HELP NEEDED THIS WEEKEND I need the following text translated into YOUR language asap! If you are one of the regular readers of this blog, please email me with a translation of the following, all in lower case.
Until about two years ago, the story went something like this: calorie restriction extends lifespan in yeast, worms, flies, and rodents. Lifespan extension by calorie restriction appears to be biologically universal, therefore it's probably only a matter of time until it's demonstrated in humans as well. More than 20 years ago, independent teams of researchers set out to demonstrate the phenomenon in macaque monkeys, a primate model closer to humans than any lifespan model previously tested.
Recent findings have caused me to seriously question this narrative. One of the first challenges was the finding that genetically wild mice (as opposed to inbred laboratory strains) do not live longer when their calorie intake is restricted, despite showing hormonal changes associated with longevity in other strains, although the restricted animals do develop less cancer (1). One of the biggest blows came in 2009, when researchers published the results of a study that analyzed the effect of calorie restriction on lifespan in 41 different strains of mice, both male and female (2). They found that calorie restriction extends lifespan in a subset of strains, but actually shortens lifespan in an even larger subset. Below is a graph of the effect of calorie restriction on lifespan in the 41 strains. Positive numbers indicate that calorie restriction extended life, while negative numbers indicate that it shortened life:
This week the Kings Fund published its report on health inequalities citing what we probably knew in our heart-of-hearts: the poorer you are, the worse your life expectancy: the wealthier you are, the more likely you are to have followed government advice on reducing dangerous lifestyles - thus you’ll live longer. So this isn’t wind-surfing and abseiling we’re talking about, but what you eat, drink and puff on - and if you spend your days sat on the sofa soaking up daytime TV and playing on the computer. It seems that the public health messages have been driven home successfully to those already interested in their health, but people who are disengaged for whatever reason (poverty?) will statistically die earlier.
Over this same period, we’ve had two rather tragic legal cases being played out in the media: that of Tony Nicklinson who wanted to choose how and when he died, and more importantly, he fought for the legal right to end his life and make any doctor that helped him be immune from prosecution. The other story is that of the anonymous Mr L from Greater Manchester who reportedly is in a persistent vegetative state following a series of heart attacks, and is being cared for by Pennine Acute Hospitals NHS Trust who feel that it’s in his best interest not to be resuscitated, if he succumbs to infection, further heart attack or stroke. However, his family want to prolong his life, whatever the quality, for as long as possible. What a terrible situation. These painful cases illustrate the need to discuss the manner in which we die, much earlier in our lives and as a society, we seem loath to ever discuss the manner of our deaths, until we are in a terminal health crisis. Even sadder, is that following the High Court’s rejection of Tony Nicklinson’s case, he gave up his fight and succumbed to pneumonia.
It seems a whole-life approach to talking about death and dying could be easily achieved through the introduction of something very similar to a Birth Plan, which expectant mothers routinely develop with their partner and midwives. Wouldn’t something similar in the manner of an Advanced Directive, be a simple and useful resource to develop? Could Health Visitor’s and Palliative Care Nurse’s be a more visible part of this conversation, earlier in our lives?
Admittedly, this doesn’t take into account the political and social ramifications of assisted dying, voluntary euthanasia, or more generally our right to die in a manner and at a time of our choosing, but nevertheless it introduces and normalises conversations about life and death - something to which we seem culturally divorced from.
I’m pleased to say I’ll be working with a new Arts for Health intern for 12 months alongside MA Contemporary Curating, and we’ll be exploring some of these very issues: issues which I began to discuss in relation to culture and the arts last year, in my opening paper; Towards Sentience, at the 4th International Arts and Health Conference at the National Gallery of Australia. We’ll be holding an exhibition here at The Holden Gallery in July 2013, which will be accompanied by a series of events and discussions, and is being developed under the working title of ‘Imagining Death’.
Inequalities & death - blimey, seems insurmountable doesn’t it? Well, death certainly is, but inequalities, quality of life and the manner in which we die are something we can most definitely have some control over. Whilst we struggle blindly to make sense of seemingly immovable inequalities, we miss their connection to poverty of aspiration and wide-spread disillusionment at politics; we miss the connection to apathy and blind acceptance of inequalities. The Bank of England’s Quantitative Easing has helped the wealthier citizens of the UK markedly, but has been invisible to the majority of us - unacceptable. Poorer people die earlier than wealthier people? Sorry - this is outrageous.
Quantitative Easing is having limited impact on the austerity we’re all facing, the Kings Fund have illustrated the failure of policy to impact on the poorest in the UK, our high streets are increasingly boarded-up; grocers, bakers and butchers being replaced by fast-food outlets, betting shops, coffee chains and mobile-phone and charity shops. The banks and building societies seem to be surviving, albeit in a fortified manner, but other than the proliferation of increasing necessary charity shops, our high streets represent something of the 21st century drug peddler. There’s no shortage of plasma screens for our telephone-based talent shows; computer games to feed our short attention span; alcopops, caffeine and fried gizzards. All you can eat for £2.99 - not bad eh? Short cut to a state sponsored short life...
I worry that some of the blindingly superb work of arts/health practitioners/projects, whilst cushioning and supporting marginalised and displaced individuals, frequently fails to engage the very same people - often miraculously turned around, in engagement with the political process. What we do so unequivocally, is enable people to grow and thrive - give people a voice - but doesn’t this singular voice need to be connected to that of others? If we are meaningfully lifting people from isolation, depression or giving voice to people affected by homelessness - what next: just put them right back into a system that feeds on such divisions? How can we connect our practice and facilitate real change? Well for a start, we can acknowledge that both our health and wellbeing, and the arts, are political.
So, as an antidote to all this, and with our home-spun Olympian NHS Saviour in mind, Danny Boyle, lets remind ourselves of his interpretation of the Irvine Welsh novel Trainspotting. The following brief extract from the film, offers something of a poem to our consumer addiction. Be warned though, it is peppered with expletives that are appropriate, but that might offend. Text below and video, by clicking on the film.
Choose Life.
Choose a job. Choose a career. Choose a family. Choose a fucking big television, choose washing machines, cars, compact disc players and electrical tin openers. Choose good health, low cholesterol, and dental insurance. Choose fixed interest mortage repayments. Choose a starter home. Choose your friends. Choose leisurewear and matching luggage. Choose a three-piece suite on hire purchase in a range of fucking fabrics. Choose DIY and wondering who the fuck you are on a Sunday morning. Choose sitting on that couch watching mind-numbing, spirit-crushing game shows, stuffing fucking junk food into your mouth. Choose rotting away at the end of it all, pishing your last in a miserable home, nothing more than an embarrassment to the selfish, fucked up brats you spawned to replace yourself.
Choose your future.
Choose life... John Hodge/Irvine Welsh
Volunteering in the Arts Toolkit Launch
You are invited to the launch of the Volunteering in the Arts Toolkit September 10th at the GMCVO centre, Ardwick Green, Manchester. Full details, including how to book can be found by clicking on the ice-cream van.
We have been working with Arts Council England and Volunteering England on the production of the Toolkit. It developed as a result of an audit of Arts Council funded organisations s who currently work with volunteers. The toolkit is aimed at professional arts organisations to support them in the recruitment, management and retention of volunteers with the aim of improving the volunteer experience for both host organisation and volunteer. This really useful resource comes with case studies, guides and a whole range of relevant information including health and safety, safeguarding, working with volunteers on benefits and advice on how to avoid using volunteers as substitutes for paid workers. The toolkit is free and will be downloadable from the Voluntary Arts website.
The State of Arts and Health in England and Further Afield...
In 2009 and alongside colleagues from the field, I contributed to the introductory essay, the State of Arts and Health in England, to Arts and Health: An International Journal for Research, Policy and Practice. Since this paper was written the face of arts/health practice and research has evolved at a fast pace. Taking into account the political landscape of the UK and the ongoing changes within the public sector, I am working with colleagues in Europe to better understand the changing field, and am revisiting this paper. I am particularly keen to hear from you in relation to mapping and research undertaken between 2009 and 2012 and am also keen to hear from international research projects. Please email me directly at artsforhealth@mmu.ac.uk
Networking Event
BANG...out of the blue, a brand new one-off event. No agenda. No guest speaker. Just us having the opportunity to chew the fat, and perhaps hatch some plans! Thursday 27th September 6:00 - 8:00PM. So email artsforhealth@mmu.ac.uk if you want to come along, and the venue at MMU will be emailed to you the week before.
Whilst our the Olympic Games have been and gone, the flame blown out (remember that stirring in your loins, but get ready for the bill) and we’ve had the thrill of the opening corporate celebration of our floundering NHS, (and the gibberish of the closing ceremony - what a platform for Pussy Riot this could have been): what about the Paralympic Games which start on the 29th? I sincerely hope that this won’t be an after-shock, without all the razzmatazz of the ‘main-event’. I wonder too, what mischief our elected and non-elected miscreants will have been up to, whilst our eye’s have been off (or rather on) the ball? So whilst we’re feeling pumped up and patriotic, lets not forget our dear old NHS and that by April 2013, it will have undergone some quite radical changes.
'Healthwatch England will act as a champion for those who sometimes struggle to be heard'
Anna Bradley, Chair of Healthwatch
The new NHS Commissioning Board Special Health Authority (NHS CBA), will be playing a ‘key role in the Government’s vision to modernise the health service and secure the best possible outcomes for patients. Its role is to make all the necessary preparations for the successful establishment of the NHS Commissioning Board (NHS CB) in October 2012 before it takes on full statutory responsibilities in April 2013.’ We will shortly be seeing a flurry of activity around Health and Wellbeing Boards, Clinical Commissioning Groups and the emergence of Healthwatch, which takes over the role of independent ‘consumer champion’ for us, the public. I’d suggest that our arts/health agenda should engage at the highest level with all these groups, and of course, locally. If Healthwatch is to make sure that the views of the public and people who use services are taken into account, I can think of a variety of ways that culture and the arts will be essential to their work - and if they genuinely want to work with people who don’t have a voice and are marginalised, this is an opportunity for the arts to facilitate dialogue.
On 19 July 2012, champion of arts and health, Lord Howarth of Newport again raised a question about our work in the House of Lords, questioning the Government Minister Earl Howe about how we encourage commissioners to invest resources in the arts as a means of improving health. Here are the question and response.
Lord Howarth of Newport: My Lords, as Ministers review the skills needs of the health service, will they take into account the significant contribution that can be made in healthcare settings to recovery and well-being by the arts-music, poetry and reading aloud, for example? Will they signal to healthcare professionals and commissioning bodies that it is legitimate to invest certain resources in the arts and, of course, design in order to promote good health?
Earl Howe:One of the features of the reforms that we have enacted is the ability for allied health professionals, including those mentioned by the noble Lord, to have a say in the planning of services at a local level-health and well-being boards. The value of those activities, rightly emphasised by the noble Lord, will I hope in time be more greatly appreciated as the outcomes framework takes effect, and the patient experience of care becomes more prominent in the way that we assess services.
We should be very aware of the efforts Alan Howarth puts into this agenda, and he has my debt of gratitude for his consistent efforts and enthusiasm. He was in fact, an early respondent to manifesto part one. Here is a reminder of his position.
‘What is at issue is the right each one of us has to be human. To be human is to identify and liberate our own authentic and best nature. That quest will sometimes be private and sometimes be communal, and in the end the one merges into the other as we make the world we inhabit a better place. Trust, arduousness, risk, self-expression, shared work are means of moving towards individual and collective integrity. Teaching and companionship sustain us; orthodoxy and exploitation blight us.
Politics should be predicated on these values.’
I was thrilled to listen to the soundcloud of A.L Kennedy’s wonderful lecture at the launch of the London Creativity and Wellbeing Week at TATE Modern. This is excellent and is well worth taking the time to listen to. Grab a coffee, unplug the phone, click on the image below and take an hour out.
Lloyds TSB Foundation: Programme to Support Older People (England & Wales) The Lloyds TSB has announced a new £2 million funding programme to support projects aimed at improving the lives of older people living in difficult financial circumstances in England and Wales. The funding is open to all registered charities that are currently working with older people particularly those living in financial difficulties; that can demonstrate a track record and knowledge of working with this group of people; and are particularly interested in innovative work and proactive interventions that encourage and support individual empowerment and independence. The minimum grant that eligible organisations can apply for is £50,000 and grants will be available for up to a period of three years. The closing date for submissions is 5pm on the 20th September 2012. Read more at: http://tinyurl.com/d7xvyax
Funding to Tackle Stigma & Discrimination Facing People with Mental Illness (England) Time to Change, a new campaign to end the stigma and discrimination that faces people with mental health problems, has announced its second funding round. Time to Change will provide grants for projects which will change public attitudes and behaviour towards mental health problems. The grants fund will distribute £2.7 million to approximately 75 community projects across England from May 2012-March 2015. All applications should evidence how people with personal experience of mental health problems will be involved in shaping, delivering and managing the project. The grants available range from £10,000 through its small grants programme, to up to £100,000 through the Flagship grants programme. The closing date for applications is 2pm on the 21st September 2012. Read more at: http://www.time-to-change.org.uk/grants
The LankellyChase Foundation has announced the launch of its new grants programme. The LankellyChase Foundation works to bring about change that will transform the quality of life of people who face severe and multiple disadvantages. Through its new grants programme the Foundation wants to form a funded network of 15 to 20 organisations who are working to transform the lives of people who face severe and multiple disadvantages. Read more at: www.lankellychase.org.uk/accessing_funding/funding_opportunities.
Deadline: 14 September 2012 Thank you for following this blog...C.P.
I recently returned from AHS12 and a little side trip to visit family. The conference was hosted at Harvard University through the Harvard Food Law Society. Many thanks to all the organizers who made it happen. By and large, it went smoothly.
The science as expected ranged from outstanding to mediocre, but I was really encouraged by the presence and enthusiastic participation of a number of quality researchers and clinicians. The basic concept of ancestral health is something almost anyone can get behind: many of our modern health problems are due to a mismatch between the modern environment and what our bodies "expect". The basic idea is really just common sense, but of course the devil is in the details when you start trying to figure out what exactly our bodies expect, and how best to give it to them. I think our perspective as a community is moving in the right direction.
The FDA recently approved a new drug called lorcaserin (brand name Belviq) for the treatment of obesity. Lorcaserin causes an average of 13 lbs (5.8 kg) of weight loss over a year, compared to 5 lbs (2.2 kg) for placebo (1), which is less than the other recently approved drug Qsymia (formerly Qnexa; topiramate/phentermine).
Learning about obesity drugs is always a good opportunity to gain insight into the mechanisms that underlie the development and reversal of obesity. If you've been following this blog for a while, you already have a pretty good guess what organ this new drug acts on. Make your guess and read on!
OK...it’s time that this blog took a moment to rest, to reflect on the very nature of life. There will be a short intermission whilst Arts for Health pulls down the blinds and shuts up shop for a couple of weeks. Tiaras and tears will be on plentiful display on the streets of our empty capital.
This year has seen the highest number of hits this modest blog receives, with new friends emerging from the unlikeliest of countries. To those of you who quietly read these pages, I hope you find this work interesting and occasionally, entertaining: and for those of you who go on to get in touch, thank you. One or two of you, I feel lucky enough to call friends - so a big thank you to you.
This field we call Arts for Health; Arts in Health or Arts and Health is expanding and contracting - evolving right before our eyes. Its flexing its muscles too. Those in the wider cultural sector are getting it - realising that if the work’s done well, it can have a profound reach and impact. And then there are those exhilarating health practitioners, who’ve always got it, and who are now seeing a window of opportunity to assert the place of culture and the arts in the very real world of health and wellbeing. Acute settings, cultural settings, prisons, schools, on the streets, in shopping centre’s and yes, in theaters and galleries too - this arts and health thing we do, is transforming itself into more diverse and engaged practice - the beating heart of civic societies, that will emerge from the wreckage of our contemporary dystopia.
Lets re-imagine ourselves then: post olympics - post jubilee - post global economic downturn...post dystopia. Its hard, isn’t it? From Robert Montgomery’s poetic attack on consumer culture and Shamsia Hassani’s graffiti on the streets of Kabul, to Pussy Riot’s neutering by an oppressive government - the arts offer critique of the status quo and give voice to frustration and anger, offering a thousand new opportunities of possible futures. Our wellbeing is at stake if we fail to understand the relevance of culture and the arts in relation to wider social and political agendas. Goodbye for now, enjoy life...and a lovely summer song.
By Dr. Hans-Rudolf Berthoud, from a recent paper, "The Neurobiology of Food Intake in an Obesogenic Environment" (1). I came across it because it cites my review paper (2). My perspective on obesity is similar to his. From the abstract:
The modern lifestyle with its drastic changes in the way we eat and move puts pressure on the homoeostatic system responsible for the regulation of body weight, which has led to an increase in overweight and obesity. The power of food cues targeting susceptible emotions and cognitive brain functions, particularly of children and adolescents, is increasingly exploited by modern neuromarketing tools. Increased intake of energy-dense foods high in fat and sugar is not only adding more energy, but may also corrupt neural functions of brain systems involved in nutrient sensing as well as in hedonic, motivational and cognitive processing.
