To read Clive Parkinson's paper on Big Society, go to: http://www.nalgao.org/e107_images/custom/aahseptfinal1b.pdf
Arts at the Heart feature on Big Society
To read Clive Parkinson's paper on Big Society, go to: http://www.nalgao.org/e107_images/custom/aahseptfinal1b.pdf
RAMBERT DANCE: AWAKENINGS
Much of the arts and health movement is concerned with the instrumental impact of the arts, with organisations like Arts for Health striving to engage marginalised communities in creative and cultural activity that might impact on well-being. There is ample evidence that illustrates engaging in the arts not only improves physical and mental health, but the very act of bringing people together provides something of the civic glue to healthy communities.
The implicit impact of the arts in relation to health and well-being however, is harder to define. Many interesting studies illustrate that the theatre and gallery-going public are more likely to be the educated middle-classes, and that people marginalised by issues such as mental ill-health are far less likely to participate in cultural opportunities because of broad ranging social and economic barriers.
For someone with limited experience of contemporary dance, an invitation to the Lowry to watch a new piece of dance being premiered could have made for a challenging evening. The Lowry was full to capacity for this premiere of Rambert Dance Company’s interpretation of the work of Dr Oliver Sacks, Awakenings, already made famous by the Hollywood film of the same name,
As its stimulus, Awakenings, uses the true story of a group of patients affected by sleeping sickness following the 1918 flu pandemic. Through the prescription of the drug L-Dopa, the patients who had been in a catatonic state for decades become suddenly animated, but the drug’s effects are short lived and this brief period of lucidity is marred by seizures and delirium, with patients ultimately slipping back into a twilight world.
This performance visually and physically captures the passage of treatment, from the liberation of symptoms to the subsequent relapse of the patients. For the audience and dancers, the music replaces the drug L-Dopa and offers us the opportunity to connect viscerally to the isolated and disjointed worlds of the individuals affected by this strange sleeping sickness.
The unpredictability of the tics and twitches of this condition were made manifest by the dancers as they entered, walking backwards onto the stage, as if wary and watchful of their condition. Suddenly, we would see their bodies contract in spasm, accompanied by spikes of music. In contrast were the darker moments, when a percussive thrum reflected the depressive slump of the patients; the dancer’s bodies heavy with the burden of this illness.
There was a real sense of tension in the audience, watching people dressed as if for work on a summer’s day on Madison Avenue, literally frozen in their tracks, as they made their way to or from their destination. We had the impression that they were locked into a world entirely within them-selves and that all they could do was to observe the effects of the condition as it took over them.
On the empty stage, the elegantly dressed and beautifully lithe performers made visible something of the internal landscape of the patients they inhabited. But what relevance to this arts and health agenda is there?
Having worked with a wide range of communities who believe that the ‘high-arts’ have nothing to do with them, I’m aware that dance or ballet is often dismissed as inaccessible to people who haven’t experienced it. I am often looking for ways to describe disease, illness or concepts of well-being and frequently words are insufficient. What I crave are universal metaphors that reach out beyond the confines of language or cultural experience and beyond the common assumptions that status is a barrier to appreciating subtle or complex ideas.
It would be easy to argue that Awakenings was very unambiguous and without a need for tricky interpretation or you may share my view, that this visceral manifestation of what it is to be human and to have free will, only for that free will be taken away, makes both fluid and solid the potential and frustration that our fleeting experience of life offers.
It would be easy to argue that Awakenings was very unambiguous and without a need for tricky interpretation or you may share my view, that this visceral manifestation of what it is to be human and to have free will, only for that free will be taken away, makes both fluid and solid the potential and frustration that our fleeting experience of life offers.
Potatoes and Human Health, Part II
Glycoalkaloids in Commonly Eaten Potatoes
Like many edible plants, potatoes contain substances designed to protect them from marauding creatures. The main two substances we're concerned with are alpha-solanine and alpha-chaconine, because they are the most toxic and abundant. Here is a graph of the combined concentration of these two glycoalkaloids in common potato varieties (1):
We can immediately determine three things from this graph:
Glycoalkaloid Toxicity in Animals
Potato glycoalkaloids are undoubtedly toxic at high doses. They have caused many harmful effects in animals and humans, including (1, 2):
All of the studies I mentioned above, except one, involved doses of glycoalkaloids that exceed what one could get from eating typical potatoes. They used green or blemished potatoes, isolated potato skins, potato sprouts or isolated glycoalkaloids (more on this later). The single exception is the last study, showing that normal doses of glycoalkaloids can aggravate inflammatory bowel disease in transgenic mice that are genetically predisposed to it (3)*.
What happens when you feed normal animals normal potatoes? Not much. Many studies have shown that they suffer no ill effects whatsoever, even at high intakes (1, 2). This has been shown in primates as well (4, 5, 6). In fact, potato-based diets appear to be generally superior to grain-based diets in animal feed. As early as 1938, Dr. Edward Mellanby showed that grains, but not potatoes, aggravate vitamin A deficiency in rats and dogs (7). This followed his research showing that whole grains, but not potatoes, aggravate vitamin D deficiency due to their high phytic acid content (Mellanby. Nutrition and Disease. 1934). Potatoes were also a prominent part of Mellanby's highly effective tooth decay reversal studies in humans, published in the British Medical Journal in 1932 (8, 9).
Potatoes partially protect rats against the harmful effects of excessive cholesterol feeding, when compared to wheat starch-based feed (10). Potato feeding leads to a better lipid profile and intestinal short-chain fatty acid production than wheat starch or sugar in rats (11). I wasn't able to find a single study showing any adverse effect of normal potato feeding in any normal animal. That's despite reading two long review articles on potato glycoalkaloids and specifically searching PubMed for studies showing a harmful effect. If you know of one, please post it in the comments section.
In the next post, I'll write about the effects of potatoes in the human diet, including data on the health of traditional potato-eating cultures... and a curious experiment by the Washington State Potato Commission that will begin on October 1.
*Interleukin-10 knockout mice. IL-10 is a cytokine involved in the resolution of inflammation and these mice develop inflammatory bowel disease (regardless of diet) due to a reduced capacity to resolve inflammation.
Like many edible plants, potatoes contain substances designed to protect them from marauding creatures. The main two substances we're concerned with are alpha-solanine and alpha-chaconine, because they are the most toxic and abundant. Here is a graph of the combined concentration of these two glycoalkaloids in common potato varieties (1):
We can immediately determine three things from this graph:- Different varieties contain different amounts of glycoalkaloids.
- Common commercial varieties such as russet and white potatoes are low in glycoalkaloids. This is no accident. The glycoalkaloid content of potatoes is monitored in the US.
- Most of the glycoalkaloid content is in the skin (within 1 mm of the surface). That way, predators have to eat through poison to get to the flesh. Fortunately, humans have peelers.
Glycoalkaloid Toxicity in Animals
Potato glycoalkaloids are undoubtedly toxic at high doses. They have caused many harmful effects in animals and humans, including (1, 2):
- Death (humans and animals)
- Weight loss, diarrhea (humans and animals)
- Anemia (rabbits)
- Liver damage (rats)
- Lower birth weight (mice)
- Birth defects (in animals injected with glycoalkaloids)
- Increased intestinal permeability (mice)
All of the studies I mentioned above, except one, involved doses of glycoalkaloids that exceed what one could get from eating typical potatoes. They used green or blemished potatoes, isolated potato skins, potato sprouts or isolated glycoalkaloids (more on this later). The single exception is the last study, showing that normal doses of glycoalkaloids can aggravate inflammatory bowel disease in transgenic mice that are genetically predisposed to it (3)*.
What happens when you feed normal animals normal potatoes? Not much. Many studies have shown that they suffer no ill effects whatsoever, even at high intakes (1, 2). This has been shown in primates as well (4, 5, 6). In fact, potato-based diets appear to be generally superior to grain-based diets in animal feed. As early as 1938, Dr. Edward Mellanby showed that grains, but not potatoes, aggravate vitamin A deficiency in rats and dogs (7). This followed his research showing that whole grains, but not potatoes, aggravate vitamin D deficiency due to their high phytic acid content (Mellanby. Nutrition and Disease. 1934). Potatoes were also a prominent part of Mellanby's highly effective tooth decay reversal studies in humans, published in the British Medical Journal in 1932 (8, 9).
Potatoes partially protect rats against the harmful effects of excessive cholesterol feeding, when compared to wheat starch-based feed (10). Potato feeding leads to a better lipid profile and intestinal short-chain fatty acid production than wheat starch or sugar in rats (11). I wasn't able to find a single study showing any adverse effect of normal potato feeding in any normal animal. That's despite reading two long review articles on potato glycoalkaloids and specifically searching PubMed for studies showing a harmful effect. If you know of one, please post it in the comments section.
In the next post, I'll write about the effects of potatoes in the human diet, including data on the health of traditional potato-eating cultures... and a curious experiment by the Washington State Potato Commission that will begin on October 1.
*Interleukin-10 knockout mice. IL-10 is a cytokine involved in the resolution of inflammation and these mice develop inflammatory bowel disease (regardless of diet) due to a reduced capacity to resolve inflammation.
We’ve heard a lot about Big Society over the last few months, but what does it mean for the Arts/Health agenda in the North West?
We’re planning an event at Manchester Metropolitan University on the 29th October 2010.
This will follow on from last years North West Frontier, where health professionals, artists and other actors from the field fed into the start of a regional/sub-regional conversation around inequalities, the arts, health and well-being.
Aspirations from this event included; networking opportunities; access to wider networks and knowledge; training and advocacy.
We also discussed a strategic framework for the region, but with government changes, ongoing structural changes across all sectors and now vicious cuts, creating another strategy seems a futile exercise.
Following feedback from the networking sessions and dialogue across the region, what we’d be interested in doing is spending time together and creatively pulling together a Manifesto for Arts/Health across the region.
So this isn’t necessarily about frameworks, bullet-points and strategy; but it will be a statement about shared vision, passion, commitment and possibility that we and key allies can sign up to.
If you want to take part, places will be very limited and details will be forthcoming, but for now email artsforhealth@mmu.ac.uk to express your interest in taking part.
We’re planning an event at Manchester Metropolitan University on the 29th October 2010.
This will follow on from last years North West Frontier, where health professionals, artists and other actors from the field fed into the start of a regional/sub-regional conversation around inequalities, the arts, health and well-being.
Aspirations from this event included; networking opportunities; access to wider networks and knowledge; training and advocacy.
We also discussed a strategic framework for the region, but with government changes, ongoing structural changes across all sectors and now vicious cuts, creating another strategy seems a futile exercise.
Following feedback from the networking sessions and dialogue across the region, what we’d be interested in doing is spending time together and creatively pulling together a Manifesto for Arts/Health across the region.
So this isn’t necessarily about frameworks, bullet-points and strategy; but it will be a statement about shared vision, passion, commitment and possibility that we and key allies can sign up to.
If you want to take part, places will be very limited and details will be forthcoming, but for now email artsforhealth@mmu.ac.uk to express your interest in taking part.
Speaking at Wise Traditions 2010
I'm happy to announce that I'll be presenting at the Weston A. Price foundation's 2010 Wise Traditions conference. The conference will be held in King of Prussia, Pennsylvania, Nov 12-14. The theme is the politics of food.Sally Fallon Morell has invited me to give a talk on the diet and health of Pacific islanders. The talk will be titled "Kakana Dina: Diet and Health in the Pacific Islands", and it will take place on Sunday, November 14th from 4:00 to 5:20 pm. In preparation for the talk, I've read eight books and countless journal articles. Although some of the material will be familiar to people who follow the blog, I will not be rehashing what I've already published. I have nearly an hour and a half to talk, so I'll be going into some depth on the natural history and traditional food habits of Pacific island populations. Not just macronutrient breakdowns... specific foods and traditional preparation methods.
Learn about the health of traditional Pacific island populations, and what has changed since Western contact. Learn about traditional cooking and fermentation techniques. See unpublished photos from the Kitava study, courtesy of Dr. Staffan Lindeberg. Learn about the nutritional and ceremonial role of mammals including pork... and the most gruesome food of all.
I hope to see you there!
Kitava photo courtesy of Dr. Staffan Lindeberg
Dogen Zenji on Nutritionism
Dogen Zenji was the man who brought the Soto lineage of Zen Buddhism to Japan. He was a prolific writer, and many of his texts are respected both inside and outside the Soto Zen community. Last week, my Zen group was discussing the Genjo Koan, one of his works that is frequently used as a chant. Here's an excerpt. It may seem cryptic but bear with me:
...when you sail out in a boat to the middle of an ocean where no land is in sight, and view the four directions, the ocean looks circular, and does not look any other way. But the ocean is neither round or square; its features are infinite in variety... It only look circular as far as you can see at that time. All things are like this.Though there are many features in the dusty world and the world beyond conditions, you see and understand only what your eye of practice can reach. In order to learn the nature of the myriad things, you must know that although they may look round or square, the other features of oceans and mountains are infinite in variety; whole worlds are there. It is so not only around you, but also directly beneath your feet, or in a drop of water.
What Dogen meant, among other things, is that the world is much more complex than what our conscious minds can perceive or understand. It was true in the 13th century, and it's still true today, despite our greatly expanded understanding of the natural world.
We can apply this principle to nutrition. For example, what is red palm oil? Two hundred years ago, perhaps we only knew a few basic facts about it. It's a fat, it's red, it comes from an African palm fruit and it has a particular melting point and flavor. Then we learned about vitamins, so we knew it contained vitamin E, carotenes (provitamin A), and vitamin K. Then fatty acid composition, so we found out it's mostly palmitic and oleic acids. Now we know red palm oil contains an array of polyphenols, sterols, coenzyme Q10 and many other non-essential constituents. We don't know much about the biological effects of most of these substances, particularly in combination with one another.
Add to that the fact that every batch of red palm oil is different, due to strain, terroir, processing, storage, et cetera. We know what the concept "red palm oil" means, roughly, but the details are infinitely complex. Now feed it to a human, who is not only incredibly complex himself, but genetically and epigenetically unique. How can we possibly guess the outcome of this encounter based on the chemical composition of red palm oil? That's essentially what nutritionism attempts to do.
To be fair, nutritionism does work sometimes. For example, we can pretty well guess that a handful of wild almonds containing a lot of cyanide won't be healthy to eat, due at least in part to the cyanide. But outside extreme examples like this, we're in a gray zone that needs to be informed by empirical observation. In other words, what happens when the person in question actually eats the red palm oil? What happened when a large group of people in West Africa ate red palm oil for thousands of years? Those questions are the reason why I'm so interested in understanding the lives of healthy non-industrial cultures.
I'm not criticizing reductionist science or controlled experiments (which I perform myself); I just think they need to be kept in context. I believe they should be interpreted within the framework of more basic empirical observations*.
One of the most important aspects of scientific maturity is learning to accept and manage uncertainty and your own ignorance. Some things are more certain than others, but most aren't set in stone. I think Dogen would tell us to be wary of nutritionism, and other forms of overconfidence.
* Wikipedia's definition of empirical: "information gained by means of observation, experience, or experiment." As opposed to inferences made from experiments not directly related to the question at hand.
The China Study on Wheat
Denise Minger has just put up another great China Study post that's worth reading if you haven't already. Denise has been busy applying her statistics skills to the mountain of data the study collected. She noted in a previous post that wheat intake was strongly associated with coronary heart disease (CHD), the quintessential modern cardiovascular disease. I, and several other people, requested that she work her mathmagic to see if the association could be due to some other factor. For example, wheat is eaten mostly in the Northern regions of China, and CHD rates are generally higher at higher latitudes (vitamin D insufficiency?). This is true in Europe as well, and may be partly responsible for the purported benefits of the Mediterranean diet. You can mathematically determine if the association between wheat and CHD is simply due to the fact that wheat eaters live further North.
To make a long story short, nothing could explain the association except wheat itself, even latitude. Furthermore, she found a strong association between wheat intake and body mass index, typically a predictor of fat mass although we can't say that for sure. That finding echos a previous study in China where wheat eaters were more likely to be overweight than rice eaters (1, 2). Head over to Denise's post for the full story.
The China Study has major limitations built into its basic design, due to the fact that it was observational and pooled the blood samples of many individuals. Therefore, its findings can never prove anything, they can only suggest or be consistent with hypotheses. However, the study also has some unique advantages, such as a diversity of diets and regions, and the fact that people had presumably been eating a similar diet for a long time. I feel that Denise's efforts are really teasing out some useful information from the study that have been de-emphasized by other investigators.
There has been very little serious investigation into the health effects of wheat in the general population. Researchers studying celiac disease and other forms of gluten allergy, and the efforts of the paleolithic diet community in spreading that information (for example, Loren Cordain and Pedro Bastos), have been major contributors to understanding the health effects of wheat. Denise's analysis is one of the strongest pieces of evidence I've come by so far. I think there's enough indirect evidence that investigators should begin taking the idea seriously that wheat, particularly in the form of industrial flour products, may contribute to chronic disease in more than just a small subset of the population.
To make a long story short, nothing could explain the association except wheat itself, even latitude. Furthermore, she found a strong association between wheat intake and body mass index, typically a predictor of fat mass although we can't say that for sure. That finding echos a previous study in China where wheat eaters were more likely to be overweight than rice eaters (1, 2). Head over to Denise's post for the full story.
The China Study has major limitations built into its basic design, due to the fact that it was observational and pooled the blood samples of many individuals. Therefore, its findings can never prove anything, they can only suggest or be consistent with hypotheses. However, the study also has some unique advantages, such as a diversity of diets and regions, and the fact that people had presumably been eating a similar diet for a long time. I feel that Denise's efforts are really teasing out some useful information from the study that have been de-emphasized by other investigators.
There has been very little serious investigation into the health effects of wheat in the general population. Researchers studying celiac disease and other forms of gluten allergy, and the efforts of the paleolithic diet community in spreading that information (for example, Loren Cordain and Pedro Bastos), have been major contributors to understanding the health effects of wheat. Denise's analysis is one of the strongest pieces of evidence I've come by so far. I think there's enough indirect evidence that investigators should begin taking the idea seriously that wheat, particularly in the form of industrial flour products, may contribute to chronic disease in more than just a small subset of the population.
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