words health increases in bad times more than good. Again there are many reasons put forward. Less stress is a key factor .If people have less work to do they slow down, get more sleep and may make more time for exercise. Now there are downsides to recessions too so this effect is not across the board. However the overall effect on the health of the population is positive.

Averages reflect numbers on both sides of the “average”, the question then becomes what are the people who live longer than “average” doing and what can be learned from them. From my experience as a doctor talking to thousands of people over the years, those who live healthiest longest are looking after their bodies. They are putting in the right fuels, they are active on a regular basis, they get enough sleep and relaxation, they keep themselves hydrated, they have good relationships and they enjoy what they are doing. None of this is difficult or beyond the reach of anyone

What matters most is quality of life. Living more years if you are in pain or immobile or have lost your memory is not appealing to most people. The good news is that looking after your health means you enjoy a better life and it in turn makes it more likely that you will live longer and enjoy those years.

http://www.msnbc.msn.com/id/33121805/ns/health-aging/?ocid=twitter

http://www.msnbc.msn.com/id/33139622/ns/health-aging/?ocid=twitter

Let the Sun Shine

2009-10-01T05:43:00.000-07:00

Without the sun there would be no life on earth. Yet somehow over the last 30 year the sun has become something evil to be feared and avoided at almost all costs. Lets be very clear up front -getting sunburnt is not a good idea and if you do it often enough there is an increased chance of you developing skin cancer

Much like there is a difference between your steak being raw medium rare or burnt; there is a difference between getting adequate sun exposure, too little and too much. In the rush to avoid the sun at all costs there have been an unexpected problem. Many (estimated up to 40%) are now deficient in vitamin D. -the active form of which (D3) is produced in the body under uv light exposure.

Classic vitamin D deficiency (rickets) was associated with underground miners in the late 1800’s. It was thought that in the modern era, such deficiencies of vitamins would be unheard of in the developed world.

European studies on trials involving 57,000 people published in the Archives of Internal Medicine, showed vitamin D had an important role in helping protect against colon and breast cancer as well as diabetes and heart disease. The trials found that those with adequate levels of vitamin D had a 7% lower overall death risk during the six year period of the trial. The results prompted Professor Edward Giovannucci from the Harvard School of Public Health to call for a debate on the merits of “moderate sun exposure”.

The Moore’s Cancer Centre at the University of California suggested that up to 600,000 breast and colorectal cancers could be prevented each year if vitamin D3 levels among populations worldwide were increased.

Inadequate vitamin D may also have a role in the development asthma, osteoarthritis and Alzheimer’s

So the obvious question becomes, how can one get the right amount of sunlight so as to get the benefits of adequate vitamin D in the body but not get excessive exposure .The exact amount of time doesn’t seem to have been determined yet, however, it is likely that something between 10-15 minutes per day on 4-6 days per week of sun exposure to the arms and face is likely to be enough for most people.

In other words, it is not about laying for three hours sunbaking. In particular, the best time to be out in the sunshine is before 10am or after 3pm. At this time, the risk of burning is reduced. The closer to sunrise and sunset, the longer one can stretch this out as the rays aren’t as strong and the risk of burning is lessened.

Unfortunately, the public health people are still paranoid about sunlight .For those doing DIY health the take home message is get the right amount of sun without getting burnt. This means getting a ”healthy” tan but not burning.