Tuesday, June 28, 2016

Who will take care of obesity?


Today I was listening to a podcast during which it was established that in general, people are uncomfortable talking about money, sex, and health. I agreed with the "money and sex" part, but considering health as a difficult topic was puzzling. Why not? Why cannot we discuss our health? Is it because (a) it would be equivalent to revealing our vulnerabilities, (b) it would be an admission of a failure of character/will, or (c) we simply do not want to complain?
 

Probably we should have organizations “Obese Anonymous”, “Food Addict Anonymous”, or “Couch Potato Anonymous”. If sugar can be as addictive as smoking, why cannot we have “Sugar Addict Anonymous”? Are alcohol abuse or smoking more frequent causes of death than unhealthy diet and physical inactivity? Even in the developing world, smoking seems to be taking the back seat as a killer when compared to obesity and physical inactivity.  

Why do we feel comfortable when our kids have school lectures on the dangers of alcohol, drugs, and smoking, but not on obesity and inactivity? 

Do our teachers lead by example? Do our medical doctors lead by example? In reality, our docs cannot advise on diet or physical activity, as this is not the knowledge introduced to them in medical school. May be this is why at least 44 percent of the American doctors are overweight or obese.

Also, consider the following fact: after 1953, when it was already published that smoking causes lung cancer, and the causation is beyond any doubt, large numbers of doctors were still unconvinced. 


In 1960, in a poll organised by the American Cancer Society, only a third of all US doctors agreed that cigarette smoking should be considered ‘a major cause of lung cancer’. This same poll revealed that 43% of all American doctors were still smoking cigarettes on a regular basis, with occasional users accounting for another 5%. With half of all doctors smoking, it should come as no surprise that most Americans remained unconvinced of life-threatening harms from the habit.” (The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll. Proctor RN. Tob Control. 2012, 21:87-91).

By the way, an effective and cheap way of quitting smoking has existed for the past 50 years, but it has not been popularized in the U.S., probably because it is too cheap and too effective?

The point of this story is that the medical doctors have rarely been at the forefront of prevention. But could we blame the doctors for not confronting the obesity and promoting healthy dietary habits today? 


Habits are established in childhood. The childhood years should be the focus of any prevention campaign if we want to achieve a major impact.  

Who can accomplish this? The schools? The parents? Special government-led programs for the entire families? 

Do you have any suggestions?

Saturday, June 25, 2016

Thursday, June 23, 2016

All Hail the Immortal!



The small, freshwater hydrozoan animal Hydra appears to be truly immortal.
In ancient Greek myth, the Hydra was a multi-headed monster that grew two more heads for every one that it lost. As it turns out, the real-life animal named after this mythical beast may be even more tenacious.

A new study finds that hydra — spindly, freshwater polyps — can live seemingly forever, without aging.

Unlike most multicellular species, hydra don't show any signs of deteriorating with age, according to the new research, published Dec. 7 in the journal Proceedings of the National Academy of Sciences

Over eight years, the researchers found no evidence of senescence in their coddled hydra. Death rates held constant at one per 167 hydras per year, no matter their age. (The "oldest" animals studied were clones of hydras that had been around for 41 years — though individuals were only studied for eight years, some were biologically older because they were genetic clones.) Likewise, fertility remained constant for 80 percent of the individual hydras over time. The other 20 percent fluctuated up and down, likely because of laboratory conditions.
 
"I do believe that an individual hydra can live forever under the right circumstances," Martinez said.

In the wild, disease, predators and water contamination kill off hydras before they can achieve immortality. But the findings fly in the face of old models that assumed that all animals must decline with age, Martinez said. And that means that studying hydra could help scientists unravel the mystery of why most animals do age.

"I’m hoping this work helps sparks another scientist to take a deeper look at immortality," Martinez said, "perhaps in some other organism that helps bring more light to the mysteries of aging.”
 
The actual paper is here.
Senescence, the increase in mortality and decline in fertility with age after maturity, was thought to be inevitable for all multicellular species capable of repeated breeding. Recent theoretical advances and compilations of data suggest that mortality and fertility trajectories can go up or down, or remain constant with age, but the data are scanty and problematic. Here, we present compelling evidence for constant age-specific death and reproduction rates in Hydra, a basal metazoan, in a set of experiments comprising more than 3.9 million days of observations of individual Hydra. Our data show that 2,256 Hydra from two closely related species in two laboratories in 12 cohorts, with cohort age ranging from 0 to more than 41 y, have extremely low, constant rates of mortality. Fertility rates for Hydra did not systematically decline with advancing age. This falsifies the universality of the theories of the evolution of aging that posit that all species deteriorate with age after maturity. The nonsenescent life history of Hydra implies levels of maintenance and repair that are sufficient to prevent the accumulation of damage for at least decades after maturity, far longer than the short life expectancy of Hydra in the wild. A high proportion of stem cells, constant and rapid cell turnover, few cell types, a simple body plan, and the fact that the germ line is not segregated from the soma are characteristics of Hydra that may make nonsenescence feasible. Nonsenescence may be optimal because lifetime reproduction may be enhanced more by extending adult life spans than by increasing daily fertility.

Obviously, the mechanisms of immortality (or as scientists would call it “nonsenescence”) for Hydra are not directly applicable to interventions designed to retard the human aging process. However, the benefit of basic science research such as this is that it can lead to novel, sometimes, unexpected, directions, can promote work in other species, and can lead to innovative discovered that may, eventually, directly or indirectly affect human health. So, no, humans cannot have “a high proportion of stem cells, constant and rapid cell turnover, few cell types, a simple body plan, and…[a] germ line is not segregated from the soma;” nevertheless, further investigation into the Hydra and other relevant mechanism may someday help unlock the key to inhibition of senescence in humans, leading to longer and healthier lives.

Saturday, June 18, 2016

Pointing fingers does not work – in everyday life or in cancer treatment


We all know how the ritual of pointing fingers starts after a somewhat-preventable disaster strikes. However, identifying the culprits does not reverse the disaster.

In the past 20 years or so, “pointing fingers” has also been our major strategy against cancer. The prevalent notion is that we can deal with cancer by pointing out at the mutations that contribute to abnormal cell development. The eureka moment goes like this “AH, IT IS THE MUTATION IN THE GENES X, Y, and/or Z that causes cancer.” This realization is followed by the design of a compound against the mutant X, Y or Z products. Does it work? To be fair, the strategy works sometimes. In most cases, however, the strategy yields return only for the drug company. Why?


1. The approach is this of management of the disease, but not cure of the disease (usually).

2. Each cancer patient has a unique combination of gene mutations causing cancer.

3. With time, each cancer changes its mutation profile (this is known as the "evolution" of cancer). If at the beginning of the treatment the mutations are X, Y, and Z, by the end of the treatment there could be newly identified mutations Z, W, and D. The outcome? The patient dies, the pharmaceutical company profits, and the patient’s family might be financially broke.


What is wrong with this picture


Everything!

Before any disaster strikes and before we reach the stage of pointing fingers, there is a period, when the potential for a disaster could be evaluated and if high, could be addressed.


Cancer is not different from other disasters. There are risk factors we can eliminate and signals that we can detect BEFORE CANCER STRIKES.


P.S. As I was writing this post, it was confirmed that in the next 4 years $240 million tax payers money will be spent on sequencing 200,000 human genomes. The goal is to identify genes that modulate our risk of diabetes, heart disease, and autism.  I am still waiting to hear about an anti-obesity program funded as generously as this sequencing project. Perhaps, decreasing obesity makes no sense, since we already know that obesity is the major cause of all rampant chronic conditions in this country, including heart disease, diabetes, and cancer?