A little health secret: gratitude

I always thought this was a bit corny, but having an "attitude of gratitude" is very real.

Gratitude has recently become the favorite feast of psychologists studying the consequences of giving thanks. Cultivating an “attitude of gratitude” has been linked to better health, sounder sleep, less anxiety and depression, higher long-term satisfaction with life and kinder behavior toward others, including romantic partners. A new study shows that feeling grateful makes people less likely to turn aggressive when provoked.

How do you get started? One suggestion: start with “gratitude lite.” 

That’s the term used by Robert A. Emmons, of the University of California, Davis, for the technique used in his pioneering experiments he conducted along with Michael E. McCullough of the University of Miami. They instructed people to keep a journal listing five things for which they felt grateful, like a friend’s generosity, something they’d learned, a sunset they’d enjoyed. 

The gratitude journal was brief — just one sentence for each of the five things — and done only once a week, but after two months there were significant effects. Compared with a control group, the people keeping the gratitude journal were more optimistic and felt happier. They reported fewer physical problems and spent more time working out. 

Further benefits were observed in a study of polio survivors and other people with neuromuscular problems. The ones who kept a gratitude journal reported feeling happier and more optimistic than those in a control group, and these reports were corroborated by observations from their spouses. These grateful people also fell asleep more quickly at night, slept longer and woke up feeling more refreshed. 

“If you want to sleep more soundly, count blessings, not sheep,” Dr. Emmons advises in “Thanks!” his book on gratitude research.

I'm going to give this a try. I'm grateful that I came across this article.

Throw grandma under the bus

I often write about breakthroughs in medical research. Innovation is the only way out of our healthcare mess: new discoveries in the lab and new ways of getting them to people.

Unfortunately, the new bureaucracies rising up under Obamacare are going to hurt this.

Benjamin Zycher, a senior fellow at the Pacific Research Institute, writes:

Obamacare established the Patient-Centered Outcomes Research Institute to “conduct research to provide information about the best available evidence to help patients and their health care providers make more informed decisions.” What could be wrong with that? CER is supposed to be “a rigorous evaluation of the impact of different options that are available for treating a given medical condition for a particular set of patients.” 

Alas, there is a problem: The federal government does not have patients. Instead, it has interest groups engaged in a long twilight struggle over shares of the federal budget pie. Less for one group means more for others, and even modest reductions in the huge federal health-care budget are a tempting goal for other constituencies.

In other words, there can be no such thing as unpoliticized science in the Beltway, he writes. 

It is inevitable that political pressures will lead policymakers to use the findings yielded by CER analyses to influence decisions on coverage, reimbursement, or incentives within Medicare, Medicaid, and other federal health programs.

Consider the new environment confronting would-be investors in new and improved medical technologies, examples of which are pharmaceuticals and medical devices and equipment. One cannot know in advance either how CER analyses of interest will turn out or how the findings will be used. Indeed, the uncertainties are enormous.

This is staggering:

Recent research from the Pacific Research Institute examined the likely effects of these CER implications for R&D investment in new and improved pharmaceuticals and devices and equipment. Using data from the National Science Foundation and other sources, R&D investment would be reduced by about $10 billion per year over the period 2014 through 2025, or about 10-12 percent. Based upon the scholarly literature on the benefits of medical innovation, this reduction in the advance of medical technology would impose an expected loss of about 5 million life-years annually, with a conservative economic value of $500 billion, an amount substantially greater than the entire U.S. market for pharmaceuticals and devices and equipment.

This adverse effect would be concentrated upon technological advances likely to serve the needs of smaller subgroups within the overall patient population, upon riskier investments among new treatments, and upon drugs and equipment expected to prove relatively less profitable.

Well, if people die the cost of their healthcare drops to zero. So there's a solution.

Eat less, think more, live forever

Many studies suggest that obesity is bad for our brain, slows it down, causes early brain aging, making it susceptible to diseases typical of older people as the Alzheimer's and Parkinson's. In contrast, caloric restriction keeps the brain young. 

Nevertheless, the precise molecular mechanism behind the positive effects of an hypocaloric diet on the brain remained unknown till now.

Now a team of Italian researchers at the Catholic University of Sacred Heart in Rome have discovered that this molecule, called CREB1, is triggered by "caloric restriction" (low caloric diet) in the brain of mice. They found that CREB1 activates many genes linked to longevity and to the proper functioning of the brain.

Here's some good news for all of us: "Our hope is to find a way to activate CREB1, for example through new drugs, so to keep the brain young without the need of a strict diet," Dr Giovambattista Pani, researcher at the Institute of General Pathology, said.

Yeah, you can keep slurping that pasta.

I've been trapping lots of mice in my attic. Guess they eat too much, because they're pretty stupid. Of course, I'm luring them with peanut butter with the correct mixture of omega fatty acids, so they may not be so dumb after all. Just nutrionally-correct dead.

What's in that expresso?

A study of 20 commercial expresso coffees in Scotland reveals a 6-fold differences in caffeine levels, a 17-fold range of caffeoylquinic acid contents, and 4-fold differences in the caffeoylquinic acid : caffeine ratio.

Yikes! I had no idea that stuff was in there.

These variations reflect differences in batch-to-batch bean composition, possible blending of arabica with robusta beans, as well as roasting and grinding procedures, but the predominant factor is likely to be the amount of beans used in the coffee-making/barista processes. The most caffeine in a single espresso was 322 mg and a further three contained >200 mg, exceeding the 200 mg day upper limit recommended during pregnancy by the UK Food Standards Agency.

This snap-shot of high-street expresso coffees suggests the published assumption that a cup of strong coffee contains 50 mg caffeine may be misleading. Consumers at risk of toxicity, including pregnant women, children and those with liver disease, may unknowingly ingest excessive caffeine from a single cup of espresso coffee. As many coffee houses prepare larger volume coffees, such as Latte and Cappuccino, by dilution of a single or double shot of expresso, further study on these products is warranted.

Starbucks had the lowest amount of caffeine.

One way we'll control the cost of healthcare

More than 3,000 people in England with diabetes, heart failure or COPD (a serious lung disease called chronic obstructive pulmonary disease) took part in a recent two-year trial of telehealth technology for monitoring people who are chronically ill.

According to the results of the trial, published by the Department of Health, telehealth can reduce mortality, reduce the need for admissions to hospital, lower the number of days spent in a hospital bed and cut the time spent in A&E.

Here's how it works.

First thing in the morning, Terry Munro always puts the kettle on. "Then I take my blood sugar, take my blood pressure and my weight and in that time the kettle's boiled.
"And I've got a record of it on my TV. It's marvellous, it really is." 

Terry, who is 67 years old and has diabetes, has been keeping tabs on his own health using nothing more than his television. The testing equipment uses Bluetooth so when Terry has taken his daily measurements they are automatically uploaded to the TV. 

A trained nurse can access and monitor the readings from a central location and make decisions about potential changes in treatments. "I like walking, but I used to go out and go hypo. Now I know I can't go out if my blood sugar is too low, so I am more aware now. 

"It's like having a doctor there all the time."

Patients like Terry are constantly being watched by nurses, albeit at a distance. Any unusual readings entered onto the TV are picked up straight away and will prompt a visit by a nurse or an alert to the patient's doctor.

Your amazing brain

Your brain know a lot more than you realize, neuroscientist David Eagleman writes, He explores the processes and skills of the subconscious mind, which our conscious selves rarely consider.

Are there transvestite chicks?

Let's start with chickens.

When chicken hatchlings are born, large commercial hatcheries usually set about dividing them into males and females, and the practice of distinguishing gender is known as chick sexing. Sexing is necessary because the two genders receive different feeding programs: one for the females, which will eventually produce eggs, and another for the males, which are typically destined to be disposed of because of their uselessness in the commerce of producing eggs; only a few males are kept and fattened for meat. So the job of the chick sexer is to pick up each hatchling and quickly determine its sex in order to choose the correct bin to put it in. The problem is that the task is famously difficult: male and female chicks look exactly alike. 

Well, almost exactly. The Japanese invented a method of sexing chicks known as vent sexing, by which experts could rapidly ascertain the sex of one-day-old hatchlings. Beginning in the 1930s, poultry breeders from around the world traveled to the Zen-Nippon Chick Sexing School in Japan to learn the technique. 

The mystery was that no one could explain exactly how it was done. It was somehow based on very subtle visual cues, but the professional sexers could not say what those cues were. They would look at the chick’s rear (where the vent is) and simply seem to know the correct bin to throw it in. 

And this is how the professionals taught the student sexers. The master would stand over the apprentice and watch. The student would pick up a chick, examine its rear, and toss it into one bin or the other. The master would give feedback: yes or no. After weeks on end of this activity, the student’s brain was trained to a masterful—albeit unconscious—level.

And let's conclude with baseball.

On August 20, 1974, in a game between the California Angels and the Detroit Tigers, The Guinness Book of Records clocked Nolan Ryan’s fastball at 100.9 miles per hour. If you work the numbers, you’ll see that Ryan’s pitch departs the mound and crosses home plate—60 feet, 6 inches away—in four-tenths of a second. This gives just enough time for light signals from the baseball to hit the batter’s eye, work through the circuitry of the retina, activate successions of cells along the loopy superhighways of the visual system at the back of the head, cross vast territories to the motor areas, and modify the contraction of the muscles swinging the bat. Amazingly, this entire sequence is possible in less than four-tenths of a second; otherwise no one would ever hit a fastball. But even more surprising is that conscious awareness takes longer than that: about half a second. So the ball travels too rapidly for batters to be consciously aware of it.

Think I'd rather be a baseball player than a chicken.

Go to the dentist, live forever

Modern dentistry: nothing to fear.

Among more than 100,000 people, those who had their teeth scraped and cleaned (tooth scaling) by a dentist or dental hygienist had a 24 percent lower risk of heart attack and 13 percent lower risk of stroke compared to those who had never had a dental cleaning. The participants were followed for an average of seven years.

Professional tooth scaling appears to reduce inflammation-causing bacterial growth that can lead to heart disease or stroke.

Peridontal disease is also a no-no:

-- Fewer than 21 teeth had a 69 percent increased risk of heart attack compared to those with the most teeth.
-- A higher number of deepened periodontal pockets (infection of the gum around the base of the tooth) had a 53 percent increased risk of heart attack compared to those with the fewest pockets.
-- The least amount of teeth had a 2.5 increased risk of congestive heart failure compared to those with the most teeth.
-- The highest incidence of gum bleeding had a 2.1 increased risk of strokecompared to those with the lowest incidence.

I'm going tomorrow, so I'll probably be around another 100 years.

Listening to other people chew

Misophonia terrorist.

For people with a condition that some scientists call misophonia, mealtime can be torture. The sounds of other people eating — chewing, chomping, slurping, gurgling — can send them into an instantaneous, blood-boiling rage, Joyce Cohen writes.

Many people can be driven to distraction by certain small sounds that do not seem to bother others — gum chewing, footsteps, humming. But sufferers of misophonia, a newly recognized condition that remains little studied and poorly understood, take the problem to a higher level.

They also follow a strikingly consistent pattern, experts say. The condition almost always begins in late childhood or early adolescence and worsens over time, often expanding to include more trigger sounds, usually those of eating and breathing.

Aage R. Moller, a neuroscientist at the University of Texas at Dallas who specializes in the auditory nervous system, believes the condition is hard-wired, like right- or left-handedness, and is probably not an auditory disorder but a “physiological abnormality” that resides in brain structures activated by processed sound. 

Misophonia (“dislike of sound”) is sometimes confused with hyperacusis, in which sound is perceived as abnormally loud or physically painful. But Dr. Johnson says they are not the same. “These people like sound, the louder the better,” she said of misophonia patients. “The sounds they object to are soft, hardly audible sounds.” One patient is driven crazy by her beloved dog licking its paws. Another can’t bear the pop of the plosive “p” in ordinary conversation.

Yeah, that one gets me, too.

How to think about cancer screening tests

I wrote the other day of a new recommendation that men not undergo the PSA test for prostate cancer. It's still a choice, and some men, and doctors, might want the test. National statistics are not the same as your particular body.

The decision to screen for breast cancer is somewhat similar -- there are questions about whether it actually saves lives.

Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, has written an excellent article for The New York Times explaining the difficulty of deciding, and I recommend that you read all of it.

I'll just grab a few of the highlights.

Both breast and prostate cancer screening are really difficult calls, and the statistical differences between them are only of degrees. Reasonable individuals, in the same situation, could make different decisions based on their valuation of the benefits and harms of screening.

Screening is like gambling: there are winners and there are losers. And while the few winners win big, there are a lot more losers.

False positives are really common in both breast and prostate cancer screening. Approximately 15 to 20 percent of women and men who are screened annually over a 10-year period will have to undergo at least one biopsy because of a false-positive mammogram or PSA — prostate-specific antigen — test.

Patients who are overdiagnosed are the big losers here. They undergo surgery, radiation and chemotherapy unnecessarily. And then there are the associated complications: chemotherapy can cause nausea and radiation can burn normal tissue; breast surgery can be disfiguring, and prostate surgery can lead to bladder and sexual dysfunction.

Now let’s consider the winners — those who have avoided dying from breast or prostate cancer by getting screened. While there is some debate about whether they really exist, my reading of the data is that they do, but they are few and far between — on the order of less than 1 breast or prostate cancer death averted per 1,000 people screened over 10 years. That’s less than 0.1 percent.

"The truth is that neither test works that well," he concludes. "Even with screening, most people destined to develop deadly, untreatable cancers will still do so. When it comes to breast and prostate cancer screening, there are no right answers, just trade-offs."

It's worth your time to read the whole thing.

If you're a man, read this

Healthy men should no longer receive a PSA blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence in many, a key government health panel has decided.

This issue is not new. I have played the PSA game for more than a decade, and I no longer care to play. My number goes up, I'm off to the urologist. Then it goes down. Then it goes up again, and I'm off to the urologist, who now wants to biopsy. Over and over.

The recommendation:

is based on the results of five well-controlled clinical trials and could substantially change the care given to men 50 and older. There are 44 million such men in the United States, and 33 million of them have already had a PSA test — sometimes without their knowledge — during routine physicals.

“Unfortunately, the evidence now shows that this test does not save men’s lives,” said Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force. “This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does.”

Moreover, there is no evidence that a digital rectal exam or ultrasound are effective, either. “There are no reliable signs or symptoms of prostate cancer,” said Dr. Timothy J. Wilt, a member of the task force and a professor of medicine at the University of Minnesota. Frequency and urgency of urinating are poor indicators of disease, since the cause is often benign.

From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence or both. As a result of these complications, the man who developed the test, Dr. Richard J. Ablin, has called its widespread use a “public health disaster.”

Plenty of reputable people are opposed to this new recommendation. What should you do? Talk to your doctor, and ask a lot of questions about everything you hear. Remember, there's a difference between public health statistics and your own body. Read everything you can. Get a second opinion, and a third. Ultimately, the decision is yours.

You can read a lot more about this here.

How to talk to your doctor

You go in, and he's rushed, and you're confused, and you forget to ask the question you came in with. I've finished an exam without knowing the diagnosis and had to ask.

The federal Agency for Healthcare Research and Quality has created a website to help.

Patients talking to the doctor about a proposed surgery, for example, are prompted to ask how long it will take to recover. The site offers tips on what to do before, during and after medical visits, such as calling the doctor if there are any side effects. The site includes an interactive "Question Builder."

Here are some typical questions to ask at a checkup.

• What is my diagnosis?
• What are my treatment options? What are the benefits of each option? What are the side effects?
• Will I need a test? What is the test for? What will the results tell me?
• What will the medicine you are prescribing do? How do I take it? Are there any side effects?
• Why do I need surgery? Are there other ways to treat my condition? How often do you perform this surgery?
• Do I need to change my daily routine?

Read more in The Wall Street Journal here.

Let the games begin

Online gamers have deciphered the structure of an enzyme of an AIDS-like virus that had thwarted scientists for a decade.

Their target was a monomeric protease enzyme, a cutting agent in the complex molecular tailoring of retroviruses, a family that includes HIV. Figuring out the structure of proteins is vital for understanding the causes of many diseases and developing drugs to block them.

Foldit, developed in 2008 by the University of Washington, is a video game in which gamers, divided into competing groups, compete to unfold chains of amino acids -- the building blocks of proteins -- using a set of online tools.

To the astonishment of the scientists, the gamers produced an accurate model of the enzyme in just three weeks. Cracking the enzyme "provides new insights for the design of antiretroviral drugs," says the study, referring to the lifeline medication against the human immunodeficiency virus (HIV). 

"We wanted to see if human intuition could succeed where automated methods had failed," Firas Khatib of the university's biochemistry lab said in a press release. "The ingenuity of game players is a formidable force that, if properly directed, can be used to solve a wide range of scientific problems."

Hey kids, next time your parents get crazy about you playing video games ...

Have a bowl of cereal for dinner

Dinner's ready!

Bill Phillips, the editor of MensHealth.com, likes a bowl of cereal with bananas for dinner. It wouldn't be bad for the rest of us either. Here's why.

Eat a bowl of 100 percent B12-boosted cereal and milk every morning and you'll be covered for B12, he writes, and that vitamin is essential if you don't want to lose brain matter as you age. Acid-blocking drugs may be depriving you of as much B12 as you need.

The banana offers potassium -- without this essential mineral, your heart couldn't beat, your muscles wouldn't contract, and your brain couldn't comprehend this sentence. Why? Potassium helps your cells use glucose for energy. A banana offers 400 mg of the 4,700 mgs a young man needs each day.

The milk offers iodine, and you probably don't get what you need from salt. However, iodine can also be found in a nearly sodium-free source: milk. Animal feed is fortified with the element, meaning it travels from cows to your cereal bowl. Not a milk lover? Eat at least one serving of eggs or yogurt a day; both are good sources of iodine.

Good news for your mice

Will live longer than you.

Keep them on that little treadmill.

Researchers have found one more reason to exercise: working out triggers influential stem cells to become bone instead of fat, improving overall health by boosting the body's capacity to make blood. The body's mesenchymal stem cells are most likely to become fat or bone, depending on which path they follow. Aerobic exercise triggers those cells to become bone more often than fat. In sedentary mice, the same stem cells were more likely to become fat, impairing blood production in the marrow cavities of bones.

I didn't know I had mesenchymal stem cells. Maybe that explains that annoying itch.

"The interesting thing was that a modest exercise program was able to significantly increase blood cells in the marrow and in circulation," says one of the researchers. "What we're suggesting is that exercise is a potent stimulus -- enough of a stimulus to actually trigger a switch in these mesenchymal stem cells."

Can someone hand me the remote?

Miracles and wonders: new ears, new hearts

Vincent, call your office.

Yes, there's good news out there: breakthroughs in the world of medicine:

People in need of surgery to repair or reconstruct damaged cartilage could soon find help in an unlikely place -- their ears. Stem cells from human ears have successfully been grown into chunks of cartilage that could replace the synthetic materials currently used in surgery.

Stem cell researchers are trying to grow spare parts for the human heart that may be ready for tests on people within five years. Scientists have already made basic heart muscle from stem cells, but the team wants to refine it so it can replace any part damaged in heart attacks, and to recreate the natural pacemaker, where the heartbeat originates.

In a bit of high-tech recycling, researchers have developed an innovative way to identify already-approved drugs that may work against diseases they weren't designed to combat. The scientists have also demonstrated how a couple of such repurposed drugs may have benefits in treating two conditions, inflammatory bowel disease and lung cancer. The researchers found that topiramate, a drug used in epilepsy, might work on inflammatory bowel disease, including Crohn's disease and ulcerative colitis. Another hit suggested that cimetidine, an ulcer drug, might be effective in lung cancer. They then tested the two generic drugs in small studies using animal models of the diseases. In the bowel-disease study, the drug reduced symptoms, and in the lung-cancer paper, the drug was found to slow tumor growth.

Researchers have found a protein normally involved in blood pressure regulation in a surprising place: tucked within the little "power plants" of cells, the mitochondria. The quantity of this protein appears to decrease with age, but treating older mice with the blood pressure medication losartan can increase protein numbers to youthful levels, decreasing both blood pressure and cellular energy usage. The researchers say these findings may lead to new treatments for mitochondrial–specific, age-related diseases, such as diabetes, hearing loss, frailty and Parkinson's disease.

A biomedical engineer has developed a lab-on-a-chip that can perform complex laboratory assays, and do so with such simplicity that these tests can be carried out in the most remote regions of the world. It requires only a tiny finger prick of blood, effective even for a newborn, and gives results in less than 15 minutes. This technology significantly reduces the time between testing and treating. New low-cost diagnostics like the mChip could revolutionize medical care around the world.

Roughly the time you spend watching TV commercials

Less than 15 minutes.

A study of more then 400,000 Taiwanese concludes that just 15 minutes of light exercise a day will extend your pathetic life by three years.

Your risk of dying decreases four percent for each additional 15 minutes of exercise a day.

Light exercise includes: falling out of bed, reaching for the remote, putting on your socks ... wait, I just made that up.

"Exercising at very light levels reduced deaths from any cause by 14 percent," said study senior author Xifeng Wu, M.D., Ph.D., professor and chair of The University of Texas MD Anderson Cancer Center Department of Epidemiology. "The benefits of exercise appear to be significant even without reaching the recommended 150 minutes per week based on results of previous research."

So if you don't want to die, get out there and do something.

Tat tech: skin-deep electronics

This is just weird.

It may soon be possible to wear your computer or mobile phone under your sleeve, with the invention of an ultra-thin and flexible electronic circuit that can be stuck to the skin like a temporary tattoo, The Independent reports.

The devices, which are almost invisible, can perform just as well as more conventional electronic machines but without the need for wires or bulky power supplies, scientists said. The circuit is about the size of a postage stamp, is thinner than a human hair and sticks to the skin by natural electrostatic forces rather than glue.

Try not to scratch.

What can you do with this thing?

A simple stick-on circuit can monitor a person's heart rate and muscle movements as well as conventional medical monitors, but with the benefit of being weightless and almost completely undetectable. Scientists said it may also be possible to build a circuit for detecting throat movements around the larynx in order to transmit the information wirelessly as a way of recording a person's speech, even if they are not making any discernible sounds.

Tests have already shown that such a system can be used to control a voice-activated computer game, and one suggestion is that a stick-on voicebox circuit could be used in covert police operations where it might be too dangerous to speak into a radio transmitter.

This could give a whole new meaning to a hickey

Physical problems can lead to mental problems

Are you crazy? No, you may be just sick.

More than 100 medical disorders can masquerade as psychological conditions, according to Harvard psychiatrist Barbara Schildkrout, author of Unmasking Psychological Symptoms, a book aimed at helping therapists broaden their diagnostic skills.

Studies have suggested that medical conditions may cause mental-health issues in as many as 25% of psychiatric patients and contribute to them in more than 75%, The Wall Street Journal reports.

Common culprits include under- or over-active thyroid glands, which can cause depression and anxiety, respectively. Deficiencies of vitamins D, B-12 and folate, as well as hormonal changes and sleep disorders have also been linked to depression. 

Diabetes, lupus and Lyme disease can have a variety of psychiatric symptoms, as can mercury and lead poisoning and sexually transmitted diseases. Many medications also list mood changes among their side effects, and substance abuse is notorious for causing psychiatric problems.

In some cases, a psychological problem is just the first sign of a serious medical issue. "Depression predicts heart disease and heart disease predicts depression," said Gary Kennedy, director of the geriatric psychiatry at Montefiore Medical Center in Bronx, N.Y.

Experts say mental health counselors should ask patients about their medical histories as well as emotional issues, and make sure they've had a recent physical exam.

How to live forever: whatever

Will live forever, but why?

Researchers at the Albert Einstein College of Medicine of Yeshiva University have found that many very old people — age 95 and older — could be poster children for bad health behavior with their smoking, drinking, poor diet, obesity and lack of exercise.

The very old are, in fact, no more virtuous than the general population when it comes to shunning bad health habits, leaving researchers to conclude that their genes are mostly responsible for their remarkable longevity. 

But before you fall off the wagon and start tossing down doughnuts for breakfast just because your Aunt Edna just turned 102, remember that genetics is a game of chance. What didn't kill Aunt Edna still could kill you prematurely, the researchers cautioned.

About 1 in 4,400 Americans lives to age 100, according to 2010 census data. I'm going to submit my name to be in that group.

The living, old people in the study were remarkably ordinary in their lifestyles, Barzilai said. By and large, they weren't vegetarians, vitamin-pill-poppers or health freaks. Their profiles nearly matched that of the control group in terms of the percentage who were overweight, exercised (or didn't exercise), or smoked. One woman, at age 107, smoked for over 90 years. 

Whatever killed the control group — cardiovascular disease, cancer and other diseases clearly associated with lifestyle choices — somehow didn't kill them. "Their genes protected them," a researcher said.

Taking the fun out of everything, the researchers said that for the general population, there is a preponderance of evidence that diet and exercise can postpone or ward off chronic disease and extend life. Many studies on Seventh Day Adventists — with their limited consumption of alcohol, tobacco and meat — attribute upward of 10 extra years of life as a result of lifestyle choices.

Well, poo poo pi doo on you, research Nazis.

Will this happen to your doctor?

A physician in Seattle who calls himself Dr. Bob describes how the profession is changing.

The past year or so has been one of the most challenging in many a season, on a number of fronts. Professionally, the passage of Obamacare has made it abundantly clear that the independent private practitioner is a dying breed, and likely will disappear — with the exception of cash-only, concierge-style arrangements — within the next few years. The administrative burden is crushing — unfunded mandates, such as pay-for-performance, compliance programs, HIPAA, mandated “government certified” EMRs (even though existing, non-certified ones are fully functional), and intrusive, abusive audits by the Feds and third party carriers.  

Such mandates and regulatory excesses place, or will soon place, such an overwhelming burden on the solo physician or small group as to make their continued existence unsustainable, even in the near term — and the full implementation of Obamacare will put roses on their grave. Reimbursements are dropping precipitously (my income dropped about 25% last year), as expenses spiral upward (employee health insurance rates are up 25%; malpractice rates up 15%, etc., etc.). The small business model of solo practice or small medical group is rapidly becoming extinct: its executioner, Big Government and Big Insurance.

And so, big changes are in store: my practice will be sold in the next few months to a large medical group affiliated with a nearby hospital, and I will have as a primary responsibility inpatient hospital care, with a much diminished office practice focusing primarily on my specialty of male infertility and vasectomy reversal. I have decidedly mixed feelings about this change — I anticipated going to my deathbed as a private, solo practitioner, loving the independence and rich patient relationships which this brings. 

But I am weary. After nearly 30 years in private practice, I am not sure which straw broke the camel’s back, but it is most surely broken. It is a weariness born of 14 hour days; of dictating charts and finishing paperwork until 8 or 9 pm each night, after starting the day at 7 am; of endless audits by the insurance industry and Medicare; of the constant threat of litigation; of the crushing burden of one more federal requirement mandated but never recompensed; of a host of ever-expanding administrative burdens having nothing to do with patient care, and everything to do with bureaucratic micromanagement of the profession. And this before we have even begun to see the nightmare which Obamacare will inflict. Camels weren’t designed to carry such a load.

I've started to notice this around here.

The geniuses who want to manage your health

Here's a look at the bureaucrats who are sticking their fingers ever deeper into your healthcare.

President Barack Obama's health care law would let several million middle-class people get nearly free insurance meant for the poor, a twist government number crunchers say they discovered only after the complex bill was signed.

Remember how they shoved this down the country's throat in weekend and late night sessions? Remember how lawmakers admitted they hadn't read it?

By changing the way it pays, Medicare under the Accountable Care Organization rule is effectively mandating a new business model for practicing medicine. The vague cost-control hope is that ACOs will run pilot programs he successful ones will become best practices. While the program is voluntary for now, the government's intention is to make it mandatory in the coming years. However, the American Medical Group Association, a trade association of multispeciality practice groups and other integrated providers, calls the rule recently drafted by the Department of Health and Human Services "overly prescriptive, operationally burdensome, and the incentives are too difficult to achieve." In a survey of its members, 93% said they won't enroll.

That's what you get when you have a bunch of staff egg heads writing legislation fundamentally changing one-sixth of the economy.

Long after questions were first raised about the overuse of powerful CT scans, hundreds of hospitals across the country needlessly exposed patients to radiation by scanning their chests twice on the same day. Yet some hospitals were doing that more than 80 percent of the time for their Medicare chest patients. “If you do both, you bill for both,” one doctor said.

So existing incentives under government rules cause this, but nobody has bothered changing it.

Medicare fraud --  estimated now to total about $60 billion a year -- has become one of, if not the most profitable, crimes in America.

We've know this for years, as well, but it continues.

Certainly our healthcare system is screwed up, but are Washington bureaucrats the right people to fix it? Dream on.

Be your own therapist

Positive psychology involves more than just thinking happy thoughts. Positive psychology focuses on the strengths and virtues that help people thrive, such as courage, gratitude, compassion, resilience and creativity. While most therapists attempt to "fix what's wrong," positive psychologists also want to "build what's strong."

Therapists who practice positive psychology help individuals see their strengths and virtues and find ways to foster them. They also help people identify positive experiences and the circumstances that brought them about, as well as encourage behaviors that give life a sense of meaning and purpose. Here are some positive psychology techniques you can try:

Identify and use signature strengths. Write down your top five strengths and try to use them more and in new ways each day.  

Keep a gratitude journal. Often recommended by Oprah Winfrey, this positive psychology technique involves writing down each evening three good things that happened to you and noting why you think they happened. Many people focus on negative emotions or events and ignore the positive ones. Keeping a gratitude journal is a way to shift your focus to the more positive aspects of your life and to reflect on them.

Express appreciation to other individuals. Extend your gratitude to the important people in your life. 

Perform acts of kindness. Turning your focus to improving the lives of people around you can increase your own happiness. Try to help others in ways both random (like holding the door open for someone or letting someone go in front of you in line) and planned (such as volunteering or donating blood).

Do it yourself and save big bucks. 

The ticking male timebomb

It's known that women who postpone childbirth into their 30s and 40s place their offspring at risk for countless disorders and diseases. Why that is so might surprise you.

Writing in The Wall Street Journal, Jennifer Vanderbes suggests that it's because women in their 30s tend to couple off with older men. And when it comes to fathering healthy children, older men, it turns out, are just as much at the mercy of their biological clocks as women.

Several years ago researchers at the Mount Sinai School of Medicine reported that a man over 40 is almost six times as likely as a man under 30 to father an autistic child. Since then, research has shown that a man's chances of fathering offspring with schizophrenia double when he hits 40 and triple at age 50. The incidence of bipolarity, epilepsy, prostate cancer and breast cancer also increases in children born to men approaching 40.

After each ejaculation, a man regenerates millions of new sperm cells, and with each cellular replication, the chances rise of an error in genetic coding. 

These "new" sperm might still be able to fertilize an egg, but they can contain dangerous mutations. "As men get older, maybe there is some sperm available, but a lot of that DNA may be abnormal," says Harry Fisch, author of the pioneering 2004 book The Male Biological Clock.

Here's a chart showing the rising age at which men get married.

That's the average, meaning half get married at a later age. And here's a chart showing the rising diagnoses of autism.

This may be one piece of the puzzle of the apparent epidemic of autism.

Miracles and wonders: brain in a dish

Microelectrodes measure stem cells

Here's the real story in healthcare -- the amazing discoveries coming every day.

Researchers at the University of Florida have found a way to reanimate brain cells that have been quieted by strokes and traumatic head injuries. "The brain in the dish, or as the scientists prefer to call it, the 'biologically relevant neural model,' is a computer chip with an array of 60 microelectrodes that measure the action potential of neurons grown on top. The microelectrode array, or M.E.A., records the brain cell signals so the scientists can analyze them." After simulating a stroke, which quiets the neurons on the chip, adult stem cells are added, after which the neurons regain strength.

Scientists are at last almost ready to unveil a new drug-delivery system that uses the membranes of red blood cells. It's biocompatible, it's efficient, and evolution has already conducted extensive trials. Researchers at the University of California at San Diego say this system is better than other nanoparticle drug-delivery devices because there is no need for a synthetic membrane. There is no better way to trick the body into believing the device belongs there if it is coated in a natural membrane.

Parallel developments in research may bring sufferers of Type 1 and Type 2 diabetes very near a cure. A team of physicians at Massachusetts General Hospital have found a tuberculosis vaccine, called BCG, prevents T cells from destroying insulin-secreting cells, allowing the pancreas to regenerate and begin producing insulin again, curing the disease. Meanwhile, researchers in the U.K. have pioneered an extremely low-calorie diet of just 600 calories a day. In addition to lowering body fat, insulin levels returned to normal. Out of the eleven participants on the diet, seven were diabetes-free just three months later.

The Mermaid

Japanese researchers have developed the world’s first self-propelled endoscopy device, a remote controlled tadpole-like camera that can “swim” through the digestive tack gathering imagery along the way. This kind of endoscopy isn’t wholly new, of course, but previous iterations of ingestible cameras relied on natural muscle contractions to move them through the body. The “Mermaid,” as it is known, simplifies the process by moving quickly through the digestive tract to its destination, whatever that point may be. To speed the process, it can be inserted into the digestive system at either end, entering the body orally or--well, you know. The device is just 0.4 inches in diameter and just shy of two inches long, and uses magnetic machinery to control its movement and location. Doctors pilot the endoscope with a joystick, watching its progress on a monitor. All said, it takes only a few hours to traverse the whole system from esophagus to colon. It could help ease the strain on patients and detect hard-to-see cancers earlier than was previously possible.

Let me hear an oooom

It's science, people.

Researchers who tracked 201 people as they underwent either transcendental meditation or health education classes found that those who meditated had lower blood pressure and a 47% reducation in strokes, deaths and heart attacks, which they calculated together as one result.

A previous study, in 2009, found that meditation can cut the risk of heart attack, stroke, and death by almost 50% in patients with existing coronary heart disease, according to a new clinical trial. The findings indicate that relaxation and mental focusing can be as effective as powerful new drugs in treating heart disease.

The reason for such a dramatic improvement isn't obvious, but the researchers note that the meditating patients had lower blood pressure, a key risk factor for heart attacks and stroke. Past studies have also indicated that meditation reduces stress hormone levels and dampens the sympathetic nervous system, which triggers the body's stress response. "We've shown that the brain has a direct positive influence on clinical outcomes," says Schneider, whose team presented its findings at the annual meeting of the American Heart Association in Orlando, Florida.

Meditation has also been found to:

• significantly reduce depressive symptoms. 
• have greater pain relieving effects than morphine.
• decrease the levels of the stress-causing hormone, cortisol.

The most important discovery, however, is that cats that were unwell became less stressed when they listened to yoga meditation music. The poorly felines calmed down and began to breathe more slowly.

Is yoga good for your heart?

Idiots pose for picture.

Could be, the doctors at Harvard Medical School say. Although most studies to date are small, and lots of weasel words are in order, they write that yoga may:

• reduce high blood pressure
• improve symptoms of heart failure
• ease palpitations
• enhance cardiac rehabilitation
• lower cardiovascular risk factors such as cholesterol levels, blood sugar, and stress hormones
• improve balance, reduce falls, ease arthritis, and improve breathing for people with chronic obstructive pulmonary disease.

How so?

Getting into the various postures during a yoga session gently exercises the muscles. Anything that works your muscles is good for your heart and blood vessels. Activity also helps muscles become more sensitive to insulin, which is important for controlling blood sugar. 

The deep-breathing exercises help slow the breathing rate. Taking fewer but deeper breaths each minute temporarily lowers blood pressure and calms the sympathetic nervous system, which is responsible for generating stress hormones. The postures and deep breathing offer a kind of physical meditation that focuses and clears the mind. Meditation and the mindfulness of yoga have both been shown to help people with cardiovascular disease.

The research shows that bending your body into a pretzel alerts your heart that things could get really ugly if it decides to stop beating.

The really big story of the past century

Look to your left. Look to your right. Without advances in agriculture and medicine, one of you would not be alive today. We're not only living longer; we're also getting taller and heavier.

The average adult man in 1850 in America stood about 5 feet 7 inches and weighed about 146 pounds; someone born then was expected to live until about 45. In the 1980s the typical man in his early 30s was about 5 feet 10 inches tall, weighed about 174 pounds and was likely to pass his 75th birthday. 

For nearly three decades, the Nobel Prize-winning economist Robert W. Fogel has  researched what the size and shape of the human body say about economic and social changes throughout history, and vice versa.  “In most if not quite all parts of the world, the size, shape and longevity of the human body have changed more substantially, and much more rapidly, during the past three centuries than over many previous millennia,” he writes.


This “technophysio evolution,” powered by advances in food production and public health, has so outpaced traditional evolution, he  argues, that people today stand apart not just from every other species, but from all previous generations of Homo sapiens as well.

 “I don’t know that there is a bigger story in human history than the improvements in health, which include height, weight, disability and longevity,” said Samuel H. Preston, one of the world’s leading demographers and a sociologist at the University of Pennsylvania. Without the 20th century’s improvements in nutrition, sanitation and medicine, only half of the current American population would be alive today, he said.

Eat your Wheaties, boys and girls.

What's up, Doc?

Always take this to a gun fight.

News from the world of medicine:

Manuka honey could be an efficient way to clear chronically infected wounds and could even help reverse bacterial resistance to antibiotics, according to research.

Researchers testing raw turkey, pork, beef, and chicken purchased at grocery stores in five different cities across the U.S. say that roughly one in four of those samples tested positive for a multidrug antibiotic-resistant “superbug” bacterium.

A new study by researchers at the University of Alberta shows that for best results in stable patients after a heart attack, early exercise as well as prolonged exercise is the key to the best outcomes.

A survey of more than 1,600 U.S. parents showed that that 74% of children between the ages of 5 and 10 do not get enough exercise daily, based on the 60 minutes of daily physical activity recommended in the government’s Physical Activity Guidelines for Americans.

A serendipitous discovery has shown that a simple illusion can significantly reduce -- and in some cases even temporarily eradicate -- arthritic pain in the hand.

Treating high blood pressure and other so-called vascular risk factors in people who have mild cognitive impairment may reduce their risk of progressing to Alzheimer's disease, according to a new study.

Toss those cookbooks

I've been going through the business throwing stuff away. Seems I've saved every telephone I've ever owned. There are three computer printers down there. And more books than the Library of Congress. What to keep?

An article in the New York Times has some advice, including this on books.

Keep them (with one exception). Yes, e-readers are amazing, and yes, they will probably become a more dominant reading platform over time, but consider this about a book: It has a terrific, high-resolution display. It is pretty durable; you could get it a little wet and all would not be lost. It has tremendous battery life. It is often inexpensive enough that, if you misplaced it, you would not be too upset. You can even borrow them free at sites called libraries. 

But there is one area where printed matter is going to give way to digital content: cookbooks. Martha Stewart Makes Cookies a $5 app for the iPad, is the wave of the future. Every recipe has a photo of the dish (something far too expensive for many printed cookbooks). 

Complicated procedures can be explained by an embedded video. When something needs to be timed, there’s a digital timer built right into the recipe. You can e-mail yourself the ingredients list to take to the grocery store. The app does what cookbooks cannot, providing a better version of everything that came before it. 

Now all Martha has to do is make a decorative splashguard for a tablet and you will be all set.

What's up, Doc?

Will live forever.

Middle-aged men and women may be able to lower their blood pressure readings by laughing more and listening to music they enjoy, new research indicates.

Prescribing antibiotics for patients with discoloured phlegm caused by acute cough has little or no effect on alleviating symptoms and recovery, a Cardiff University study has found.

Itching, like yawning, may be contagious, causing people to feel an urge to scratch after they see another person scratching. That’s according to a new study published in the British Journal of Dermatology.

Researchers have found that people living at higher altitudes have a lower chance of dying from ischemic heart disease and tend to live longer than others.

Cocoa, used throughout history as a folk medicine, may actually have significant health benefits, according to a new study by Harvard researchers. Their analysis of 21 studies with 2,575 participants shows that cocoa consumption is associated with decreased blood pressure, improved blood vessel health, and improvement in cholesterol levels, among other benefits.

A lesser known side effect of sleep deprivation is short-term euphoria, which can potentially lead to poor judgment and addictive behavior, according to new research

Regular exercise and a low-sodium diet are two lifestyle changes that are often recommended to lower high blood pressure. Now a new study shows that physical activity appears to help keep blood pressure from climbing after people eat eye-popping amounts of salt -- 18,000 milligrams a day to be exact.

Is this the next exercise fad?

Likes jumping rope and ice cream.

Traditionally the turf of the boxing ring and schoolyard, jumping rope is nearly perfect exercise in terms of conditioning, cost-benefit and convenience, William Hamilton writes in the Wall Street Journal.

"To coordinate that kind of rhythm, the whole body has to be in sync—core, shoulders, legs," said Brian Nguyen, the actor Mark Wahlberg's personal trainer. Mr. Nguyen trained with Mr. Wahlberg for his role in last year's film "The Fighter." "It's a very intense movement for the body," he explained. 

Jumping is also gentler and kinder, though. "You're getting the most bang for your buck, because you're working almost every part of your body, but there's not the impact of running, because of the way the foot lands," said Alexis Colvin, an assistant professor of sports medicine in the Department of Orthopaedic Surgery at Mount Sinai Medical Center in Manhattan.

So then Hamilton gets down to technique.

John Snow, the manager of Trinity Boxing Gym in Lower Manhattan, has basic pointers. He has me jump in place, without a rope, practicing my arm movement: elbows to my sides, turning the wrist and bending and rolling the elbow, breathing through my nose, setting a pace, staying focused and loose. Mr. Snow called it "controlled relaxation," an eloquent attitude towards life, as well as rope jumping.

"An eloquent attitude towards life." I like that. I think Moose Tracks ice cream is an eloquent attitude toward life.

I say, let them eat broccoli

Will do well in corporate meetings.

If you’re not a big fan of bitter food, chemists have just the loophole for you. You still have to take the bitter, but you won’t have to taste it. Scientists have concocted a new and improved “bitter blocker.” 

We likely find bitter bad because many toxic substances are bitter. So an aversion to bitter may have helped our ancestors survive.

Right you are, Sparky -- that's why no one should ever eat beets. Ever. If you do, you will die.

Problem is, plenty of healthful foods are bitter, too. Take broccoli and kale. (Please.) The standard solution, drowning out the bitter with butter, sort of cancels out the veggies’ health food status.

Rather than getting rid of the bitter, chemists came up with a compound that simply blocks our receptors for the bitter molecules, and our ability to taste them. So you may not need that spoonful of sugar to make the medicine go down. Or the broccoli.

However, we all know it's true: spare the spinach, spoil the child. God invented vegetables to give parents a means of disciplining children so that they will be prepared to go forth into the world and join the accounts receivable department at a global conglomerate and be miserable the rest of their awful lives.

Besides, how much bitter can a bitter blocker block if a bitter blocker blocks broccoli? You see what I mean.

I told you there is a god

Eat this, live forever.

Here's some good news: Strawberries have the potential to prevent esophageal cancer, according to a preliminary study.

Freeze-dried strawberries slowed the growth of dysplastic, or precancerous, lesions in about 30 people who consumed the fruit for six months. The freeze-dried substance is about 10 times as concentrated as fresh strawberries, but the study's lead researcher, Tong Chen, an assistant professor in the oncology division of Ohio State University, suggested people could still benefit from eating whole strawberries daily.

Stay with me. Other researchers claim that eating a bar of dark chocolate once a week can lower the risks of cancer, but what is more important: dark chocolate can be used even to inhibit the growth of cancerous cells.

Told you.

Eat your fiber, boys and girls

Eat rope, live forever.

Dietary fiber may be associated with a reduced risk of death from cardiovascular, infectious and respiratory diseases, as well as a reduced risk of death from any cause, a new study says.

In the study involving 219,123 men and 168,999 women, fiber intake was associated with a significantly decreased risk of total death in both men and women -- the one-fifth of men and women consuming the most fiber (29.4 grams per day for men and 25.8 grams for women) were 22 percent less likely to die than those consuming the least (12.6 grams per day for men and 10.8 grams for women).

The risk of cardiovascular, infectious and respiratory diseases was reduced by 24 percent to 56 percent in men and 34 percent to 59 percent in women with high fiber intakes. Dietary fiber from grains, but not from other sources such as fruits, was associated with reduced risks of total, cardiovascular, cancer and respiratory disease deaths in men and women.

You can see a list of foods with lots of fiber here. Potato skins are included.

Miracles and wonders: cancer-smart phones, tic-tac size pacemakers

Cancer detection system.

Everyday something amazing comes out of the medical labs and research centers.

Scientists at the Massachusetts General Hospital that have integrated a microNMR device that accurately detects cancer cells to a smartphone. Though just a prototype, this device enables a clinician to extract small amounts of cells from a mass inside of a patient, analyze the sample on the spot, acquire the results in an hour, and pass the results to other clinicians and into medical records rapidly. How much does the device cost to make? $200.

Researchers at Wake Forest Baptist Medical Center have become the first in the world to use patients’ own cells to build tailor-made urinary tubes and successfully replace damaged tissue. They replaced damaged segments of urinary tubes (urethras) in five boys. Tests to measure urine flow and tube diameter showed that the engineered tissue remained functional throughout the six-year follow-up period.

Medtronic, the world's largest medical-device maker, is using microelectronics and chip manufacturing to shrink pacemakers — implanted devices that regulate the heart's rhythm. Whereas current pacemakers are about as big as a silver dollar, Medtronic's device would be smaller than a tic tac. At that size, the device would be small enough to be inserted via catheter, rather than invasive surgery.

Scientists from the Russian city of Chelyabinsk have developed “a bio-artificial liver” which not only cleans the blood, but is also capable of “jumpstarting” a sick body. Several successful operations have already been conducted at a local hospital.

A joint team of Indian and Australian scientists claims to have achieved a breakthrough by creating an antibody which could be used for developing a "medical smart bomb" that would help seek out and eradicate the root of cancer — the stem cells. 

The promising results of a gene-therapy trial have offered new hope to people with Parkinson's disease. The controversial approach uses virus particles to infuse new genes into a patient's own cells. The goal of the therapy is to provide patients' cells with the blueprints to make proteins that have a therapeutic effect. In this case, the blueprint encoded an enzyme called GAD that would act like a chemical form of deep-brain stimulation, avoiding the need for electrodes, wires and battery packs.