What does “dead” mean?

Should death be defined in strictly biological terms — as the body’s failure to maintain integrated functioning of respiration, blood circulation, and neurological activity? Should death be declared on the basis of severe neurological injury even when biological functions remain intact? Or is it essentially a social construct that should be defined in different ways?

❝ These are among the wide-ranging questions explored in a new special report, “Defining Death: Organ Transplantation and the Fifty-Year Legacy of the Harvard Report on Brain Death,”…The special report is a collaboration between The Hastings Center and the Center for Bioethics at Harvard Medical School.

Sometimes, these days, I think of death and dying. Some of us must. The old ones. I think of Dylan Thomas. I must needs think of science. Most of me pretty worn; but, I may provide a jot of knowledge simply for what I have experienced and survived.

And, now, a gluten-free moment or two…

Reporter Vivien Williams discusses gluten with Dr. Joseph Murray

The Celiac Disease Foundation wants to make the process of going gluten-free easier for people with celiac disease, an autoimmune disease. Mayo Clinic experts agree that people with celiac disease should not consume gluten. But, many people who don’t have celiac disease also go gluten-free, because it makes them feel better. Dr. Joseph Murray says for that group, gluten may not be the issue.

In addition:

…Most of the people who reach for gluten-free products don’t have celiac disease and or even a sensitivity to wheat, Peter H.R. Green, MD, director of the Celiac Disease Center at Columbia University, told WebMD. “The market for gluten-free products is exploding. Why exactly we don’t know. Many people may just perceive that a gluten-free diet is healthier.”

In fact, it isn’t. For people with celiac disease, a gluten-free diet is essential. But for others, “unless people are very careful, a gluten-free diet can lack vitamins, minerals, and fiber,” says Green.

Experts estimate that about 1% of Americans have celiac disease. The condition, caused by an abnormal immune response to gluten, can damage the lining of the small intestine. That, in turn, can prevent important nutrients from being absorbed…

How can you know if you have celiac disease? The only way is to be tested. The first test is typically a blood test that detects antibodies related to an abnormal immune response. If the blood test is positive, a biopsy is performed to confirm inflammation in the lining of the small intestines…

So what’s wrong with the rest of us trying a gluten-free diet a try to see how we feel?

For starters, going gluten-free means saying no to many common and nutritious foods. Gluten is a protein found in wheat, barley, and rye. Gluten also shows up in many whole grain foods related to wheat, including bulgur, farro, kamut, spelt, and triticale (a hybrid of wheat and rye). Some celiac disease experts warn patients to steer clear of oats, as well…

Gluten itself doesn’t offer special nutritional benefits. But the many whole grains that contain gluten do. They’re rich in an array of vitamins and minerals, such as B vitamins and iron, as well as fiber…

If there’s anything lacking in what the average American consumes it is fiber. Eat lots of processed food? You eat damned little fiber.

Many folks who impulsively decide on going gluten-free gain weight, To make new foods palatable, producers add sugar and fat. Two food groups Americans already love. You also may be losing beaucoup minerals and trace elements from whole fiber foods.

Go talk to your doctor, find a nutritionist who has the reputation of being professional – not plugged into this year’s favorite magic bullet. Make certain you’re not wasting money on food that produces nothing more than increased profits for the corporations that specialize in hustling Americans with the latest fad diet.

Hope for reversing type 2 diabetes


Allan Tutty on the beach in SunderlandRobert Ormerod/NYTimes

Many experts believe Type 2 diabetes is an incurable disease that gets worse with time. But new research raises the tantalizing possibility that drastic changes in diet may reverse the disease in some people.

Recently, a small clinical trial in England studied the effects of a strict liquid diet on 30 people who had lived with Type 2 diabetes for up to 23 years. Nearly half of those studied had a remission that lasted six months after the diet was over. While the study was small, the finding offers hope to millions who have been told they must live with the intractable disease…

It is not the first time that people have reversed type 2 diabetes by losing a lot of weight shortly after a diagnosis. Studies have also shown that obese individuals who have bariatric surgery frequently see the condition vanish even before they lose very much weight.

But the new study, published in Diabetes Care, proved the reversal after diet can persist for at least half a year as long as patients keep weight off, and can occur in people who have had the disease for many years.

Another conclusion that losing weight and exercising is good for you.

The researchers followed the participants after they had completed an eight-week low-calorie-milkshake diet and returned to normal eating. Six months later, those who had gone into remission immediately after the diet were still diabetes-free. Though most of those who reversed the disease had had it for less than four years, some had been diabetic for more than eight years.

❝ When Allan Tutty, 57, learned five years ago that he had Type 2 diabetes, he asked health care providers if there was a cure. “It was a case of, look, you’ve got it, deal with it, there’s no cure,” said Mr. Tutty, who manages a home for people with brain injuries in Newcastle.

Later, Mr. Tutty spotted a notice recruiting volunteers for a diabetes study that asked, “Would you like the opportunity to reverse your condition?”

Mr. Tutty said he jumped at the chance, becoming one of 30 men and women ages 25 to 80 to sign up. Mr. Tutty was one of 13 participants whose fasting plasma glucose dropped, and during the six-month follow-up remained below the seven millimole per liter (or 126 milligrams per deciliter) that defines diabetes. Although Mr. Tutty completed the study nearly three years ago, his fasting blood sugars continue to range from 5.2 to 5.6 mmol/L, he said…

Going on a very-low-calorie diet may allow the body to use up fat from the liver, causing fat levels to drop in the pancreas as well. That “wakes up” the insulin-producing cells in the pancreas, normalizing blood glucose levels.

While some previous studies have shown that blood sugars can normalize after significant weight loss, endocrinologists said they were impressed by the persistence of the lower blood sugar levels for months after the diet.

The participants in the Newcastle trial, who ranged from overweight to extremely obese, were told to stop their diabetes medications and start a 600- to 700-calorie-a-day diet, consisting of three diet milkshakes a day at mealtimes and half a pound of nonstarchy vegetables a day.

Mr. Tutty, who weighed about 213 pounds before the trial, lost a little more than 30 pounds, the average weight loss in the trial. The people in the study most likely to respond to the treatment were in their early 50s on average and younger than the nonresponders, and they had had diabetes for fewer years…

Good news is good news even when it hasn’t yet been carried forward to a point when more generalized conclusions may be made.

Good news for many folks in this trial. Especially those who learned a new “normal” diet and maintained exercise.

Americans eat too damn much crap food


Scott Olson/Getty Images

A new study thinks it knows the culprit fueling America’s bad eating habits: ultra-processed foods.

That category includes foods like frozen pizzas, breakfast cereals, and fizzy sodas. Researchers at Tufts University and the University of Sao Paulo analyzed the eating habits of more than 9,000 Americans and concluded that about 58 percent of the average American’s calories come from ultra-processed foods every day.

The study, which was published in the medical journal BMJ Open, drew findings from in-depth interviews with the study’s participants, who were asked to recall every item they’d eaten over a 24-hour period. On average, they consumed about 2,070 calories per day.

In addition to the ultra-processed foods, participants took in about 28 percent of their calories from unprocessed foods, such as eggs, milk, vegetables, or fresh fish. An additional 10 percent came from regular processed foods – items like cheese or cured meat.

But ultra-processed foods carry a particular risk: They contain significant amounts of added sugars, the sweeteners that food production companies artificially add to their products. Overall, ultra-processed foods contribute 90 percent of the added sugars Americans consume each day…

Of course, the problem with this heightened sugar intake is that it makes Americans more likely to be overweight or obese. That, in turn, increases the chances of developing serious health problems like diabetes, heart disease, stroke, and cancer.

If Americans want to cut back on those risks, the researchers conclude, they’ll have to take in a lot less added sugar – which means they’ll need to cut way back on ultra-processed foods.

Here’s a link to the Harvard School of Public Health and a post about added sugars – including all the names camouflaging the real deal.

Tracing the activity of a cancer-fighting component in tomatoes

san-marzano-tomatoes
Click to enlarge

❝Years of research in University of Illinois scientist John Erdman’s laboratory have demonstrated that lycopene, the bioactive red pigment found in tomatoes, reduces growth of prostate tumors in a variety of animal models. Until now, though, he did not have a way to trace lycopene’s metabolism in the human body.

❝”Our team has learned to grow tomato plants in suspension culture that produce lycopene molecules with a heavier molecular weight. With this tool, we can trace lycopene’s absorption, biodistribution, and metabolism in the body of healthy adults. In the future, we will be able to conduct such studies in men who have prostate cancer and gain important information about this plant component’s anti-cancer activity,” said John W. Erdman Jr., a U of I emeritus professor of nutrition…❞

❝In this first study, the team followed lycopene activity in the blood of eight persons by feeding them lycopene labeled with the non-radioactive carbon-13. The researchers then drew blood hourly for 10 hours after dosing and followed with additional blood draws 1, 3, and 28 days later…❞

❝”The results provide novel information about absorption efficiency and how quickly lycopene is lost from the body. We determined its half-life in the body and now understand that the structural changes occur after the lycopene is absorbed,” Erdman explained.

❝”Most tomato lycopene that we eat exists as the all-trans isomer, a rigid and straight form, but in the bodies of regular tomato consumers, most lycopene exists as cis isomers, which tend to be bent and flexible. Because cis-lycopene is the form most often found in the body, some investigators think it may be the form responsible for disease risk reduction,” Nancy Engelmann Moran explained.

❝”We wanted to understand why there is more cis-lycopene in the body, and by mathematically modeling our patients’ blood carbon-13 lycopene concentration data, we found that it is likely due to a conversion of all-trans to cis lycopene, which occurs soon after we absorb lycopene from our food,” she added…❞

❝The plant biofactories that produce the heavier, traceable lycopene are now being used to produce heavier versions of other bioactive food components…Right now, though, the Illinois-Ohio State team is excited about the new information the lycopene study has yielded. “In the future, these new techniques could help us to better understand how lycopene reduces prostate cancer risk and severity. We will be able to develop evidence-based dietary recommendations for prostate cancer prevention,” Erdman said.❞

Once again, I offer special thanks to the Italian half of my family for continuing the Mediterranean diet they grew up with – after they came to these shores. Passing it along to my mother, to my generation, born here.

Americans are finally eating less – Phew!

After decades of worsening diets and sharp increases in obesity, Americans’ eating habits have begun changing for the better.

Calories consumed daily by the typical American adult, which peaked around 2003, are in the midst of their first sustained decline since federal statistics began to track the subject, more than 40 years ago. The number of calories that the average American child takes in daily has fallen even more — by at least 9 percent.

The declines cut across most major demographic groups — including higher- and lower-income families, and blacks and whites — though they vary somewhat by group.

In the most striking shift, the amount of full-calorie soda drunk by the average American has dropped 25 percent since the late 1990s.

As calorie consumption has declined, obesity rates appear to have stopped rising for adults and school-aged children and have come down for the youngest children, suggesting the calorie reductions are making a difference.

The reversal appears to stem from people’s growing realization that they were harming their health by eating and drinking too much. The awareness began to build in the late 1990s, thanks to a burst of scientific research about the costs of obesity, and to public health campaigns in recent years.

The encouraging data does not mean an end to the obesity epidemic: More than a third of American adults are still considered obese, putting them at increased risk of diabetes, heart disease and cancer. Americans are still eating far too few fruits and vegetables and far too much junk food, even if they are eating somewhat less of it, experts say.

But the changes in eating habits suggest that what once seemed an inexorable decline in health may finally be changing course. Since the mid-1970s, when American eating habits began to rapidly change, calorie consumption had been on a near-steady incline.

RTFA for lots more: details, trend, suggestions, analyses, food for thought as well as the foodie in us all. Long, detailed, enjoyable chunk of information.

Of course, if the Koch Bros bought Kraft Foods – instead of Warren Buffett – you could be certain their lobbyists would have Congressional Republicans denying the existence of calories, declaiming any thought of Americans responsible for weight gain under any circumstances. The NRA would require members to increase their uptake of candy bars. Every family values hustle this side of Colorado Springs would add a cooking show to their TV lineup featuring coconut cream frosting on everything from hot dogs to your morning coffee.

Addicted to soda? You don’t need to be obese to acquire diabetes

Regular consumption of sugary drinks was linked to onset of type 2 diabetes independent of obesity, and fruit juices and no-calorie artificially sweetened drinks didn’t appear to be any healthier, in a new review.

Looking at 17 cohorts and more than 38,000 cases, researchers found that higher consumption of sugar-sweetened beverages was associated with an 18% increase in incidence of type 2 diabetes…per one serving a day. And when they adjusted for obesity, there was still a 13% increase…over those who drank no sugary drinks, found the researchers, who were led by Fumiaki Imamura, PhD, at the University of Cambridge in the UK…

There is indeed a wealth of existing evidence that soft drinks can significantly increase risk of diabetes. But Imamura and colleagues wrote that it wasn’t clear if the risk is present independent of obesity status, and in an email to MedPage Today he wrote that this is what spurred him to do the study.

“We identified a lack of clear evidence to tell if soft drinks elevate the risk of diabetes, regardless of obesity status,” he wrote. “This lack of evidence attracted us, and we thought the evidence would help further the ongoing policy debate.”

The relative risk of diabetes for artificially sweetened beverage consumption was 1.25…in ten studies. Independent of obesity, the number dropped to 1.08…

And for fruit juice, the risk ratio was 1.05…in 13 studies after adjustment and 1.07…independent of obesity.

Imamura said that it’s natural for people to look for alternatives to sugar sweetened beverages. “Diet drink and fruit juice are possible options, though there was no strong summary evidence for each,” he wrote. “We wanted to address the question of the association of consuming each with diabetes before and after accounting for obesity status.” There was some evidence for publication bias in the fruit juice studies.

Nestle added that there wasn’t enough information here to draw definitive conclusions about fruit juice, and that she’d want to see more information about the amounts consumed. “It doesn’t make sense that small amounts of fruit juice would do much of anything (other than providing vitamins),” she wrote. “It’s the large amounts you have to worry about.”…

None of the studies were industry sponsored. “We did not deliberately exclude industry-funded research,” wrote Imamura, but all of the studies that met the criteria were not sponsored by industry. “We wished to see the quality of evidence from government-funded studies and from industry-funded studies, but we could not,” he wrote…

Imamura and his team concluded that soft drinks may contribute to nearly 2 million diabetes cases in the U.S. and the U.K. over 10 years. “But this estimate is under assumption that everyone had the same weight,” he wrote in the email. “If we consider that soft drink consumption contributes to weight gain, the estimate should be higher.”

Keep those fasting glucose levels down, folks. Taste buds aside – and how they’re conditioned by your family and peers – we don’t need a whole boatload of sugar for any reason whatsoever.

Fewer than 15% of US adults eat enough fruits and vegetables

A report from the Centers for Disease Control and Prevention found that most adults in the US consume fewer fruits and vegetables than recommended by the federal government…According to the report, less than 15% of US citizens met their recommended fruit intake, and 8.9% met vegetable recommendations in 2013.

Adults who engage in less than 30 minutes of moderate physical activity each day should consume between 1.5 and two cups of fruit and two to three cups of vegetables daily, according to federal recommendations.

Fruit and vegetable intake was lowest in the south. In Tennessee, just 7.5% of citizens met the fruit intake recommendation, and in Mississippi, 5.5% of adults ate the recommended portion of vegetables. The highest percentages were in California, where 17.7% of adults consumed the recommended portion of fruit.

The study’s lead author, Latetia V Moore of the…CDC, said the low numbers were tied to socioeconomic factors, as well as convenience…“It has to do with convenience, affordability, palatability,” Moore said. “It’s making sure fruits and vegetables are conveniently priced and convenient to access.”

How about intellectual laziness?

Moore and the report’s co-authors studied data from the…survey of 373,580 people across all 50 states and Washington DC. The survey asked people about the frequency of their fruit and vegetable intake, and took personal characteristics such as ethnicity, age and income into account.

Researchers compared survey results with recommendations from the Dietary Guidelines for Americans, which measured intake by number of cups rather than frequency…

Fruit and vegetable intake can be tied to heart disease and stroke. The study was focused on American adults, but Moore said she is starting to see a shift toward incorporating healthier foods into children’s diets.

I don’t care what the motivation may be. Changing your diet, upgrading to thoughtful, up-to-date nutritional standards ain’t expensive or difficult. Costs increase if you try to move to a completely organic diet plus availability is more likely to be a problem in some communities. But, do some reading online, folks. There’s a great deal of commercially-produced fruit and veggies that haven’t any notable risk associated with “conventional” foodstuffs.

My experience is that many thoughtful market chains that carry both also take a great deal of care with the quality and safety of that so-called conventional food.

From the pages of IMPROBABLE RESEARCH

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Dr. Pravin Jaiprakash Gupta, MS, FICS, FAIS, FASCRS, FACS of the Fine Morning Hospital and Research Center, Laxminagar, Nagpur, India, presents, in the journal Digestive Surgery, Vol. 24, No. 5, 2007, a paper entitled : Red Hot Chilli Consumption Is Harmful in Patients Operated for Anal Fissure – A Randomized, Double-Blind, Controlled Study.

“Patients were randomly assigned to receive analgesics and fiber supplement alone (control patients) or consumption of 1.5 g chilli powder twice daily along with identical fiber and analgesics (chilli group). “

“Conclusion: This study shows that consumption of red chillies after anal fissure surgery should be forbidden to avoid postoperative symptoms.”

Note: Dr. Gupta is also known for his invention — “A surgical device which is called as radiowave gun handle was named after him as ‘Pravin Gupta Procto Gun’ by the famous USA company Ellman International Inc.”

Anyone living where the state question is “red or green?” knows the answer to this study well in advance. You only have to make a mistake like this once to remember the result for the rest of your life.

Note: Everyone in New Mexico has their personal favorites. The illustration at right is mine. Try it on a sandwich of leftover roast pork for a breakfast treat.

1 in 4 Americans with diabetes don’t know they have it

Three million more people have been diagnosed with diabetes since the Centers for Disease Control and Prevention last took count in 2010. That brings the total number of Americans with diabetes to a whopping 29 million…Though large, the numbers aren’t all that surprising; the rates of diabetes 1 and 2 have been rising for several years now.

But the 29 million figure, featured in a CDC report published this week, is just the people who have been diagnosed. Many more likely have the disease but are unaware — and undiagnosed.

The CDC estimates that of the estimated 12.3 percent of the adult population with diabetes, one in four don’t know they have it. That’s not to mention some 86 million people who have prediabetes, 15 to 30 percent of whom the CDC says will develop type 2 diabetes within five years…

The resulting medical complications from diabetes and prediabetes total more than $245 billion in healthcare costs each year.

The CDC’s Ann Albright says one of the only ways Americans can chip away at these worrisome trends is to improve dietary habits. Even those with prediabetes can avoid the fate of an official diabetes diagnosis by making simple changes, like losing weight and eating healthier.

“Some of the strongest evidence suggests that small changes — like losing 5 to 7 percent of your body weight if you’re overweight — can make the biggest difference,” Albright explained.

“Invest in foods that are nutritious,” Albright added, “like fruits, vegetables, and whole grains.”

I probably qualify as prediabetic – though much less so than I used to. A couple of sedentary gigs last few years before retirement left me a lot heavier and getting less exercise than was customary most of my life. Fortunately, my better half does a serious job of encouraging not only sounder nutrition; but, more exercise. I grew new habits as simple as portion control, deriving self-satisfaction from managing a small and useful part of diet oversight.

Steadily, consistently, I lose about 6 pounds a year. Have been for about a decade.

I don’t understand people who whine that a healthy diet is twice as expensive as fast food. Yes, it’s difficult if you’re living on the road as I did for a number of years. But, if you’re home for breakfast and supper, you’re sensible enough to brown bag it for lunch – we ain’t all organic; but, we also spend less on food than we did even a few years ago. And, nowadays, I’m home at lunchtime which allows for a hot meal prepared by me.

Here’s a link to the CDC’s report [.pdf]. Graphic, simple, useful.