Dr. Kevin Patterson on Western Diets and Health

A few readers have pointed me to an interesting NPR interview with the Canadian physician Kevin Patterson (link). He describes his medical work in Afghanistan and the Canadian arctic treating cultures with various degrees of industrialization. He discusses the "epidemiological transition", the idea that cultures experience predictable changes in their health as they go from hunter-gatherer, to agricultural, to industrial. I think he has an uncommonly good perspective on the effects of industrialization on human health, which tends to be true of people who have witnessed the effects of the industrial diet and lifestyle on diverse cultures.

A central concept behind my thinking is that it's possible to benefit simultaneously from both:

• The sanitation, medical technology, safety technology, law enforcement and lower warfare-related mortality that have increased our life expectancy dramatically relative to our distant ancestors.


• The very low incidence of obesity, diabetes, coronary heart disease and other non-infectious chronic diseases afforded by a diet and lifestyle roughly consistent with our non-industrial heritage.

But it requires discipline, because going with the flow means becoming unhealthy.

Thursday Night Film Screening at MMU

FILM EVENING
This Thursday evening at MMU in room JD CO-14 in the John Dalton Building (opposite the BBC see linked map building number 11 http://www.mmu.ac.uk/travel/maps/mmu_maps_allsaints_aytoun.pdf) 
Starting 6:00 prompt till 8:30.

The Lost Generation Project is about finding the lost stories of people with intellectual disabilities, many institutionalised for most of their lives. It is about hearing these stories and recognising and celebrating people who have traditionally been socially isolated and aims to assist these people to connect to their communities through arts and culture. The Lost Generation Project has found unique people from across Australia and provided them with the technology and skills to tell their stories on film. Each core project participant or storyteller is offered the opportunity to make a short film that tells their story.

Simone Flavelle is the Manager/Executive Producer of this project and she will be giving us the opportunity to see some of these films and engage in a discussion.

To register for this event, email artsforhealth@mmu.ac.uk  There will be a small charge on the evening of £2.00 on the door to cover costs for this event.

Thank you to all those who have registered so far. 

Details of this work and 5 films are available to view on line at: http://www.disseminate.net.au/lost_generation_project_2
  
IT'S A RAP

Now I'm not sure whether this is the true public face of Arts and Health...but I can certainly see the connection! MC NxtGen and a take on NHS 'reform'. http://www.youtube.com/watch?v=Dl1jPqqTdNo

DATE FOR YOUR DIARY:
Thursday 30th June: International Arts and Health HEAD to HEAD (part of the Northern Uproar and m a n i f e s t o  events) 

Details of this unique event at MMU (which will offer members of the North West Arts and Health Network the opportunity to meet key figures from the Arts and Health field from the UK, USA, Ireland, South Africa and Australia) and will be advertised shortly.

Please note at this stage we are not able to take reservations, but details will be posted on the BLOG asap.

MoMA the Arts and Dementia

I have just returned from an intensive period of activity with the Museum of Modern Art (MoMA) in New York exploring synergies between the arts and dementia as part of an action research programme I am undertaking within an NHS trust between 2011-2015. A report relating to this work will be available via Arts for Health shortly alongside a dedicated BLOG. Thanks to Carrie McGee at MomMA and Dr Anne Basting at the University of Wisconsin.

BIG SOCIETY (a good read)
Arts Funding, Austerity and the Big Society: Remaking the case for the arts John Knell and Matthew Taylor
http://www.thersa.org/__data/assets/pdf_file/0011/384482/RSA-Pamphlets-Arts_Funding_Austerity_BigSociety.pdf

AND FINALLY...
Recent weeks have seen much action towards the m a n i f e s t o, with events in Cumbriia planned...more details soon…

Randy Tobler Show: Welcome

This morning, I had a conversation with Dr. Randy Tobler on his radio show "Vital Signs", on 97.1 FM News Talk in St Louis. Dr. Tobler is an obstetrician-gynecologist with an interest in nutrition, fitness and reproductive endocrinology from a holistic perspective. He asked me to appear on his show after he discovered my blog and found that we have some things in common, including an interest in evolutionary/ancestral health. We talked about the history of the American diet, the health of non-industrial cultures, what fats are healthiest, and the difference between pastured and conventional meat/dairy-- we took a few questions from listeners-- it was fun.

The show is available as a podcast here (3/26 show), although as far as I can tell, you need iTunes to listen to it. My section of the show starts around 8:20.

To everyone who arrived here after hearing me on the air this morning: welcome! Here are a few posts to give you a feel for what I do here at Whole Health Source:

The Coronary Heart Disease Epidemic
US Weight, Lifestyle and Diet Trends, 1970-2007
Butter vs. Margarine Showdown
Preventing and Reversing Tooth Decay
The Kitavans: Wisdom from the Pacific Islands
Potatoes and Human Health, Part I, Part II and Part III
Traditional Preparation Methods Improve Grains' Nutritional Value
Real Food XI: Sourdough Buckwheat Crepes
Glucose Tolerance in Non-industrial Cultures
Tropical Plant Fats: Palm Oil
It's Time to Let Go of the Glycemic Index

Safflower Oil Study

A few people have sent me a new study claiming to demonstrate that half a tablespoon of safflower oil a day improves insulin sensitivity, increases HDL and decreases inflammation in diabetics (1). Let me explain why this study does not show what it claims.

It all comes down to a little thing called a control group, which is the basis for comparison that you use to determine if your intervention had an effect. This study didn't have one for the safflower group. What it had was two intervention groups, one given 6.4g conjugated linoleic acid (CLA; 50% c9t11 and 50% t10c12-CLA) per day, and one given 8g safflower oil. I have to guess that this study was originally designed to test the effects of the CLA, with the safflower oil group as the control group, and that the interpretation of the data changed after the results came in. Otherwise, I don't understand why they would conduct a study like this without a control group.

Anyway, they found that the safflower oil group did better than the CLA group over 16 weeks, showing a higher insulin sensitivity, higher HDL, lower HbA1c (a marker of average blood glucose levels) and lower CRP (a marker of inflammation). But they also found that the safflower group improved slightly compared to baseline, therefore they decided to attribute the difference to a beneficial effect of safflower oil. The problem is that without a control (placebo) group for comparison, there's no way to know if the improvement would have occurred regardless of treatment, due to the season changing, more regular check-ups at the doctor's office due to participating in a study, or countless other unforeseen factors. A control group is essential for the accurate interpretation of results, which is why drug studies always have placebo groups.

What we can say is that the safflower oil group fared better than the CLA group, because there was a difference between the two. However, what I think really happened is that the CLA supplement was harmful and the small dose of safflower oil had no effect. Why? Because the t10c12 isomer of CLA, which was half their pill, has already been shown by previous well-controlled studies to reduce insulin sensitivity, decrease HDL and increase inflammatory markers at a similar dose and for a similar duration (2, 3). The safflower oil group only looked good by comparison. We can add this study to the "research bloopers" file.

It's worth noting that naturally occurring CLA mixtures, similar to those found in pastured dairy and ruminant fat, have not been shown to cause metabolic problems such as those caused by isolated t10c12 CLA.

New Ancestral Diet Review Paper

Pedro Carrera-Bastos and his colleagues Maelan Fontes-Villalba, James H. O'Keefe, Staffan Lindeberg and Loren Cordain have published an excellent new review article titled "The Western Diet and Lifestyle and Diseases of Civilization" (1). The paper reviews the health consequences of transitioning from a traditional to a modern Western diet and lifestyle. Pedro is a knowledgeable and tireless advocate of ancestral, primarily paleolithic-style nutrition, and it has been my privilege to correspond with him regularly. His new paper is the best review of the underlying causes of the "diseases of civilization" that I've encountered. Here's the abstract:

It is increasingly recognized that certain fundamental changes in diet and lifestyle that occurred after the Neolithic Revolution, and especially after the Industrial Revolution and the Modern Age, are too recent, on an evolutionary time scale, for the human genome to have completely adapted. This mismatch between our ancient physiology and the western diet and lifestyle underlies many so-called diseases of civilization, including coronary heart disease, obesity, hypertension, type 2 diabetes, epithelial cell cancers, autoimmune disease, and osteoporosis, which are rare or virtually absent in hunter–gatherers and other non-westernized populations. It is therefore proposed that the adoption of diet and lifestyle that mimic the beneficial characteristics of the preagricultural environment is an effective strategy to reduce the risk of chronic degenerative diseases.

At 343 references, the paper is an excellent resource for anyone with an academic interest in ancestral health, and in that sense it reminds me of Staffan Lindeberg's book Food and Western Disease. One of the things I like most about the paper is that it acknowledges the significant genetic adaptation to agriculture and pastoralism that has occurred in populations that have been practicing it for thousands of years. It hypothesizes that the main detrimental change was not the adoption of agriculture, but the more recent industrialization of the food system. I agree.

I gave Pedro my comments on the manuscript as he was editing it, and he was kind enough to include me in the acknowledgments.

Gluten-Free January Survey Data, Part II: Health Effects of a Gluten-Free Diet

GFJ participants chose between three diet styles: a simple gluten-free diet; a "paleo light" diet diet that eliminated sugar and industrial seed (vegetable) oils in addition to gluten; and a "paleo full monty" diet that only included categories of food that would have been available to our pre-agricultural ancestors. The data in this post represent the simple gluten-free diet group, and do not represent the other two, which I'll analyze separately.

To get the data I'll be presenting below, first I excluded participants who stated on the survey that they did not adhere to the diet. Next, I excluded participants who were gluten-free before January, because they would presumably not have experienced a change from continuing to avoid gluten. That left us with 53 participants.

For each of these graphs, the vertical axis represents the number of participants in each category. They won't necessarily add up to 53, for several reasons. The most common reason is that for the questions asking about changes in health conditions, I didn't include responses from people who didn't have the condition in question at baseline because there was nothing to change.

Question #1: What is your overall opinion of the effect of gluten free January on you?

Participants had a very positive experience with the gluten-free diet. Not one person reported a negative overall experience.

Question #2: Did you note a weight change at the end of gluten free January?

And here are the data for people who described themselves as overweight at baseline:

Two-thirds of people who were overweight at baseline lost weight, and only one person out of 37 gained weight. That is striking. A number of people didn't weigh themselves, which is why the numbers only add up to 37.

Question #3: Before January 2011, did you have a problem with intestinal transit (frequent constipation or diarrhea)? If so, did your symptoms change during the month of January?


Responses are heavily weighted toward improvement, although there were a few instances where transit worsened. Transit problems are one of the most common manifestations of gluten sensitivity.

Question #4: Before January 2011, did you have frequent digestive discomfort (pain, bloating, etc.)? If so, did your symptoms change during the month of January?


Digestive discomfort was common, and the gluten-free diet improved it in nearly everyone who had it at baseline. I find this really impressive.

Question #5: Before January 2011, did you have acid reflux? If so, did your symptoms change during the month of January?

Acid reflux responded well to a gluten-free diet.

Question #6: Before January 2011, did you have a problem with tiredness/lethargy? If so, did your symptoms change during the month of January?
Lethargy was common and generally improved in people who avoided gluten. This doesn't surprise me at all. The recent controlled gluten study in irritable bowel syndrome patients found that lethargy was the most reliable consequence of eating gluten that they measured (1, 2). That has also been my personal experience.

Question #7: Before January 2011, did you have a problem with anxiety? If so, did your symptoms change during the month of January?

Anxiety tended to improve in most participants who started with it.

Question #8: Before January 2011, did you have a problem with an autoimmune or inflammatory condition? If so, did your symptoms change during the month of January?

Autoimmune and inflammatory conditions tended to improve in the gluten-free group, although one person experienced a worsening of symptoms.

Question #9: If you ate gluten again or did a gluten challenge after gluten free January, what was the effect?

Just under half of participants experienced moderate or significant negative symptoms when they re-introduced gluten at the end of the month. Two people felt better after re-introducing gluten.


Conclusion

I find these results striking. Participants overwhelmingly improved in every health category we measured. Although the data may have been somewhat biased due to the 53% response rate, it's indisputable that a large number of participants, probably the majority, benefited from avoiding gluten for a month. At some point, we're going to compile some of the comments people left in the survey, which were overwhelmingly positive. Here's a typical comment in response to the question " In your own words, how would you describe your January 2011 experience" (used with permission):

Amazing! I would recommend the experiment to anyone. I felt completely more alert, and less bloated. When I ate some gluten at the close of the experiment, I felt gross, bloated, and lethargic.

I think it's worth mentioning that some participants also eliminated other starches, particularly refined starches. Judging by the comments, the diet was probably lower in carbohydrate for a number of participants. We may try to assess that next year.

Gluten-Free January Survey Data, Part I: Demographics and Limitations

Thanks to Matt Lentzner for organizing Gluten-Free January, and everyone who participated and completed the survey, we have a nice data set illustrating what happens when a group of people stop eating gluten for a month. Janine Jagger, Matt and I have been busy analyzing the data, and I'm ready to begin sharing our findings.

GFJ had over 500 participants, 527 of which received the survey and 279 of which completed the survey at the end of the month. Of those who received the survey, 53 percent completed it. I think these are respectable numbers for a survey of this nature, and it reflects the conscientious nature of the people who participated in GFJ.

Demographics

Although respondents were primarily from the United States, I'm happy to say that the data represent 18 different nationalities:

Respondents represented a diversity of ages, the largest group being 30-39 years old, with similar numbers in the 20-29 and 40-49 year groups.
Respondents were just under 2/3 women.

Respondents represented a variety of weights, but the sample was biased toward lean people, in comparison with the general population. There were not many obese participants.
Overall, I was pleased to see that the demographics were quite diverse, particularly in the age and gender categories.

Limitations

There are a few caveats to keep in mind when interpreting the survey results:

1. GFJ participants do not represent a random cross-section of the population at large. They represent primarily health-conscious individuals who were motivated enough to make a substantial dietary change. In addition, many of the people who participated probably did so because they already suspected they had a problem with gluten.
   
2. The survey response rate was 53%. Although I think that's a reasonable number considering the circumstances, it leaves open the possibility that survey responders differ from non-responders. It's conceivable that participants with better adherence and better outcomes were more likely to complete the survey than those who did not adhere to the diet or had neutral or unfavorable outcomes, despite our efforts to encourage everyone to complete the survey regardless of adherence or outcome. So the results could be biased toward positive outcomes, meaning that we will need to see a strong effect for it to be believable.
   
3. This was a non-blinded diet trial without a control group. There's no way to know how much of the effect was due to avoiding gluten per se, how much was due to overall changes in diet patterns, and how much was a placebo effect.
   

With that in mind, what can we take from the survey data? I feel that we can use it to answer the following question: "what is likely to happen when a motivated, health-conscious person decides to avoid gluten for a month?" And I think we can also use it to generate (but not test) hypotheses about the effects of eating gluten on the general population.

Are the Best Things in Life Free?
A Public Discussion and Debate

What matters most to you in life? If we wanted to measure wellbeing - what things should we include? These and other questions will form the focus of a stimulating public event which is being hosted by the Centre for Research for Health and Wellbeing at the Univesity of Bolton on Thursday 7th April at 4pm. The event will include a panel of experts who will make a pitch for the things they think play a role in wellbeing - and there will be lots of opportunity for the public to participate and join in the debate. The discussion and arguments will be fed back to the Office of National Statistics who have been asked by the government to devise a measure of national wellbeing.
Further details at http://www.bolton.ac.uk/CRHW/News/Articles/ONS030211.aspx 

Breakthrough are delighted to announce that they are holding another Arts in Health Event in Manchester on Friday the 10th of June, 2011. We are keen to build on the momentum generated from previous events, using the setting as a way in which to promote positive practice, showcase the talents of service users, bring people and ideas together and to work towards developing a unified, national strategy for moving forwards. It would be great to have you involved!
Please visit the website http://www.breakthroughmhart.com/  or get in touch via breakthrough@mentalhealth.freeserve.co.uk  

The Triangle Trust 1949
Fund Opens for Applications (UK)
The Triangle Trust 1949 Fund is currently inviting applications from charity organisations to support projects that support:

• Carers
• Community arts and education
• Disability
• Older people
• Poverty
• Integration and rehabilitation

Grants are normally in the range of £1,000 and £10,000. The objectives of the Fund are; the alleviation of poverty and the promotion of good health and welfare; the advancement and furthering of education. Successful projects will either maintain an open, inclusive society or promote integration (or reintegration) of individuals or groups into society. Preference will be given to smaller charities; charities which serve a locality or region of the UK, rather than national charities; and causes which find it more difficult to raise funds from the general public. The next application deadline is the 14th May 2011. For more information visit: http://thetriangletrust1949fund.org.uk/

Two Exhibitions at the University of Salford
Wed, 30 March 2011 to Sat, 30 April 2011
Ghislaine Howard: The Choreography of Walking


Personal experience drew artist Ghislaine Howard to the subject of walking: from charting the first hesitant steps of her children, to watching the determination and courage of her mother refusing to accept the debilitating progress of Parkinson’s disease. Central to this exhibition is the work Ghislaine has done in conjunction with the University of Salford’s Podiatry Department, which increased her wonder at the extraordinary choreographies of walking. “The simple act of putting one foot in front of the other - so natural it seems for most of us, so hard won for others.” http://www.ghislainehoward.com/

Venue: Chapman Gallery, Chapman Building, University of Salford, M5 4NT
Opening hours: Tuesday - Friday (12-5pm), also open Saturday 2 April & Saturday 30 April (12-5pm). The gallery will be closed on Bank Holidays Friday 22 & Friday 29 April.

Sarah Coggrave, Bronwyn Platten and others...: Mouths and Meaning
Tue, 24 May 2011 to Fri, 24 June 2011

Bronwyn Platten & Sarah Coggrave: Flumpy (2010) & Untitled (2010)

Mouths and Meaning is a research project and exhibition developed by Bronwyn Platten, towards her PhD based in the School of the Built Environment, the University of Salford. The focus of Mouths and Meaning is to explore and creatively represent experiences of embodiment, food and eating by those who have been affected by an eating disorder. Using a multisensory, holistic and interdisciplinary approach the exhibition will showcase a range of new works including photography, film and sculpture developed by Sarah Coggrave in collaboration with Bronwyn Platten; a selection of individual works by both artists as well as a series of drawings by workshop participants from England, Scotland and Australia.

Bronwyn’s studentship has been funded by EPSRC as part of the collaborative, multi-institutional Health and Care Infrastructure Research and Innovation (HaCIRIC), IMRC Centre, the School of the Built Environment, the University of Salford.
Venue: Chapman Gallery, Chapman Building, University of Salford, M5 4NT
Opening hours: 12 - 5pm, Wed to Sat
Preview/launch event: Tuesday 24 May, 6-8pm (free admission, everyone welcome!)

Flu Season is Here

I've noticed everyone around me getting sick lately (I seem to have become mostly immune to colds and the flu in the last couple of years), so I took a look at Google Flu Trends. Lo and behold, the United States is currently near peak flu incidence for the 2010-2011 season. Here's a graph from Flu Trends. This year's trend is in dark blue:


Flu Trends also has data for individual US states and a number of other countries.

It's time to tighten up your diet and lifestyle if you want to avoid the flu this year. Personally, I feel that eating well, managing stress effectively, and taking 2,000 IU of vitamin D3 per day in winter have helped me avoid colds and the flu.

Exclusive DADAA Film Screening and Call for Papers

The Lost Generation Film Project (DADAA Inc)

6:00pm to 8:30pm, Thursday 31st March 2011
At Manchester Metropolitan University

This is a unique opportunity to experience the work of DADAA and thanks to Durham University’s Centre for Medical Humanities, who have supported this event.

The Lost Generation Project is about finding the lost stories of people with intellectual disabilities, many institutionalised for most of their lives. It is about hearing these stories and recognising and celebrating people who have traditionally been socially isolated and aims to assist these people to connect to their communities through arts and culture. The Lost Generation Project has found unique people from across Australia and provided them with the technology and skills to tell their stories on film. Each core project participant or storyteller is offered the opportunity to make a short film that tells their story.

Simone Flavelle is the Manager/Executive Producer of this project and she will be giving us the opportunity to see some of these films and engage in a discussion.

To register for this event or get more details, email artsforhealth@mmu.ac.uk  There will be a small charge on the evening of £2.00 to cover costs for this event.

Thank you to all those who have registered so far. Confirmation of places and details of venue will be provided 1 week prior to the event.

Details of this work and 5 films are available to view on line at: http://www.disseminate.net.au/lost_generation_project_2  
 
CALL FOR PAPERS

Striking a Chord
Music, Health and Wellbeing:Current Developments in Research and Practice

Date: 9th-10th September 2011
Venue: University Centre Folkestone
http://www.sempre.org.uk/resources/2011_sept_calls.pdf

Gluten-Free January Raffle Winners Selected!

Raffle winners have been selected and shirts are on their way. You know who you are. Thanks to everyone who participated and filled out the survey! For those who didn't, there's always next year.

Janine Jagger, Matt Lentzner and I are busy crunching the mountain of data we collected from the GFJ survey. We got 279 responses, which is remarkable for a survey of this nature.

Stay tuned for data!

Oltipraz

Oltipraz is a drug that was originally used to treat intestinal worms. It was later found to prevent a broad variety of cancers (1). This was attributed to its ability to upregulate cellular detoxification and repair mechanisms.

Researchers eventually discovered that oltipraz acts by activating Nrf2, the same transcription factor activated by ionizing radiation and polyphenols (2, 3, 4). Nrf2 activation mounts a broad cellular protective response that appears to reduce the risk of multiple health problems.

A recent paper in Diabetologia illustrates this (5). Investigators put mice on a long-term refined high-fat diet, with or without oltipraz. These carefully crafted diets are very unhealthy indeed, and when fed to rodents they rapidly induce fat gain and something that looks similar to human metabolic syndrome (insulin resistance, abdominal adiposity, blood lipid disturbances). Adding oltipraz to the diet prevented the fat gain, insulin resistance and inflammatory changes that occurred in the refined high-fat diet group.

The difference in fasting insulin was remarkable. The mice taking oltipraz had 1/7 the fasting insulin of the refined high-fat diet comparison group, and 1/3 the fasting insulin of the low-fat comparison group! Yet their glucose tolerance was normal, indicating that they were not low on insulin due to pancreatic damage. The low-fat diet they used in this study was also refined, which is why the two control groups (high-fat and low-fat) didn't diverge more in body fatness and other parameters. If they had used a group fed unrefined rodent chow as the comparator, the differences between groups would have been larger.

This shows that in addition to preventing cancer, Nrf2 activation can attenuate the metabolic damage caused by an unhealthy diet in rodents. Oltipraz illustrates the power of the cellular hormesis response. We can exploit this pathway naturally using polyphenols and other chemicals found in whole plant foods.

What a Life

What A Life! from Clive Parkinson on Vimeo.
On 15 February 1949, the Conservative MP for Twickenham, Edward Keeling asked the President of the Board of Trade in the House of Commons.

"Has the Lord President seen this film? Does he know that it shows two men so depressed by the conditions of life the in England today that they try to drown themselves, but make a mess of it? Does he really think that this is the sort of film on which £9,000 of taxpayers' money should be spent?"

This Richard Massingham film is a bizarre contribution from the Crown Film Unit, and addresses the challenges Britain faced in the austere post-war era. Wartime enthusiasm and self-confidence had become seriously eroded by the crisis-laden year of 1947. Domestically, the continuation of rationing, including for the first time bread (between 1946-48) and the fuel and economic crises, together with Indian independence, 1947 was largely a year that dented the immediate post war assurances.

Please enjoy this post-war austerity film and its relevance today!