March 10, 2008
HEALTH: Dec 05, AU Edition
PERCHANCE TO WALK
Sleep is still barely understood; sleepwalking, even less so.
A look into the bizarre world of people who go bump in the night
So I sleepwalked the other night. I didn’t go far, just down the hall to the boys’ room and lay down on the floor and continued my snooze in the more traditional, horizontal manner. Obviously, I don’t recall this, nor do I recall my confused husband coming in to fetch me. Why should I? After all, I was asleep. Sleepwalking is a common form of parasomnia, which one sufferer described as “things that go bump in the night.” Sleep, as we all know, can be tricky.
More than 15% of children are thought to suffer from parasomnias of some sort, and this is considered normal childhood behavior. Most young children will occasionally talk or call out in their sleep (“no...I won’t share her…she’s mine!” being my favorite overheard phrase, confirming that a sleeping toddler is, indeed, a toddler).
In adults, parasomnias are less common, affecting something around 6% of the population. They are sometimes a sign that there is something more seriously wrong with the sufferer, and therefore should be investigated. In adults, parasomnias are most commonly linked to drinking, taking drugs, stress and sleep deprivation. I may have been under the influence of at least one of the above when I took my sleepwalk – I’ll leave it to you to guess which.
A parasomnia, according to the psychiatric bible, Diagnostic and Statistical Manual of Mental Disorders (or as it is known in the business, “DSM – IV”), is a “disorder of arousal, partial arousal, or sleep stage transition. It represents an episodic disorder in sleep (such as sleepwalking) rather than a disorder of sleep or wakefulness per se. May be induced or exacerbated by sleep; not a dyssomnia.” The dysomnias, by way of contrast, are a separate category of sleep ddisorder and are difficulties sleeping or waking up: sleep apnoea, narcolepsy, and that old chestnut, insomnia.
Parasomnias are things like teeth grinding, sleep talking, sleep terrors and REM sleep behaviour disorder (RSBD). This lattermost disorder is particularly scary as it is characterized by twitching and other violent movements in the sufferer’s sleep that can cause injury. And researchers have been discovering that parasomnias are in fact more common than previously thought.
As I said, sleep is tricky; it is complex and poorly understood. It’s tough to define sleep, for which reason most definitions of sleep become ridiculous. It’s some kind of important state that all animals go into where we loose consciousness to varying degrees and undergo characteristic changes to our brain waves. Dreaming is undertaken, although not always remembered, and is widely thought to be the brains system for going through junk it has picked up or is sorting through and making sense of it. A good analogy is a computer hard drive, which needs its old junk and temporary files it accumulates with use cleared out from time to time. The interpretation of dreams (paging Dr Freud) is a fun parlour game, but is like any form of insight; you need to have some in order to have more. If you keep dreaming of suitcases and hats and the cigar chompers keep telling you it’s about sex, this means you are spending too much time with the cigar chompers. The exception, obviously, is if while you are awake you believe that a dream of ripe fruit heralds a pregnancy. If everyone in your culture believes this, such a dream is a likely sign you are thinking about this. Even your own private subconscious is sociologically programmed and subject to peer pressure.
Sleepwalking can of course be incredibly dangerous: The person is not awake but they can take in some information. They can see their coffee table and walk around it, even if the sleeping brain “sees” a lake or a dragon or what have you in the place of the real object. For this reason, if you lock a sleepwalker in the house, their sleeping brain can find still find the keys if their awake brain can. Sadly, sleepwalkers have been killed walking on highways, and even behind the wheels of their cars. The latter has occurred on only a few documented occasions, and tended to lead to sleep studies being carried out, largely for medico-legal reasons.
“Sexomnia” has been studied in recent years, and looks set to be officially listed as a disorder. Last year the first and only mass-market book on the phenomena was published (Sleepsex: Uncovered by Dr. Michael Mangan, available from Amazon.com or as an e-book from www.clickbank.net). Unlike sleepwalking, sufferers are unlikely to wake up in a strange place if they have had sex in their sleep, and it occurs at a different stage of sleep to sleep walking. “Sexsomnia” is not necessarily a problem for all people who have it, although it can cause serious relationship problems, and in some cases the person may be violent. Consent therefore becomes an issue if only one party is awake. The awake person may be assaulted by the sleeper, or conversely, may believe the sleeper to be awake, and take advantage of the situation. It’s a medico-legal minefield, and raises difficult situations: if you were raped by someone who was asleep would you want them to be punished? How does one prove that someone with a sleep disorder that can be scientifically established was, nonetheless, asleep at the time?
Sleepwalking was first raised as a defense to murder in the United States in 1846, and the killer, Albert Tirrell, got off, after nearly decapitating a high-class prostitute he was obsessed with and wanted to marry. (She refused; after killing her, he then set fire to the brothel in which she worked). But he had a known history of sleepwalking, and denied all knowledge of the murder and was acquitted. Today, 150 years later, the science would not have been able to help shed much more light on things: while Tirrell could have been sent to a sleep lab to see if he had a parasomnia, there would still be know way of knowing whether he was asleep at the time of the murder and arson.
Sleep is imbued with meaning in our culture – probably in all cultures. It’s a pretty weird thing that we animals do; the only evolutionary advantage sleep is thought to confer is that perhaps there are times that being out cold is safer than running around hunting. Perhaps. It’s not the best theory, really. Just another pitiful dumb human attempt to understand why we need to sleep. We don’t understand much about sleep, except that we do need it; we get very messed up without it, and rats who are prevented from sleeping get sick and die.
For which reason, of course, we need to sleep. Practical advice: Don’t go to bed until you’re tired; face the alarm clock to the wall; if you can’t sleep get up until you are really tired; and if you read before bed don’t do it in bed. Bed is only for activities you can do with the light off. Yawn. I think I’m done.
HEALTH: Mar 05, Au Edition
DON’T WORRY, DIE HAPPY
Are party drugs really the best way to make a cancer patient’s last days more livable?
Aside from those who die suddenly in accidents, quietly in their sleep, or simply sitting at the dinner table, a good proportion of the population gets not only a fair bit of advance warning that their time is almost up, but also a rough estimate of when that will be. That diva of death, Elisabeth Kübler-Ross, counseled coming to terms with and embracing death as a part of life, seeing it as a “transition” to a better place. She was quite a morbid little lady though – and perhaps a little impatient for death to come as well, having spent so much time preparing for it.
On the other side of the coin, there are those of us who would prefer to achieve immortality through not dying. Being firmly in this camp, I plan a last-minute panic, followed by months of denial – but having spent several years working in aged care, my experience is that very few people actually spit the dummy completely when given notice. Still, there is psychological work to do to wrap up a life, and it is painful to watch a patient who is trying to achieve some measure of acceptance and reconciliation but is exhausted by the effort.
Which brings up the question: how much intervention is appropriate to help this process along? Some people these days are answering, “a lot”. Pending a license from the US Drug Enforcement Administration (DEA), Harvard will this year commence an FDA-approved trial of MDMA, better known as the party drug ecstasy, in end-stage cancer patients suffering from severe anxiety. Meanwhile in Los Angeles, the Harbor-UCLA Medical Centre is trialing the use of psilocybin (the active in ingredient magic mushrooms) in terminally ill cancer patients. But these are all very small studies, and are of the “qualitative”, or anecdotal, kind: see what happens, and then know what to look at if it progresses to the level of a drug trial. Essentially, they are pre-trial trials.
(This is not the first time since the heady days of Timothy Leary that U.S. researchers have toyed with illegal drugs to treat various mental conditions: the University of Arizona has lately reported success using psilocybin to treat obsessive compulsive disorder, while in Charleston, South Carolina, MDMA is being studied in victims of violence who are suffering post traumatic stress disorder.)
What some medical researchers have discovered is that ecstasy can make people happy. And expansive. And positive about themselves and at one with the world and like, man, there’s like love, just like, everything is love, you know? Feeling like this, they reckon, is better than being fearful and anxious, as most cancer patients are to some degree. What if we could make them happy? Give them tools to make the work of wrapping up a life and preparing for death a little easier? Or just generally unbridle the unconscious, facilitate communication with family, and defy the poet to go gently into that good night?
In the Harvard and UCLA studies, the patients will be evaluated, given low-to-moderate doses of drugs in the company of a psychiatrist, and then spend a fair few number of consecutive hours talking it all out. And then do it again a few weeks later. The studies aim to see if this helps people to deal with end of life issues. Certainly, most of the unpleasant side effects could be controlled in this very controlled setting. The idea seems to be that these are patients who may not have the time and energy for an in-depth rigorous sorting through of the subconscious issues in guided psychotherapy: if they are uninhibited and happy, it can all get done a lot quicker.
Myself, I’d like anything in my subconscious to stay put, and thus avoid both psychotherapy and hallucinogenic drugs for this reason. But putting aside the issue of how the process could be patented to make money, and determined to be safe, and then approved ten years hence, would anyone really want to find a psychiatrist to sit and talk with them for six hours at a stretch? Furthermore, how much damage might a “bad trip” do to someone in their last days? And if dad has always been a cranky old bugger, will it really help the family to hear him waxing lyrical under the influence? My own feeling is that there wouldn’t be a lot of takers for this kind of treatment, and that they would be a fairly self-selecting group. But what if it took off?
Personally, I don’t like the idea. It rings wrong to me, and I have been trying to find a way to come at it reasonably. Debating the idea of using hallucinogens like this often leads to overwrought fears about a dystopian, mood-managed future á la Huxley’s Brave New World, and brings up a lot of the same issues that came up when it was discovered that Prozac could not just cure depression, but smooth out challenging personality traits. There are, if you tilt your head and squint, some interesting ethical dilemmas here, but the reality is — as for the overwhelming majority of drugs that are tested for any medical use — that cost, profitability, patentability and practicality, as well as safety and the broader concerns of the community may well be immovable obstacles standing in the way of Nana ever getting high.
This small wave of tests involving medical mushrooms and prescription party drugs will probably die out with the patients in the studies, and people will continue to wrap up their lives in much the same ways they always have.
HEALTH: Nov 05, AU Edition
The brain is a marvelous thing – but it can also play tricks on us (for our own good, of course)
Have you ever felt badly blue, critically assessed your life and thought, Of course I’m depressed! Anyone would be under these circumstances!, and then gone to bed, or for a walk, or for coffee, or whatever it is that you do, and felt better?
‘Oh’, you thought, ‘it was the night/the weather/the deadline/the head lice that made me temporarily insane. I love my life. Could use a little bit of tweaking at the edges, maybe, but nothing major.’
Most of us have felt exactly this way at one time or another. And if you don’t feel worse than this, than guess what? You are not depressed. Instead, you’ve just suffered from a mild delusion – but that’s normal.
In fact, your life is always going to be slightly worse than you think. That’s right. You are less moral, less reasonable, less kind, less lucky and less smart than you think. Aren’t we all. If you were depressed you would feel lousy most days, and if this went on for more than two weeks you would be well advised to go and see a doctor.
But if you’re not depressed then you’re not a good judge of how things are going. The depressed – aside from being tedious negative – Nellies – are better judges in some areas of critical thinking than the rest of us. The rest of us are optimists because it gets us through the day.
How smart do you think you are? A bit above average? Isn’t everyone. I have done less-than-perfectly in exams because I was tired, anxious, pregnant, overqualified, didn’t study at all, missed the lecture, or the questions were stupid. I have never done worse than I expected in an exam because more than half the people who took it were smarter than me. Like everyone else, I am smarter than average. I don’t know where the half of people on the wrong side of the intelligence bell curve are hiding, but clearly no one has told them yet.
We – excluding the floridly delusional and the depressed – who are neurologically normal are poor critical thinkers. Some try to think well, and some don’t bother, but the results have been in for years. We are lousy at critical thinking. Our brain wants us to feel good. It tells us lies so that we do. We can’t all be ‘above average’.
People believe weird things. Few of us understand statistics (a subject which should be taught in detail in primary school), and I have seen grown adults confronted with the phrase, ‘show me a double blind study’ look up with big puppy dog eyes and say, ‘I don’t know what that means, but I’ve heard amazing stories so I know it’s true’.
And actually, even if we try not to believe weird things, they still slip through. Imagine you’re a doctor. In all probability you or your work subscribes to a couple of journals about interesting medical stuff. You probably get digests of popular journals sent to your email address. Drug reps bring pens and reports. All together, we are talking about hundreds of studies a week here. To keep up to date, you will only read the interesting ones in detail, and if they ‘seem right’ and confirm what you know to be true, you won’t dig around to be sure the study was done well. This is a self-serving bias. You see what you expect to see. And if a study comes out tomorrow showing irrefutably that smoking is good for you, everyone will look at it, squint at it, and say, ‘well, I just don’t believe that’.
Here’s an example of how this works. Studies have shown, repeatedly, that Echinacea really does nothing for the common cold. Nothing. One study showed it actually made colds worse, but that was an errant finding. I’ve been watching the Echinacea phenomenon for ten years now, and every time it is proven not to work, someone says ‘the dose they used in the study was too low, too high, preserved in alcohol, or brewed under a waning moon so of course it didn’t work…but for just $50 I can hand-bottle the perfect dose for you’.
It still doesn’t work.
Vitamin C also doesn’t work, at least not in the 2,000 mg-an-hour school of cold-fighting. The anti-viral flu injection doesn’t have as much promise as was hoped ten years ago. We all make mistakes, and we like to see things that aren’t there so long as they make us feel good. Conventional medicine is fallible, but it does get the message eventually. Conventional medicine makes errors, isn’t always skeptical enough (of drug companies), is perhaps overly-critical of herbal wisdom, but it tends eventually to get with the program. Show it enough studies and it says, ‘well…OK’.
Unfortunately people with a vested interest in something that can be proved to be false (homeopathy, for example) have, by definition, a vested interest in maintaining their point of view. True believers will never be convinced, or at least the majority won’t. Bad No good Western Medicine comes off a little better, because it is based in science which is true (I mean, specifically that it has a plausible congruent hypothesis which could be – but hasn’t been – disproven. That being a damn fine definition of a scientific fact). That this is, so the beliefs of your local GP are only nominally threatened when they read that they have been prescribing and believing in an antiarthritis drug that provides as much pain relief as panadol, and kills then odd person. They feel foolish at first; then their brain tells them they couldn’t possibly have known , then they feel better about themselves and their profession, and make a note to be cautious with arthritis management in future. If a homeopath sees a study that shows the whole thing is junk science (and doesn’t work, to boot) they have a lot to loose by accepting this. So they don’t. They become a little paranoid and delusional, which is bad, but they get to keep their jobs and their belief in themselves. Which is good. I suppose.
Anecdotes aren’t evidence. They’re stories. We all suffer the placebo effect, and what a blessing that is. The human brain abhors a vacuum. We like to feel useful. ‘Magical thinking’ is the phrase that describes believing in magical things because we don’t like to know how little we know. Magical thinking describes at times a schizophrenic’s reasoning, but it also explains our tendency to attribute cause and effect where there isn’t any. ‘I feel better because I took vitamin C’ really means, ‘the less I know about vitamin C or the cold virus, the more I see the connection’. I don’t know much about computers, but I like to feel smart, so I can gather erroneous information to form a belief about why it won’t do what I want it to. We all do this. But it doesn’t make it right.
The human brain selectively remembers information to support beliefs that support you. This is why there is no point trying to argue someone into or out of religious beliefs. They will accept your arguments only if they are receptive to them, in which case, they are susceptible to believing you and it is in their interest to do so. And yet, the letters page…
You recall the two times in your life that you intuitively thought of a person not thought of for years, only to run into them, or hear they’ve died. Because you like the idea of having spiritual powers and being intuitive. You fail to recall the four million times that you have thought of a person out of the blue, and never saw them, heard from them, or thought of them again. Great dinner party stopper: ‘I had this desire to look up this guy from school – and then a week later I heard he had died!’ Would you believe that the statistical probability that that would occur by chance is really high?
Just another trick of our wonderful, if sometimes deluded, brains.
Skin Deep: Mar 05, AU Edition
How is Karen Matthews turning Ella Baché into a great name in Australian skincare? JAMES MORROW learns the secrets of one of the country’s youngest CEOs
Youth is the name of the game in the cosmetics and beauty business, but very few players in the industry put their money where their mouth is by hiring one of the youngest CEOs in Australian history – she was just 35 when she ascended to the boss’ chair – to turn it around. Not Ella Baché Australia, however, which in 1998 hired Karen Matthews to join the company with an eye towards making her Chief Executive Officer.
It was a big risk for both Matthews and Ella Baché – at the time, the company was losing money – but it paid off big for both of them. Today the firm is flying high and expanding across Australia, and Karen Matthews was recently named Telstra’s NSW Businesswoman of the Year.
Making it big in business was always in the cards for Matthews, who grew up outside Sylvania Waters, NSW, with a corporate executive father and a schoolteacher mother – a combination which goes a long way towards explaining not just her corporate savvy but her desire to teach others the lessons she’s learned along the way.
As a freshly-minted commerce graduate with a major in marketing from the University of New South Wales, it would have been natural for Matthews, like so many with her degree before her, to hop right onto the product and brand management track. Instead, she entered the retail world, joining the Myer chain’s graduate trainee program, where she got to have a go at every section of the business.
“I loved retail – it’s such a buzz. It’s constantly changing, there’s such a great variety of people, and it requires great gut instinct and real creativity”, recalls Matthews, reflecting on her early days at Myer. Plus, she adds mischievously, “it’s great fun when you get to spend other people’s money!”
Her tenure at Myer would eventually see Matthews move to Melbourne when the company consolidated operations there in 1990. Although she missed Sydney, while at Myer she learned valuable lessons that, she says, apply to anyone in their career. First among them: don’t be afraid to speak up.
“One of the most important things I learned at Myer is, if you have a point of view, share it. Even if people don’t agree with you, letting people know what’s on your mind is the only way to develop a profile within an organization,” says Matthews, who further cautions that those who keep quiet “risk fading into the shadows, especially in a big corporation.”
Her time in Melbourne taught her a lot, too, about how to get ahead in a large corporate structure, and also about some of the biggest pitfalls – especially to be careful of people with hidden agendas as well as what she calls “the art of the dysfunctional meeting”.
Eventually, though, it was time to move back to Sydney with her husband Ian, an accountant. “It was great grounding to spend eight years at a corporation like Myer,” she says, but found her role in such a large organization, between meetings, office politics, and only
being responsible for a relatively small part of the business, limiting. When an opportunity came in 1994 to join F.J. Benjamin, the Singapore-based fashion distributorship, she leapt at it. The differences between her new job, where she was responsible for setting up licensees for such major international and American labels as Guess, Ann Taylor, and Brooks Brothers, and her old one, were head-spinning. If Myer was all corporate politics and highly structured decision making, F.J. Benjamin was all about family,
instinct, and what Matthews likes to call “gut”.
“It couldn’t have been more extreme, coming from Myer,” Matthews recalls fondly. “F.J. Benjamin was a family business where the entire family was involved, and everything was done completely on instinct and emotion.” It was a great time in her career, she says, but also one that led to “major burnout.”
“I learned an incredible amount about being flexible, rolling with the punches, and how to change fast,” she says, “but I was on the road all the time. By 1998 I had been at the company for four years, and I realized that over that time, I hadn’t spent more than six weeks in Australia at any one time.”
Suddenly, she realized, it was time to go.
Having told the F.J. Benjamin family she was leaving, Matthews looked forward to spending six months off and doing all the things she hadn’t had a chance to do when she was bopping from Europe to Australia to Asia and back in less time than you can say, “priority boarding.” Matthews had barely cleaned out her desk when the phone rang with what would turn into her chance to make corporate history. It was a headhunter on the line, saying that there was an opportunity for her to join a cosmetics and skincare company as a marketing manager. At first, says Matthews, her reaction was no, no and no: “I didn’t want to go back to work, I certainly didn’t want to go back to work as somebody’s yes-person, and I didn’t want to go work for a polished brand like Estee Lauder.”
Then she heard that the opportunity was with Ella Baché, and that they were not so much looking for a marketing manager as someone to be groomed to take over as chief executive officer. Matthews took the job as much for the opportunity to be CEO as the strength of the name itself: “There was something about the brand: it had a certain attitude to it, a real Australian larrikinism,” she says, noting that the company has sponsored an 18-foot racing skiff and the Sydney Swans.
“I liked that there was a real element of living on the edge and that they embraced the rawer, unpredictable side of things – and one thing I’ve really encouraged here is for people to use their gut and intuition within a structured framework.”
Of course, in taking on the role of CEO – she was elevated a scant six months after joining the firm – Matthews was also taking on a company that she says “lacked focus” and was losing around $1.5 million a year. (Thanks to Matthews’ stewardship, Ella Baché is now quite comfortably in the black). To turn things around, she had to act fast, and that meant that there was not a lot of time for on-the-job training. “It was a major learning period for me,” she says, but despite never having been responsible for so many people or processes before, Matthews was able to quickly find the keys to success.
“One of the biggest challenges when you become CEO is that suddenly, you’re the boss, and everyone watches you and knows what you are doing,” notes Matthews, reflecting on the sudden feelings of isolation she felt when she stepped into the lead role. But in this, she says, there are lessons for others who someday wish to sit in the boss’s chair: “As leader of the company, you have to lead by example and practice what you preach,” she says. “People really do care about when you come and go, and they are very watchful of whether you are in a good mood or not.” Matthews notes that, a few years ago, when she was feeling particularly run down for an extended period of time, people under her constantly monitored her movements in and out of the office, and even paid attention to whether she was looking particularly pale from one day to the next.
This attention, combined with isolation, can make it difficult for any CEO to do their job, says Matthews, who was startled to find that even though her new job put her in charge of the company’s strategic vision, she was less and less able to call on colleagues for long-term thinking. One way she ameliorated this is to join a group called The Executive Connection, or TEC, which gives her a “safe space” to meet with other chief executives – almost all male, a benefit because “sometimes it’s great to get that male, cut-and-dried perspective on things” – and have a forum to bounce ideas off of and share experiences with.
On a day-to-day level, of course, things are different: “As CEO, one is responsible for a whole range of functions, but for me, I had never really had any exposure to areas of the business like finance and operations,” she says. As a firm believer in the principle that strong leaders surround themselves with strong people, Matthews says that a good CEO “learns very quickly where they are weak, and finds good people to help manage them.” In that same vein, she says, one of the best lessons she has learned is that there is no shame in admitting a mistake: in fact, it can often times be an asset. Says Matthews, “to be the first person to put your hand up and admit an error is a very strong thing to do, and people will respect you for it.”
One thing that Karen Matthews has never done is let her being a woman stand in the way of her goals – if anything, she says it’s been a plus in her career. “Sure, I’m not in the building or engineering industries, but I haven’t had any problems with a glass ceiling,” she reports, adding that she believes that being female has in many ways made her a better leader.
“Being a woman and a chief executive, I really see the benefits as a leader,” she says. “Women are more intuitive, and I think that contemporary businesswomen are very comfortable in letting their emotions show and be part of the workplace, so long as that is structured within a framework.”
Ultimately, says Matthews, the key to being a successful person or growing a successful business is not whether someone is male or female, but rather the blend of people that one is surrounded with: “The best companies are those that have a mix of sexes, ages, backgrounds and cultures working together. The more depth you have as a company, the more solid and effective you will be not just in the marketplace but as an employer with a great corporate culture.”
HEALTH: May 05, AU Edition
TYPE-A FOR EFFORT
A little hard work never killed anyone, but coping poorly with it can do some real damage
Keep working like this and you’ll give yourself an ulcer!’ The year is 1982, and all they do is work, work, work. Late into the night and early into the morning on this damn fool scheme of theirs. These are driven men, mavericks, pursuing their research until finally one of them gets an ulcer.
And what was the grail these blokes were chasing? Proof that stress and personality are not the major factor in the development of peptic ulcers. The men were Australian doctors J. Robin Warren and Barry Marshall, and they intentionally gave Marshall an ulcer to prove their hypothesis, namely, that the bacterium Helicobacter Pylori (and not worry or stress) is what causes ulcers. It took a long while to persuade the medical world of this, so it is little wonder that many amongst us still believe stress causes ulcers, amongst other things.
Science has been hard at work on the stress-and-health connection for some time now, and it’s now very clear that – for rats – being confined in a small cage with lots of other rats, an unpredictable food supply, and the odd electric shock is definitely not a healthy way to live.
Human studies are not nearly so conclusive. For every study that sees a link, another one doesn’t. Time for some hair-splitting.
So-called ‘type-A’ personalities are hostile, impatient and competitive. Picture a red-faced fellow running across the road (can’t wait for the traffic lights), yakking into the mobile phone that is wedged between his shoulder and ear while at the same time shoveling a burger and coffee into his mouth. This type of individual is often described as a workaholic. He (or she) is also probably very good at his or her job, very likely feared and reviled by employees and underlings and, in all probability, proudly describes himself (or herself) as a ‘Type-A personality’. Everyone he or she knows warns them of their health risk. (Then again, when did you last meet someone who described themselves as calm and worry free? I just took an on-line stress test, and apparently my low score indicated that I am in severe denial about my stress. I think they were trying to sell me something.)
But if this hard-charging type-A isn’t destined for a stomach ulcer, then what kind of problems does he or she face? Although it runs contrary to conventional wisdom, having a ‘Type-A’ personality in itself has also repeatedly been shown not to cause heart disease. (In hospitals the joke is that this must be true, because cardiologists do not, as a rule, have particularly sanguine personalities). More often than not, it is how people choose to cope with the stress that brings them to grief.
Aggressive and high-energy workaholics do many of things to deal with their stress, and smoking and drinking (often a lot) is at the top of many a type-A’s list of hobbies. Thus high stress often appears to cause illness, when in fact it doesn’t. The stress causes bad behaviours, and the bad behaviours cause health problems.
Did I mention that there would be hair-splitting?
But this is a useful distinction, because behaviours like smoking can be changed. Of course, if society stopped rewarding angry men who work hard with nice jobs and lots of money that kind of behaviour might also diminish, but that’s another story.
The counter-argument that turns this on its head is one I hear a lot, and basically goes like this: ‘If I don’t deal with my aggressive feelings by yelling at people and slamming my phone down, all those repressed feelings will make me even more sick, even give me cancer’. Nice try, but no. Instead, it’s the same old story: genetics, diet, environment, smoking, booze, plus some other factors for some specific types, all cause cancer. Personality doesn’t.
But, despite the lack of a connection to heart and stomach problems, too much stress is definitely not healthy. Remember learning about the body’s fight or flight response in high school biology? Sense danger; flood body with stress hormones like adrenaline; in crease heart rate; make breathing rapid and shallow; constrict arteries near the skin (to curtail blood loss); increase blood pressure; release energy stores. All very, very good things to do if you happen to be cornered in a dark alley or need to flee a lion on the African veldt. But these physical responses to stress are of very little help in most offices – unless it is a particularly bad day.
One stress hormone that does have an impact on health is cortisol. This stuff raises blood pressure, increasing the work the heart has to do (fine in the short term, bad in the long) and suppresses the immune system, which means that it can lead to more infections and the like. Lots of cortisol, lots of the time, leads to lots of irritating colds and flus. So chill out. Take a deep breath and breathe out slowly. Now try to keep your blood pressure low and brace yourself for one last little nag.
And don’t even bother with ‘I don’t have time to…’ speech. If you’re a busy person, you don’t have time to be sick either, so take the time to look after yourself now.
Here’s the deal: Stress isn’t good or bad. But lots and lots of stress is bad. Go fix it so that disasters don’t happen constantly in your life, or failing that, teach yourself to cope better when they do. Practice saying the words, ‘thank you for telling me,’ instead of ‘what!!!!! How the !@#$...’ This works equally well for ‘Mummy, the dog did a poo on the sofa’ as, ‘Sweetheart, I love you, but I’m moving to Rio with the tennis pro’.
Also, stop doing all the things that really will shorten your life, and maybe even make it unpleasant while it lasts. Sorry. Let’s do that again. The cardiologist is going to say that. I’m going to say this: do one thing to be healthier. Maybe it’ll be enough. Maybe it will lead to other lifestyle changes. If you know you eat terribly, and you don’t want to change, at least take the odd vitamin. Run to the shops for your smokes, instead of driving. Drink with dinner, instead of for breakfast, that kind of thing. For my money, I’d start with exercise.
Even if it feels terrible the first twenty times, it will actually start to make you feel good. You will enjoy it, your mood will brighten, and you’ll sleep better. Maybe you’ll smoke less and eat healthier as well. It’s also easier to start doing something and make a new habit than it is to break an old one. If you think you might be getting a bit overwhelmed with stress or have some niggling physical problem, see the doctor. She’ll probably say what I said, only in a bossier tone, but better safe than sorry.
Look, you know what you’ve gotta do, so do I. I’m just going out for a run. To the shops…
HEALTH: June 05, AU Edition
NOT SO FAT
New numbers from America suggest obesity isn’t as dangerous as previously thought. But don’t reach for that Big Mac just yet
Obesity is the second-leading preventable cause of death in the United States, and it’s only a matter of time before we catch up. Unless, that is, you use their newly-revised statistics, which place obesity way down at number seven in the leading preventable cause of death in the US. In which case Australia’s death rate from obesity is now almost four times higher than that of the Americans! C’mon, that can’t be right. How many fatty-fatty fat-fats are keeling over, here and abroad? I want answers – and a burger, stat!
Well, there are lies, damned lies, and statistics. There is no universal formula for working out something as complex as how many people die from diseases caused by obesity. Working out how many people die from guns is relatively straightforward. As far as I know, the leading cause of gun deaths is guns. But what about cancer? It might be related to obesity, but the obesity isn’t required for the cancer. Skinny people die of heart disease, as do the, ahem, big-boned. If someone has a heart attack and dies, and is also overweight, there may be correlation. But since we know that skinny people have heart attacks too, how do we know if their chubbier cousin would have died of a heart attack anyway, irrespective of his weight?
To use the example of the Australian state of Victoria, their “Burden of Disease” statistics show that in 2002, 650 overweight or obese people died from cardiovascular disease, 450 from type-two diabetes and 300 from cancer. Catch the trick? That’s how we get our statistics down under. If a fat person dies from something that can be related to excess weight, it’s an obesity- related death. No statistics are available on how many of those people might have died anyway.
An example: Let’s suppose that one of those people was called Dazza. Dazza had a heart attack at a family barbie and died in rural Victoria died in 2002. At the time of his death he had three charred steaks, mounds of potato salad and eight or nine beers on board. He also snuck off behind the shed and had five or six Winnie Blues with his brother, but his wife didn’t catch him, so they don’t count. Always the clown, when old Daz grabbed his chest and fell down, it was six minutes before “get up, ya retard” turned to panic. The ambulance took fifteen minutes to arrive. Now although Dazza died of a heart attack, his passing also counts as a weight-related death and a tobacco-related death. Of course, the delay in treatment contributed. Having a father and two uncles who died of heart attacks before 50 also contributed. Now if Dazza died at 65, he’s doing well, compared with his ominous family history. The statistics fail to take these nuances into account.
The US Centers for Disease Control and Prevention estimated in April 2005 that too much weight accounted for 25,814 deaths a year in the United States, 14 times less than their January estimate of 365,000 deaths. Now the same number of people died, and the same number were overweight or obese. What the CDC did to get the new figures was to improve their statistical analysis. They took into account a range of factors, some of which may seem surprising.
Much of the problem comes from the use of the Body Mass Index, or BMI. You can easily calculate your Body Mass Index, which is your weight in kilograms (kg) divided by their height in meters (m) squared. So if I am 178 cms tall (from memory) and 59 kgs (distant memory), my BMI is 59 1.782, which makes 18.62 and places me at the low end of the healthy weight range (BMI of 18.5 – 25). If you are very fit (muscular), under 18, experiencing the effect of age (losing muscle), or pregnant, the BMI may not be accurate. The World Health Organisation also recommends different cut offs for south-east Asians, so if your genetic heritage is such, the BMI may not be accurate. If you have recently had a baby, you should substitute the lowest weight you’ve ever been for your actual weight, as I did (just for fun).
Generally 25-30 is considered overweight, and over 30 is considered obese. Further confusing the matter, the cut-off may change between countries and over time. For example in 1998 the US National Institute of Health changed their cut-off for “overweight” from BMI 27.8 to BMI 25. 30 million Americans, previously “technically healthy” became overnight “technically overweight”.
With limited variations this is how the statistical bodies know if you’re an obesity or weight-related death. Because of the limitations of the BMI I prefer the LBM assessment (Look in the Bloody Mirror). It should be abundantly clear (unless you have a body image disorder) whether you are healthy, overweight or obese. And I have to say, being obese is defiantly not good for you, there aren’t two ways about it. It will put you at risk for a lot of things (cancer, heart disease) that will shorten your life (you’ll die). More so than if you were trim and terrific. If you are merely overweight, however, it’s not so clear.
How many people do you know (often women, but not always) who go to the gym, swim twice a week and do yoga on Saturdays and are still “big boned”? They probably have good muscle tone from the exercise, but you may not see it for the soft curvaceous coating. I personally spend a good deal of time participating in toddler aerobics and I believe you could bounce a penny off my “abs”. If you could find them under the squishy layer of stored energy, which you can’t. So if people are overweight, are they automatically at risk of overweight related death?
A study in 1996 confirmed earlier research which showed that for adults over 35 attempted weight loss is associated with lower all-cause mortality, regardless of whether or how much weight is lost. So trying to loose weight is beneficial for your health, even if you don’t loose weight. It’s common sense: an overweight person who works out and eats well should be much healthier than a lazy, unfit, skinny person. Fitness generally seems to mean cardiovascular fitness, which is achieved through cardiovascular exercise, which leads to a healthy heart. If you happen to exercise until you can talk, but not easily (a useful rough definition of effective cardiovascular exercise) for 40 minutes at a time 3 times a week, you should know for yourself that you are healthy. You may, however, still be overweight.
Have a look at the people in your family. Scientists have not yet discovered the gene that causes a craving for breakfast at McDonalds, but they have discovered a small number of genes for obesity. And there are probably more. As in all things, some people are better at some things than others, even at a physiological level. Some people don’t get enough iron in their diet, but their body is very good at using what they get, and they just never get anaemic. Some people are just efficient fat burning machines, eat badly and do no exercise yet stay skinny. Not healthy, mind you, just skinny. Some people just have a hard time losing weight, but if they are doing all the right things, they could well be healthy. If a 10-metre sprint for the bus leaves you breathless, I don’t care how you look, your health is in trouble.
You can be fit but overweight if you try because for all the books on weight loss out there, the whole thing is simpler than you’d think. If the energy you take on is more than the energy you expend, you gain weight. You burn calories/ kilojoules/energy (synonyms for popular purposes) all the time, to breath, to sleep – perchance to dream – to walk to the shop. And you intake energy all the time. If it’s not water and it goes in your mouth to your stomach, it counts as energy.
The more energy you expend (all common sense; walking burns more energy than watching TV etc) the more energy you burn. You could get fat eating apples if you ate a lot of them and moved as little as possible. So if you are overweight, you need to eat less or exercise more. Of course, if you exercise more, you will be fit, which is good. If you just eat less, you could be skinnier but no healthier.
Bottom line, fitness counts for more than weight. We don’t really know how many “overweight and obesity related” deaths happen. I’m not sure what it matters. Being overweight may cause (indirectly) death, being unfit is a better target.
We shouldn’t (alas we do) judge this on how you look. It doesn’t matter what the stats are, I tell you this; if you can’t run for the bus, you’re in trouble.
HEALTH: Apr 05, AU Edition
SLICE OF LIFE
The circumcision debate has reignited, with a Melbourne doctor calling the controversial cut a lifesaver. But is it really?
What do you call the useless bit of skin at the end of a penis? The man. Sorry, that just popped out. And while it may be funny, it’s also just as inaccurate an answer as any, since the human foreskin is actually not particularly useless; it protects the penis underneath.
It also harbours the Human Papilloma Virus, which causes penile and cervical cancer. Oh yeah, and it is also said to facilitate the transmission of HIV.
On second thought, it’s worse than useless – it’s an absolute death trap! Off with their…anyway.
Somewhere between 80 and 90 per cent of Australian boys are, like my own two sons, uncircumcised. The Royal Australasian College of Physicians sees no reason to support routine newborn circumcision, so it is not regularly performed in Australia or New Zealand except for religious or medical reasons.
Ah, but wait. The aptly-named Professor Roger Short of Melbourne University and the Royal Women’s Hospital’s obstetrics department, has recently suggested that we reconsider our attitudes. Short’s research has shown that because the HIV virus enters the body via the foreskin, circumcised men have 7 times less chance of contracting HIV than uncircumcised men.
The Human Papilloma Virus, or HPV (a nasty little bug that causes cervical cancer in women and the much rarer penile cancer in men), also lives under the foreskin, so women with an uncircumcised partner have twice the risk of developing cervical cancer.
This research is actually in line with previous research on the subject, so I’m going to go along with the man and presume he’s correct in his research findings. It’s the conclusions that follow on from these findings that I have trouble with. Let’s walk through this: you live in a western democracy which has soap, running water and condoms widely available. Rates of HIV are low in your community. The spread of both HIV and HPV viruses can be nearly entirely stopped by the use of the aforementioned condoms. So you conclude that to prevent your tiny baby from ever contracting HIV or HPV, you should go messing about with his penis.
I’m not saying the science is faulty: I’m saying that if my boys can’t think of a better way to avoid contracting HIV than surgery, then we have a whole other set of problems on our hands.
The value in Prof. Short’s research mayfc be found in countries with endemic HIV. Encouraging routine circumcision of newborns in countries which already support the practise may have implications for reducing the spread of AIDS in conjunction with public health teaching about safer sex practices. (Less happily, it may also fuel the belief that condoms aren’t necessary). Unfortunately, countries with high HIV rates don’t tend to have large clean modern obstetric units or much in the way of local anaesthetics and sterile equipment, so one would have to assume that the complication rates of circumcision would be higher than in Western countries.
Of course, there are other reasons for circumcision, religion being chief among them. Jewish and Muslim babies are circumcised in the first week or so of life, rapidly (as one would hope), and generally with local anaesthesia.
That’s all very well and good, but my bigger concern is with the pursuit of circumcision for “socio-cultural reasons” (“so that the boy matches his dad” is a surprisingly common justification). Parents wishing their child to be circumcised for these sorts of aesthetic reasons are advised to wait until the child is
HEALTH: Sep 05, AU Edition
A HEART-MENDING TALE
Turning the growth of blood vessels on and off could treat not just cardiac problems, but many cancers as well
The great elephant descended and left the indentation of its foot upon my chest….a Frankenstein’s monster of zipper scars and pirated body parts. Two heart attacks and two bypass operations – six grafts in all, loops of hosing jury-rigged around my jalopy of a heart. Two major crashes, but the motor still runs.”
One of the most beautiful writers I know was almost killed by that last heart attack. There is a touching, miserable aside in Heart: A Memoir about going on a farewell tour of good food. The author, my father-in-law, barely recalls it. Defending his memory, he points out that the book is ten years old. And the motor still runs.
So you see, I have a vested interest in keeping hearts running. According to the New Zealand Ministry of Health, cardiovascular disease is New Zealand’s biggest cause of death. Now, I’ll grant you, some of those people have reached an advanced age and are in the “gotta die of something” demographic. Unsurprisingly, when very old people are autopsied, examiners tend to find not just lots of things wrong, not just the heart failure that killed them. Cardiovascular disease, however, also takes a lot of lives prematurely. To die at 50 is not a tragedy in the sense that dying at 5 years old is, but it still has the sense of a life cut short about it that dying at 80, for example, does not.
You all know the risk factors, so I will not trouble to mention that being a chain-smoking, salt-shaking, cholesterol-scarfing, diabetic couch-potato booze-hound is not good for your heart. If this is you, you need to find a sympathetic family doctor and explain that you are not quite ready to change yet, but would they be a love and give you a quick once-over. Knowing your cholesterol levels and blood pressure may encourage you to change, but even if it doesn’t, at least you can get on some nice drugs to try and slow down the damage whilst you try to work up the motivation to change.
The heart is a muscle and it pumps blood, just like the Counting Crows song tells us. Let’s simplify it for a minute, and pretend that there is simply a loop of hose going in a circle from one side of the heart-pump to the other. Of course, it is a tricky hose, it narrows into increasingly tiny vessels to supply every bit of you with blood. But it will do, as a metaphor. Blood pressure is a measure of how hard heart-pump needs to work to push the blood all the way around the hose and back to the heart. Hopefully the pump can do this easily. When blood pressure is high, the pump is knocking itself out trying to push the blood around. Probably because there is some kind of gunk (cholesterol) clogging up the inside of the hose. The clog can be in your foot, your brain, anywhere. If there is so much gunk (cholesterol) built up that the blood can’t get through it will swell up and burst. If this happens in our brain, cerebral aneurysm (stroke) ensues.
(Note to guys not motivated to change: you know how if blood supply isn’t getting to your brain, it will loose function? Now replace the word “brain” with other body parts until you feel alarmed. Some causes of impotence are avoidable. Maybe a jog, perhaps?)
If all the gunk is near the heart, and the hose is narrowed, then the heart-pump doesn’t get blood. Your actual heart, not our hypothetical pump, needs oxygen, and blood carries oxygen. If blood is not getting to your heart, it is not getting oxygen. It will alert you by causing pain. In angina, the pain is an alert that the heart is suffering, but getting some oxygen and will be OK with rest or a nitro tablet. Beyond angina, the heart keeps aching. The elephant standing on the chest is a common symptom, but the chest pain may be in the arm, shoulder, back. If you have the slightest doubt about chest pain, call the ambos. They will not be angry at you for being fine. You will be angry at yourself if your heart has been dying while you sat at home with the martyr’s wait-and-see attitude. Some people, especially women and the elderly, report symptoms other than chest pain as the primary symptom, for example sudden shortness of breath, dizziness or extreme fatigue.
We assume, at this point, that you have heeded none of my advice except the bit about calling the ambulance. You are in the cardiac care unit, having had your first or second heart attack. What are your
options? You can have angioplasty, where they get into the hose going into your heart and squash, laser or chop out the offending cholesterol. They can put a nice little stent in to hold the artery open. If things have gone past that point, you can get a CABG (coronary artery bypass graft, known as “cabbage” in the trade). The trick here is to dig up a nice big artery, probably from your leg, and jury-rig a detour for the blood to get back to your heart. Obviously there will be some chest-cracking here – it is not a low-risk procedure. Ah, but that spot of dead lazy heart is still freeloading on the rest of your heart, so you must take care.
Now imagine if you could just get the heart to grow nice new hoses, or blood vessels. Angiogenesis is the word for this, and it is an exciting idea at the bleeding edge of research. If doctors can control the growth of blood vessels then they can do two things: grow new hoses where they are needed (in cases of peripheral vascular disease and coronary artery disease) and stop cancers from growing their own blood vessels. Solid cancers need blood supplies to get oxygen and nutrients to grow. No blood, cancer dies.
Human trials are currently underway in the US to develop gene therapy for treatment of heart disease. It is a complex procedure, done at the research level. It works like this: first, researchers find a useful gene and then try to get a patent on it so that they have the intellectual property rights to develop it. (Yes, a lot of people are opposed to this, but consider the alternative: A research-and-development company thinks they have a gene that might revolutionise cancer therapy. It may take many years and a lot of money to get it to market, and many promising therapies will be dropped well before the end of the race. So, what, they should apply for an arts council grant instead?) Then the researchers trick a bacteria or mammalian cells into reproducing the gene, and then they strain it out and clean it up at a very high level. Then all they have to do is prove that what they have created – complex very large proteins – is what they have the patent for. The only thing left is to make it work.
An Australian company, Amrad, has the rights to something called vascular endothelial growth factor B (VEGF-B) and is developing potential cancer therapies with it. Specialising in cancer treatment themselves, they would license the rights to the gene to develop cardiac treatments. David Crump, Amrad’s medical director, told me, “It’s an area of a lot of interest and theoretically it should work…when it hasn’t we have to find out why. Eventually we will get it to work…but then you’ve got to prove it”. Several American companies have reached the human trial stage with these types of therapies, and there are a few coming on to the market now.
For obvious reasons, researchers are only allowed to trial new medicines in people for whom readily available treatment isn’t working. Over ten years ago, only one of the angiogenesis patients in his trial showed any particularly amazing response, and it was decided that the treatment needed much more work and wasn’t brought to market then.
Overall, it was not a particularly successful venture. But, hopefully not in the too distant future, more patients will be good responders to the new medicines. Like my father-in-law, the one good patient, very much alive today.
June 05, AU Edition
In America, it’s ‘no glove, no love’. Across the Tasman, the rule is, ‘no rubba, no hubba’. In parts of Australia, the message is, ‘safe sex, no regrets’. So with all the money being spent pushing the message that condoms are a cure-all, why are many sexually transmitted diseases on the rise? As JAMES MORROW finds out, the safe sex ad campaigns are only telling half the story – which begs the question,
IS SAFE SEX REALLY SAFE?
Here’s an interesting but little-known fact about condoms that may just win you a meat tray down at the pub Thursday night: the use of condoms dates back at least as far as ancient Rome and Egypt. Not only that, but archaeologists have discovered early cave paintings that seem to suggest (appropriately enough) that pre-historic Frenchmen may have discovered the things thousands of years before the New York Times ran the first-ever print ad for ‘Dr. Power’s French Preventatives’.
Looking for more condom trivia? Before the latex condom was invented, condoms were made by hand-dipping molds into rubber cement (hence the slang term). But in 1919 an inventor in Ohio by the name of Frederick Killian figured out that latex was a much better material for the purpose, and by the mid-1930s, at the height of the Depression, American manufacturers were producing 1.5 million condoms a day.
Oh, and here’s one more interesting thing about condoms: contrary to popular belief, they are not hugely effective in preventing an incredible variety of sexually transmitted diseases – from HPV, or human papilloma virus, which is linked to more than 90 per cent of cases of cervical cancer and also causes infertility, to herpes.
How can this be? Since the mid-1980s and the discovery that AIDS could be prevented by condoms, ‘French letters’, ‘rubbers’, and ‘raincoats’ have stopped being something that people whispered and tittered about and instead become deadly serious business. Around the world public health authorities, looking for a way to keep AIDS from spreading out of control, have been promoting condoms in earnest for nearly two decades now with a variety of advertising campaigns.
And at least in terms of AIDS prevention, it seems to have worked, especially in Australia: since the all-time high of 953 newly-diagnosed AIDS cases in this country in 1994, the number of new patients has been steadily trending downwards. In 2003, the latest year for which figures are available, there were just 290 diagnoses of new AIDS cases. With an incidence rate of just 1.5 people stricken per 100,000 population – compared to far higher rates in many other Western countries, including the United States, where the rate is ten times higher – Australia could truly seem like the lucky country, sexual-health wise.
But all is not happy and healthy in Australia’s bedrooms. While the number of AIDS cases is admirably low, the rates of many other infections are on the rise – and while none are necessarily the death sentence that an HIV infection represents, they have potentially huge consequences, including cancer and infertility. Public health experts have seen a tremendous increase in cases of diseases like chlamydia and syphilis; in the state of Victoria, the situation is so bad that Chief Health Officer was compelled this past March to issue a formal Health Alert to general practitioners telling them to watch out for the sudden uptick in syphilis cases. That sort of warning is not an everyday occurrence: the last time the Chief Health Officer issued such a bulletin was in 2003, warning doctors to be on the lookout for SARS.
There are many factors behind the rise in various STDs, but one has gone all but unreported in a culture where, officially at least, condom use has taken on an almost sacramental nature: studies conducted over the past few years show that, far from being the be-all and end-all in sexual protection, condoms only offer limited protection.
In other words, when the emperor has no clothes on, a condom is of limited, if any, use in protecting him from a host of diseases.
Back in 2001, the United States’ National Institutes of Health published a series of findings that were shocking, both because they completely overturned long-held conventional wisdom on a very important topic, and also because they received virtually no coverage. Indeed, the Washington Post at the time reported that ‘some health officials considered keeping the report private’, adding that ‘some family planning advocates said they feared that the new report would be used to put pressure on the FDA to change condom labels to reflect the conclusions.’
As one commentator put it, ‘It’s like hearing that Grandma died and immediately asking if Grandma will be making brownies for the funeral. The reality of the loss just hasn’t sunk in yet.’
Among other things, the study found that when one partner is infected with herpes, using condoms cut the risk of transmission by only about forty percent. Meanwhile, with regard to human papilloma virus, by far the number one cause of cervical cancer, ‘the Panel concluded that there was no epidemiological evidence that condom use reduced the risk of … infection’.
And this doesn’t even begin to take into account the misuse, or irregular use, of condoms: according to just one study of high school students in NSW, 68 percent of those surveyed who said they were sexually active admitted that they didn’t use condoms every time they have sex, despite the fact that virtually every kid in the state’s schools is given lessons in how to use the things. And even among adults, condom usage can be irregular, or start too late in an encounter, to prevent the spread of many infections.
‘The term “safe sex” needs to be examined in detail’, says Dr. Caroline Harvey, Medical Director for Family Planning Queensland. ‘We give people many mixed messages depending on whether we are talking about preventing pregnancy or sexually transmitted infections or HIV. In my dealings with clients, I’ve found that when they ask about safe sex, you need to talk to them and pull apart what they’re talking about.’
‘Viral infections like herpes and HPV do spread from skin-to-skin contact’, she adds, something that many people who come into her office are unaware of. According to Harvey, depending on what the client is looking to prevent, the options may be very different – something that doesn’t always come through in media campaigns such as NSW Health’s recent ‘Safe Sex, No Regrets’ effort.
Still, ‘condoms are useful’, maintains Anna McNulty, Director of the Sydney Sexual Heath Centre, when asked about diseases that spread despite the use of condoms. McNulty adds that the increase in the rates of infection various sexual diseases – chlamydia rates have trebled in NSW alone in the last five years according to one estimate – could come from a variety of factors, including the lack of access to health care among young people.
The problem, says McNulty, is that ‘people use them some of the time but not all of the time’, and admits that while a great way to prevent things like AIDS and unintended pregnancies, in terms of preventing herpes and the genital warts that can lead to cervical cancer, ‘they are not as effective.’
An added challenge is that fact that many diseases such as chlamydia can be asymptomatic, especially in men. ‘It can be silent for a long time, but it can cause significant damage’, says Dr. Harvey.
Despite this, many of Australia’s state governments and other public health bodies are delivering a mixed message. While, for example, South Australia’s Health Department’s web site frankly states that ‘condoms will give you some protection from most sexually transmitted infections, but some, like herpes, crabs and genital warts, can spread through skin-to-skin contact’, it is a message that often gets lost when it is boiled down to a catchy slogan – such as ‘Safe Sex, No Regrets’, the message currently being pushed in NSW Health ad campaign.
Featuring a variety of television and print ads, the ‘Safe Sex, No Regrets’ campaign shows groups of healthy, happy, good-looking young people – straight and gay and of various ethnicities – in different social circumstances. The copy on the print ads says things like, ‘Tonight I’m picking up chlamydia’ or some other disease, with the name of the disease crossed out the word ‘condoms’ printed underneath it – the implication being that condoms are all one needs to have what the tag-line calls, ‘no regrets’. In one ad specifically targeting Aboriginals, readers are told that ‘sexually transmitted infections … can affect anybody who has unsafe sex.’
Which is absolutely true, but again fails to mention that condoms are not foolproof against disease – and that ‘no regrets’ is a pretty broad statement that implies something close to 100 per cent reliability. Yet very little is ever 100 per cent when health and medicine are involved (and in the sense that condoms are used to prevent the spread of disease, they have a medical component). If the maker of any other device with as many caveats as condoms have attached to them ever tried to advertise in a similar way, they would be shut down by the authorities sooner than the casual couples featured in NSW Health’s campaign could wake up the following morning with a splitting headache and serious misgivings.
But while the campaign does not tell the whole truth about condoms, McNulty says that ‘you have to keep the message simple, and the “Safe Sex, No Regrets” campaign did a good job as it targeted both young heterosexuals and gay men.’ She concedes, though, that even with 100% condom usage, people are not fully protected against skin-to-skin infections.
So what to do about all this? A national strategy on sexually transmitted diseases is due to be released in July, and according to McNulty, it will definitely have an emphasis on chlamydia and the sudden spike in infection rates, and will push for increases in screening. Easy tests now exist to detect the infection, and treatment is normally a simple antibiotic treatment. But the campaign will also continue to emphasize ‘safe sex’ – something which is far as it goes, but which is not a be-all and end-all solution. The problem is that sex is a much more complicated thing than people on all sides of the debate care to acknowledge, which is why diluting information about condoms to a happy, easily-digestible slogan that inspires false confidence is an irresponsible position for public health authorities to take.
Yet that is exactly what campaigns such as ‘Safe Sex, No Regrets’ does by telling young people that using a condom is as simple a way to have a good time while preventing misery down the road as, say, advising them to only drink bottled water when they’re backpacking up some gorgeous Third World coastline.
While it may not be as sexy a message, so to speak, states should instead work to tell people of all ages in the community that despite their best efforts, behaviours – especially risky ones – can have consequences. The campaign wouldn’t have to be prudish or paranoia-inducing, either, but simply give people the facts: condoms are great for certain things, but there are still risks involved with having sex with people you are not sure the history and health status of. No one would dream of running an ad implying that wearing a helmet was all one needed to stay safe when riding a motorbike; there are plenty of other factors involved that keep one safe on the road, and people are well aware of this. The same sort of truth needs to be told about condoms.
HEALTH: July 05, AU Edition
CRAZY ENOUGH TO WORK?
Bad movies and worse ideas contribute to our misunderstanding of mental illness
The infamous Australian stockbroker Rene Rivkin was convicted of insider trading in 2003. Now my understanding of insider trading is that you know something other people don’t and use it to make money on the stock market. Dangerous criminals such as Martha Stewart have been jailed for this heinous crime, as was Rivkin, who was given nine months periodic detention. He fell to pieces in prison and was hospitalised. There was little sympathy for him at the time, perhaps because he didn’t suffer from something nice and straightforward, like epilepsy or a stroke. Of course he did have that benign brain tumour, but since it only affected his mental health and not, say, his ability to walk, no one cared. That and bipolar disorder. ‘The big baby’, people thought, ‘trying to get out of his prison term by saying he was unbalanced. Pull your socks up Rene, you big faker. Get over it and do your time.’ Rivkin was divorced from his wife and committed suicide at his mother’s home earlier this year. He was survived by five adult children.
Great attitude towards the mentally ill, huh?
About a month ago I saw one of the local mums in the playground. New babe in arms, looking drowsy, and could this supermum be her pre-pregnancy weight? ‘You’ve got it going on’, I commented. I waited for the inevitable litany: ‘oh no, I had terrible morning sickness, I actually lost weight…” Well, I should have known her better; she has integrity. I have never known her not to be straight up and she was. ‘No, it’s crap. I’m depressed.’
Give the woman a medal: it takes a hero to stand up and shine the light on the proverbial black dog. It really stood out for me because of the rarity of both insight in a person with a mental illness, and the raw honesty she displayed.
The movie Me, Myself and Irene was about a ‘schizophrenic’ who had two personalities. More like Jekyll and Hyde, really. I asked around and apparently a lot of people believe that schizophrenia is something that gives a person a split personality where normal self is intermittently replaced with a Jim Carey character who thinks he’s Jesus. Kinda fun-sounding, almost. Another film, Girl, Interrupted, features Winona Ryder as a young woman with ‘borderline personality disorder’ (and the tagline, ‘sometimes the only way to stay sane is to go a little crazy’) who suffers psychological distress and in the end receives enlightenment. It could happen to anyone, right? Well, no. Personality disorders are pervasive, life-long, and serious. Meeting Angelina Jolie does not provide any insight for the patient, and for their poor families, it probably makes things worse.
Mental illness affects a lot of people, but the statistics are different depending whom you ask: 1 in 4, 1 in 10, 1 in 25. In the end, what difference does it make? We’re still talking about a lot of people. And yet we still can’t decide whether mental illness is a big deal or not. People seem to talk a lot more about it (Rivkin was very upfront about it), but as a community we don’t seem to do much to help. Do we even know much about mental illness? Mostly it seems to depend on which campaign the health department is running at the time.
Aside from the really esoteric out-there stuff (rare specific psychoses about shrinking genitals, Munchausen syndrome, and so forth), when people talk about mental illness they seem to mean either the psychotic illnesses where the patient sees, hears or believes things that the rest of us do not (yes, it’s complex, and there are many other symptoms) or affective disorders (disorders of mood). Aside from the obvious symptoms, mental illnesses have many other symptoms, such as disordered thinking, sleep disturbance and so forth. They are not fun, nor are they easy to deal with. They can either be managed and lived with in one way or the other (for most people), or they can spiral out of control, ruining the lives of everyone they touch. The homeless guy ranting on the street corner? How do you think his mum feels?
Maybe the term “mental illness” is too broad. It describes everyone from the person who gets mildly depressed and then mildly manic, also known as cyclothymic disorder (which can even at times be an advantage in life) to the person who is totally divorced from reality. Rivkin was desperately seeking help and understanding. The illness that gave him an energetic business edge also gave him week after week of abject misery. His family was shattered, over and over again. And Rene got the best medical care that money can buy. What do you think you get if you can’t afford private treatment?
You get a prescription. And that’s about it, unless you happen to be competent, live in an area where mental health services are accessible, and be referred by someone who knows what help is available. Private psychiatrists charge fees. Psychiatrists in public services have time to treat people in crisis, and that’s about it.
We know that early intervention works. But unless you (or a family member) have the insight and the cash to front up to the appropriate specialist(s) seeking and paying for help, you are unlikely to get help until you show up in an emergency room with a gut full of booze and grandma’s sleeping pills. People with severe mental illness don’t advocate well for themselves. The ranting homeless are sleeping under the letters to the editor, not writing them.
Perhaps part of our problem is that mental illness is a new frontier. For the longest time, we have acknowledged the existence of mental illness, but effective treatment and recovery is a new thing. The first effective treatment for a mental illness was lithium carbonate, accidently discovered by an Australian doctor in 1948, to be a highly effective treatment for mania. This was back in the days when you could just test any old theory out on your hospitalized patients. The occasional person died from lithium toxicity, of course, but suddenly we had a medication that specifically treated mania. This assisted in refining the distinction between psychotic mania and other forms of psychosis. It also allowed very sick people to quickly get better and be treated as outpatients.
Iproniazid, the first modern antidepressant, was originally developed to treat tuberculosis in the early 1950’s. In addition to treating tuberculosis, iproniazid was observed to elevate mood and in many patients. The first tricyclic antidepressant – no longer used due to toxic side effects – was likewise discovered accidentally in the search for a treatment for schizophrenia. The first modern selective serotonin reuptake inhibitor (Prozac) was released in 1987. There are now a whole new generation of treatments for depression. There are now anti-psychotic medications that do not belong to the “major tranquilizer” group, because they are not majorly tranquillizing.
Our understanding of these drugs gave us insight into how mental illnesses might work, and not the other way around. As medical treatments to treat chemical imbalances in the brain get more refined, our knowledge of mental illness increases. Go on, write me. Perhaps the odd person goes nuts and kills their family entirely due to taking Prozac. It’s very, very rare, if it happens at all. But certainly a significant number of people destroy their own lives and families (literally and figuratively) as a result of their untreated – or perhaps untreatable – mental illness.
We don’t do well at handling mental illness (in ourselves or others). Should, but don’t. The last sixty or less years have been a sharp learning curve. Sorry, Rene, you deserved better.
November 27, 2007
Aspartame: Sweet Little Lies, Sept 07 issue
How a popular artificial sweetener in all diet drinks,
“sugarless” gum, low-fat icecream and a host of “sugar-free” diet, fitness and drug products, is probably creating health problems for a good number of New Zealanders and Australians, argues campaigner CHRIS WHEELER
In 1987, a leading scientist issued a grim warning about the key ingredient in a wide range of food products: “I am a Pediatrician, a Professor of Pediatrics at Emory, and have spent 25 years in the biomedical science, trying to prevent mental retardation and birth defects caused by excess phenylalanine…I have considerable concern for the increased dissemination and consumption of the sweetener, aspartame, (1-methyl N-L-a-aspartyl-L- phenylalanine) in our world food supply.
“This artificial dipeptide is hydrolyzed by the intestinal tract to produce L-phenylalanine which in excess is a known neurotoxin. Normal humans do not metabolize phenylalanine as efficiently as do lower species such as rodents and thus most of the previous studies in Aspartame effects on rats are irrelevant to the question, ‘Does phenylalanine excess occur with Aspartame ingestion?’”
Professor Louis J. Elsas, II, M.D., Professor of Pediatrics, was testifying before the US Senate Committee of Labor and Human Resources on the subject, “Nutrasweet: Health and safety concerns”, November 3, 1987.
That was 20 years ago, and aspartame, or Additive 951, is still in use. As Elsas stressed at the time, the rat studies which were used to “prove” aspartame’s safety are inappropriate because human beings are not rats, a point which New Zealand and Australian food safety regulators, toxicologists, doctors and politicians still refuse to recognise. We, in possession of a bit more elementary commonsense, may choose to differ on the point of whether we are all being treated as the real laboratory rats by the time the sad – but also absurd – tale of aspartame is finally spelled out in these pages.
Rats are, of course, the basis of food safety science. We can’t afford to kill human beings in the course of supporting food industry profiteering. We use the poor rats – and dogs, cats, rabbits and monkeys – as part of our experiments that have seen some 80,000 toxic chemicals introduced for our “convenience” over the past 60 years by industry with often the barest attention paid to long-term health outcomes for actual human beings. Rats are – in a sense – our surrogate consumer advocates: they die on the Cross of science for our sins and bad science makes sinners of us all.
In the meantime it has often become difficult to find anyone in our immediate circle of friends who is really well, while a familiar pattern has developed of alarming new diseases and disorders developing at earlier and earlier ages alongside endemic infertility, an increased rate of birth defects and children and even babies falling sick with cancer – something previously unknown to our forefathers. But so familiar are we with the sea of synthetic chemicals washing around us we never attribute blame to them, in fact we even add them to our food to enhance flavour, “mouth feel”, smell, colour and, of course, sweetness – the thing we use aspartame for instead of ordinary old sugar or honey.
But what about our children?
Consider for a moment how many cities around New Zealand and Australia are opening new hospitals and setting up increased facilities especially for treating children who in ever-increasing numbers are going down with what used to be relatively rare adult diseases like diabetes, leukaemia, brain tumours and weird new diseases like autism and hyper-activity that turn tiny kids into monsters. Generations who had children before the 1950s would wonder why we so nonchalantly accept the huge toll of chronic disease in children that now exists, with so little comment and such apparent acceptance of the inevitable.
Meanwhile we carry on feeding ourselves and our children with the thousands of new convenience foods laden with a witch’s cauldron of chemical preservatives and additives, convinced by TV advertising and our faith in a vague common social mythology that neither our politicians, our health regulatory bureaucrats nor our complaisant food and beverage industries would deliberately poison us.
Worst of all, many of us are now feeding a new generation of human beings – our babies, our children and our pregnant selves – with a popular synthetic sweetener poison, aspartame/Additive 951 (also known as Nutrasweet, Equal, Spoonful, Benevia, Equal Measure, Canderel, etc), which has been reported in a long series of scientific, peer-reviewed studies as carrying the ability to maim, distort and disable intellectual and physical development from the foetal stage to adolescence.
In fact, over the 26 years that have passed since aspartame’s introduction into the world food chain we are now moving into generations of human beings whose parents and parents’ parents have been continuously exposed from breakfast to dinner-time to aspartame, monosodium glutamate and a baneful assemblage of human nervous system toxins that American neurosurgeon Dr Russell Blaylock has termed “excitotoxins”, chemical poisons that can over-excite the neural pathways to the point of nerve death. (1)
What is more, while we have finally accepted in our law courts and at a Government level that substances like Agent Orange, lead, and blue asbestos can medically disable particularly where long-term exposures are involved, we seem quite unable to extend that logic to the artificial dietary chemicals that we consume every day, year after year.
Little wonder then, that ill health and classrooms full of medicated children are part of normal, daily life and lunatic murders, road-rage, air-rage, depression and a steady media reportage of odd and irrational behaviour in people of all ages is just put down to “modern living.”
Unknown to most of us, and apparently ignored by the authorities we trust, aspartame use has been associated in the scientific literature with a huge list of medical and psychological disorders including irrational rage, headaches, numbness, fatigue, blurred vision and blindness, heart palpitations, brain lesions and tumours, memory loss, dizziness, muscle spasms, choking spasms, miscarriages, sexual dysfunction, irritability, anxiety attacks, vertigo, epileptic seizures, rashes, tachycardia, tinnitus, joint pain, nausea, mood alterations and depression, hearing loss, slurred speech, loss of taste, and insomnia, as well as eroding intelligence and short-term memory. It also helps trigger multiple sclerosis, epilepsy, chronic fatigue syndrome, Epstein Barr, Parkinson’s, Alzheimer’s, diabetes, mental retardation, lymphoma, and birth defects.
Since current Labour Party policy is recommending the use of diet products containing aspartame in our schools in order to counteract the growing obesity problem in our increasingly sedentary child population, we should pay attention to this recent warning from Professor Ralph G. Walton, M.D., Professor of Clinical Psychiatry, at the USA’s Northeastern Ohio Universities College of Medicine:
To whom it may concern: Although undoubtedly well intentioned, any attempt to replace sugared beverages with aspartame containing diet products will, in my opinion, have a devastating impact on the health of our children and adolescents. The alarming increase in obesity, type II diabetes, and a wide variety of behavioural difficulties in our children is obviously attributable to multiple factors, but I am convinced that one powerful force in accentuating these problems is the ever increasing use of aspartame. Aspartame is a multipotential toxin and carcinogen. The dipeptide component of the molecule can alter brain chemistry, significantly changing the ratio of catecholamines to indolamines, with resultant lowering of seizure threshold, production of carbohydrate craving and in vulnerable individuals leading to panic, depressive and cognitive symptoms. The methyl ester component of aspartame is metabolized to methanol, which in turn is broken down into formic acid and formaldehyde. Methanol can lead to serious eye problems, formic acid and formaldehyde are potent carcinogens. The diet food industry and the F.D.A. (plus, also, our own NZFSA and FSANZ – ED) are fond of saying that aspartame is “the most studied product in history” with an outstanding safety record. In fact however virtually all of the studies in the medical literature attesting to its safety were funded by the industry, whereas independently funded studies, now numbering close to 100, identify one or more problems. It would be especially tragic if an attempt to improve the health of our children led to even greater exposure to this highly toxic product. Thank you for your attention to this urgent public health issue. Ralph G. Walton, M.D. Medical Director, Safe Harbor Behavioral Health Professor of Clinical Psychiatry, Northeastern Ohio Universities College of Medicine Adjunct Professor Of Psychiatry Lake Erie College of Osteopathic Medicine NOTE: Dr. Walton’s study on aspartame: “Adverse Reactions to Aspartame: Double-Blind Challenge in Patients from a Vulnerable Population,” is viewable on the website http://www.mindfully.org/Health/Aspartame-Adverse-Reactions-1993.htm and in the folder http://www.dorway.com/doctors.html#walton
Junk food addicts in Rotorua put a baby through a spin drier. Apart from “P” ("pure" methamphetamine), was Diet Coke involved? Aspartame reacts with methamphetamine to produce totally lunatic behaviour. The 2002 Lundy murders down in Palmerston North were committed by a husband and father, Mark Lundy, who slugged back over a litre of aspartame-containing beverages every day before finally murdering his wife and daughter. How many of the truckies and car drivers who regularly lose control of their vehicles on straight New Zealand roads or drive onto level crossings in front of approaching trains were consuming one or more of the aspartame products readily available on petrol stop counters? Airline pilots, using aspartame products to keep down their weight in a sedentary job, report suddenly experiencing dizziness and loss of spatial perception at critical points in landing planes filled with hundreds of the trusting public. Henri Paul, Princess Diana’s driver in that fatal Alma Tunnel car smash in Paris, was a heavy Diet Coke consumer and the medical drugs he was taking not only interact negatively with aspartame, but were prescribed in the first place to deal with symptoms probably caused by aspartame use. Tony Blair, George Bush and Bill Clinton all steadily consume Diet Coke according to the evidence of TV news clips. One could say Monica Lewinsky and the whole Iraqi bloodbath may have been influenced by the Clinton/Bush/Blair addiction to aspartame, a chemical closely connected to irrational behaviour.
Aspartame products like Diet Coke, Wrigleys gum, Lemsip, and Roche’s fizzy Vitamin B tabs are so constantly advertised on TV and present in our brainwashed lives that we take them for granted and never for a moment examine the hidden implications behind an additive our experts assure us is completely without blame.
And let’s not forget little Abby Cormack down in Wellington at this point. Her addiction to sugar-less Wrigley’s chewing gum with its direful health consequences occupied our media’s fleeting attention span for a few seconds in recent times. Of course the arrival of American anti-aspartame activist Betty Martini in support of Abby’s growing campaign wasn’t something our newspapers, particularly the NZ Herald, wanted to know about. The media, of course, can’t afford to rile Coca Cola or Wrigleys’ New Zealand representatives and their law hacks – their aspartame products bring in a huge advertising dollar.
In fact the one distinguishing feature of the short-lived anti-aspartame campaign last August/July (2007) was just how the New Zealand media steered clear of giving ANY space to the issue of what Kiwis could be doing to their health by making famous brand diet products containing a junk poison actually extracted from virtual raw sewage (genetically engineered E. coli bacteria are used to produce aspartame) part of their daily life.
The NZ Woman’s Weekly, which might be considered supportive of Kiwi women, even thought a story about aspartame hazards directed at women, who are the largest group consuming aspartame products, was somehow inappropriate given that their pages are usually devoted to much more serious issues like Paris Hilton’s stint in jail.
One shouldn’t expect the New Zealand Food Safety Authority (NZFSA) to take much interest in the issue. They refused to let Betty Martini speak (July 19) to their oddly-named Consumer Forum, which is stacked with people happy to act as a rubber stamp for Authority policy – policy which could be summed up under the rubric “Anything good for industry is good enough for the NZFSA.” Acting CEO Sandra Daly has herself confessed to using aspartame-containing products in firm belief in their virtue and the NZFSA vigorously defend the sweetener, convinced by all the shonky science from food industry junk “experts” and an American Food and Drug Administration (FDA) loaded down with ex-chemistry industry flakes that aspartame is the best thing since sliced bread. Regulatory authorities worldwide – even at the level of United Nations and European Union involvement – are hardly any better and seem to have a revolving door relationship with the chemical and food industries. Who else, after all, is going to give chemists and toxicologists the sort of salaries their university educations lead them to expect?
“Food is just chemicals” and “People are just chemicals” is the popular mythology inherent in a science and medical education these days, so why doubt aspartame, which, when all is said and done, never kills you straight away and is “just another chemical?”
Since I first became aware of problems being caused by aspartame back in 1990, I’ve been taken aback by the relaxed attitude of the science and medical community towards the whole chemical food additive and pesticide chemical residue issue as it relates to the human food chain. More alarming still is the manner in which ordinary people can put up with huge physical and mental damage from addiction to aspartame products like diet soft drinks without ever questioning the most obvious item(s) in their diet that could be causing the problem.
When I finally got to cross-examine Abby Cormack I was astounded to discover that sugar-free chewing gums were only the tip of the iceberg.
She’d been consuming aspartame products for a total of nine years and the gum was just the last straw to break the camel’s back and cause her total collapse into massive depression, muscular dysfunction, skin problems and other chronic symptoms that half a dozen medical specialists and numerous hospital visits could provide no answer to. Simply stopping her daily use of sugar-free gum produced an immediate initial cure. Now that she has been more than forty days free of ALL aspartame products practically all her medical symptoms have disappeared and Abby has become a leading New Zealand activist in a call from the Soil & Health Association, the Safe Food Campaign and the ADHD Association for a total ban on aspartame.
The whole aspartame issue becomes, in fact, a clear indication of the huge blind-spot we all collectively have towards the things we do every day and somehow it exposes a defect in our nature that even rats and other lower order species don’t appear to suffer from.
For unlike us, laboratory rats avoid aspartame wherever possible.
In fact when US corporate additive producer G. D. Searle (later Monsanto/Nutrasweet) and Food & Drug Administration (FDA) food additive regulators tried to force-feed the stuff to rats as part of the Mickey Mouse pseudo-science used to validate such additions to our diet worldwide, the rats – being much cleverer than us – carefully isolated the chemical grains of aspartame from the food it was mixed with and left the puzzled “scientists” and “experts” with neat little piles of the poison in the corner of their cages. Rats apparently don’t need experts to tell them what is safe. They rely on commonsense.
We are the laboratory rats!
Without a question of doubt, we are the real rats in the laboratory for a large number of food additive poisons in the food chain, but we are unlikely to be exposed to anything much more virulent and disabling than the scientifically established neurotoxin aspartame, (2) officially known as Additive E951 or 951 and technically defined as L-Aspartyl-l-phenylalanine methyl ester, 98%, aspartame CAS #22839-47-0, C14H18N2O5, which is now present as a sweetener in literally thousands of supermarket food and beverage products, as well as medicines and popular supplements. Patrol the shelves of your local supermarket, health shop and pharmacy and see for yourself. Look at the ingredient lists of your favourite foods and beverages and establish your own personal damage control.
Don’t expect much sympathy for your sudden interest in what goes into your food, least of all from our doctors, health authorities and politicians.
The only doctor in the whole of Oceania to stick her head over the parapets and condemn aspartame in public is Australian Sandra Cabot, in her Liver Cleansing Diet book series. And while Sue Dengate’s Australian food allergy activist group, the Food Intolerance Network (Website: www.fedupwithfoodadditives.info) covers a huge range of food additives and the problems they cause, aspartame only gets a mention among the huge list of other problem-causing chemical additives Sue has to deal with. Jenny Scott of the Attention Deficit and Hyperactivity Disorder (ADHD) Association in Auckland and our long-standing health and organics campaign association, Soil & Health (publishers of “Organic NZ) are similarly stretched. Voluntary organisations simply lack the essential resources to carry out a job we actually employ the NZ Food Safety Authority and Food Standards
Australia New Zealand to carry out using our tax dollars.
In a society with citizens more concerned and knowledgeable about food safety, NZFSA and FSANZ wouldn’t last longer than the time it took to close down both offices and turn their collective staffs out onto the street. But we all currently seem to accept a vague social mythology that says both organizations are doing their job. Truth is, they are not. They rely solely on suspect data from the food industry and from official regulatory bodies like the FDA and European Union and United Nations food safety qangos, who defer to experts reliant on industry for employment and funding.
The simple fact is, paid employment defending the public’s interest in genuine, ethical food safety does not exist outside the odd Green-type political party as in Europe or New Zealand, where isolated politicians like our own Sue Kedgley are prepared to devote a large slice of their life to coming up to speed with the essential scientific and political background knowledge essential to understanding the nature of a chemical additive like aspartame.
The media, watchful for their industry advertisers, completely ignore the toxin and treat yours truly and the handful of food safety consumer activists like Jenny Scott, Meriel Watts, Alison White, Patricia Holborow and Sue Kedgley (the whole food safety issue is women-led), as obsessives with too much free time on our hands. It’s only the small band of phenylketonurics among us who pay attention to the only toxicity warning appearing on aspartame products – “PHENYLKETONURICS: Contains phenylalanine” or simply the term “phenylalanine”, which means nothing to the rest of us.
Phenylketonurics suffer from an inherited genetic disease known as phenylketonuria (PKU), a severe allergy to phenylalanine. They must be particularly careful about what they eat and normally follow a carefully tailored diet which excludes high protein foods. Their motivation comes from the fact that they can suffer permanent brain damage if exposed to the raw synthetic phenylalanine which comes as part of the complex aspartame molecule. For the rest of us it’s “just another additive” and “the Government wouldn’t allow that sort of thing if it was bad for us.”
Well, Governments regularly do some pretty stupid things, and remaining willfully ignorant about something you may be consuming every day which has a long history of fraud, shonky science, corrupt politics and health hazard is certainly not bliss – aspartame can kill and “death” is one of the outcomes underlined in court documents filed as part of major class action litigation against the aspartame-using food industry currently in progress in the USA. (3) About this course of events, however, the Australasian media has so far been completely silent. It’s a can of worms no one wants to open in this country where aspartame is in thousands of products and approved by Government edict.
The silence is also very much a phenomenon of our south Pacific isolation. Particularly since release of recent Italian data (4) on aspartame’s firm connection with cancer there has been growing involvement of Northern Hemisphere media in discussing
the issue. In fact ever since Professor Olney pointed to an increase in brain cancers in November 1996, drawing attention to a rising curve in brain tumours in the USA starting within a year of the introduction of aspartame/additive 951 in 1981, there has been growing concern in the science community over the continued presence of aspartame in popular diet beverages like Diet Coke and in Wrigley’s chewing gum and a host of Weightwatchers, fitness, health and diet products (read food and beverage labels for 951, “artificial sweetener” and/or “Phenylalanine” warnings).
This concern reached critical mass recently with the publication in peer-reviewed medical journals of two intensive studies by the Italian Ramazzini Foundation, in 2005 and 2007 (4), that demonstrated a clear connection between aspartame consumption and a variety of cancers including brain tumours – something that the very first research on aspartame in the 1970s indicated before aspartame approval became a political issue pushed through the Food and Drug Administration (FDA) by the Ronald Reagan White House administration in payment for election campaign funding and support from the chemical industry (G.D.Searle and Monsanto in particular).
Of course in the normal, commonsense world where we, the ordinary public live, we should be able to say “Well, if there’s a problem over aspartame’s level of toxicity and other issues of potential hazard, we don’t want it in the food chain!” This is the sensible response. What nearly everyone in New Zealand – and certainly in NZFSA’s ironically-named Consumer Forum – doesn’t know, however, is how heavily politicised the whole issue of the original approval process for aspartame was under FDA governance.
Aspartame, as we have seen, is fully approved as part of our food chain by the combined regulatory agency, Food Standards Australia New Zealand (FSANZ) and our own NZFSA. FSANZ was formerly known under the rubric of ANZFA (Australia New Zealand Food Authority), but changed its name, according to popular Internet myth, because when you do a spell-check the suggested correction for ANZFA is always “unsafe”!
“Unsafe” is certainly the least of the criticisms one might make about Additive 951/aspartame. The synthetic sweetener rapidly breaks down in the human body into three chemicals hazardous to human health: – (1.) Aspartic acid, (around 40%); (2.) Phenylalanine, (around 50%); and (3.) Methanol (10%).
This breakdown process takes place spontaneously at a temperature of 30 degrees Celsius and happens immediately a diet product enters the human body (we operate normally at a temperature of 37 degrees).
Hence a can of Diet Coke exposed in those bins outside a service station on a hot day – a common sight anywhere in New Zealand and Australia – will already be laced with a cocktail of dangerous toxins as will any diabetic bakery and Weight Watchers product containing aspartame which has been heated in its processing. Any analytic laboratory can prove this point for you for a cost of less than $100.
The science behind methanol or “wood alcohol” toxicity is beyond debate. It’s something you learn about early in a chemistry training because it’s in every laboratory and is similar in some of its effects to ethanol, the ordinary drinking alcohol in all booze of whatever description. Easy access to methanol is a standing temptation at medical school and chemistry class parties, but it can blind you. Too much ethanol will normally only cause vomiting and loss of consciousness. Methanol is another story – it’s quickly absorbed through the stomach and small intestine mucosa and converted into formaldehyde, a severe poison and carcinogen. Then, via a process called aldehyde hydrogenase, it is converted to formic acid.
These two metabolites of methanol are toxic and cumulative. They can make you go blind and they can quickly kill you – which they do, often.
Anyone who consumes a litre or more of Diet Coke or some other aspartame-containing beverage per day is probably already near the limit for chronic methanol poisoning (6) and will be suffering muscle pain, headaches, migraines, sleep problems, dizziness and/or seizures, amongst other health problems. This is because aspartame breaks down extremely rapidly in a liquid form.
The well-known Hollywood actor, Michael J. Fox, sponsored by Diet Pepsi, has been diagnosed with Parkinson’s Disease.
He received free supplies of the sponsoring diet product. Parkinson’s is a well-diagnosed outcome from excess aspartame consumption, as is Alzheimer’s. Fox denies a connection to his Pepsi consumption, but aspartame and Parkinson’s – and Pepsi sales – flourish on such denials.
At the present time, in North America, there have been a rash of court cases and coroners’ court hearings over sudden deaths from acute methanol poisoning, which we, with our knowledge here, can connect to the chronic aspartame product consumption of the victims. Similar cases are probably occurring all over New Zealand and Australia, but may easily be attributed to other causes such as a heart attack unless a careful autopsy is carried out and a history of aspartame use discovered.
As this story was going to press the ad hoc group of activists publicizing Betty Martini’s anti-aspartame speaking tour of New Zealand main centres were collating records on the dozens of New Zealanders who have been contacting us over the severe medical problems they have been suffering due to addictive consumption levels of aspartame products like diet drinks and sugar-free gum. In every case they were completely let down by our conservative medical profession, who appear to be almost completely oblivious to the medical conditions caused by aspartame and listed earlier.
It’s the same story – and even worse – in the home of aspartame.
Chuck Fleming’s wife, Diane, is currently serving a 50 year sentence down in Virginia, USA, for supposedly killing him with a methanol overdose.
Chuck was a fitness fanatic, body builder and basketball player who drank litres of aspartame-containing diet drinks every day as part of his fitness routine and suddenly dropped dead – hardly surprising under the circumstances. The autopsy showed chronic methanol poisoning, enlarged heart, fatty liver, pulmonary oedema, etc – all symptoms of aspartame abuse. Police indicted Diane for poisoning her husband even though she helped them try and find out why he died and passed a lie detector test with flying colours.
Says methanol expert Dr Woodrow Monte (presently in retirement down in Tim Shadbolt’s Invercargill) “When diet sodas and soft drinks, sweetened with aspartame, are used to replace fluid loss during exercise and physical exertion in hot climates, the intake of methanol can exceed 250 mg/day or 32 times the US Environmental Protection Agency’s recommended limit of consumption for this cumulative poison.” (6)
Dr. James Bowen, an authority on aspartame toxicity, explains that the heart muscle is very sensitive to methanol alcohol poisoning and any stress on the muscle from such a source often results in sudden death. He says: “The aspartame molecule is an alcohol poison about 20,000 times as toxic a poison as ethanol (regular old sipping, or beverage alcohol) on a per weight basis.” (7)
NZFSA and FSANZ, secure in their ivory towers down in Wellington, simply say “this can’t happen.”
Methanol’s hazard is exacerbated by the presence of the two amino-acids Aspartic acid (aspartate) and phenylalanine, in the break-down of aspartame in the human body. These two synthetic toxins (in their aspartame form) have a multiplying or synergistic role in methanol chemistry inside our bodies, a role which is still being studied and discussed in the scientific literature.
But again, their independent role as toxins is not subject of debate unless you are an “expert” under contract to the aspartame-using food industry or, perhaps, a food safety regulator working for FSANZ or the FDA.
Phenylalanine in its synthetic form causes the most pernicious problems among aspartame addicts (Yes! It’s highly addictive!).
The amino-acid lowers the epilepsy seizure threshold in the human brain and depletes serotonin, triggering manic depression, suicidal tendencies, panic attacks, anxiety, insomnia, mood swings, paranoia, hallucinations and irrational rage. Airline pilots have a standard direction within their own inner circles and publications advising them to stay well clear of all diet products containing aspartame, following some alarming aspartame-induced lapses of control and judgement at the controls of passenger jet aircraft which have resulted in pilot-deregistration. (8)
Regarding the serious issue of who is in control of your airline flight to Sydney, the pilot or a diet drink, Dr Russell Blaylock warns “Some of the more common complaints (from pilots using aspartame products) include, disorientation, difficulty thinking and concentrating, visual blurring or even monocular blindness, seizures and heart failure. It is well known that the ingredients in aspartame, as well as its breakdown products, have deleterious effects on the nervous system and retina. For example, phenylalanine is a precursor of the catecholamine neurotransmitters in the brain and elevated levels in the brain have been associated with seizures.
It should also be pointed out that these catecholamines are metabolized to form other excitotoxins and peroxide products that can lead to elevated free radical formation and lipid peroxidation within the neurons. Likewise, aspartic acid (an excitotoxin) acts as an excitatory neurotransmitter and can lower the seizure threshold making a seizure more likely. The additive effect of aspartic acid and phenylalanine would significantly increase the likelihood of a seizure, especially under hypoglycemic conditions. This would occur if a diet drink is substituted for a meal, or if one is on a stringent diet.” (9)
The confusion our regulators suffer over aspartame’s potential hazard lies in a very common area of ignorance suffered particularly by toxicologists, dieticians and, in fact, anyone with an elementary background in university-level chemistry – the sort of people who, in other words, end up as “experts” in our national and state regulatory system. Both aspartic acid/aspartate and phenylalanine are common amino-acids found in nature in foods as well as in the human body. They are protein building blocks and wherever they occur in nature and in our diet they are always combined and accompanied by a huge array of associated bio-chemicals and substances with which our digestive system and physiology is entirely familiar.
They NEVER appear as independent ISOLATED amino-acids as they do in their aspartame break-down form, and in a healthy human body their complex action in the functioning of our brains and nervous systems is carefully monitored by a huge cellular system of biological checks and balances.
Like anything that may be OK in moderation, this system is quite unable to deal with the flood of free aspartic acid, phenylalanine and methanol resulting from direct aspartame consumption.
The human body, being the glorious mechanism that it is, will try to compensate, but under the steady assault from a poison like diet soft drinks, will eventually weaken and sicken with any combination of over a thousand symptoms.
Dr H.J. Roberts, author of a leading text on the medical damage caused by aspartame, Aspartame Disease: An Ignored Epidemic, has become an acknowledged world expert on aspartame poisoning, its diagnosis and treatment at his Florida clinic. He now lists over 1,400 medical symptoms and disorders triggered by aspartame, collated from the thousands of patients who pass through his clinic’s doors. His book itself is based on the detailed case histories of 1,200 patients whose symptoms of disease disappeared when aspartame was removed from their diet. He estimates:
“Hundreds of thousands of consumers, more likely millions, currently suffer major reactions to products containing aspartame. Today, every physician probably encounters aspartame disease in everyday practice, especially among patients with illnesses that are undiagnosed or difficult to treat.” (10)
Consumption – and particularly HEAVY consumption – of aspartame-containing food and beverage products, is the equivalent in logic of tipping a can of petrol over your car’s efficiently working engine and setting the whole engine compartment on fire! Of course, petrol drives a car’s engine, but it must be in the right place under the correct controls. In flames, the car may continue to run for a little while longer, but the fire will eventually consume it and put it off the road for good.
What our bodies are not familiar with and what our bodies cannot cope with and remain healthy are the three artificially-created chemicals that result from the immediate break-down of aspartame as it passes the 30 degrees C threshold – aspartic acid, phenylalanine and methanol. But none of this fazes our health regulators.
FSANZ and NZFSA say methanol appears in many items of normal diet, like fruit, without causing damage. But natural items of diet with a methanol content invariably contain ethanol, which is a natural buffer against methanol poisoning. (6) Aspartame products contain no such buffer. Ethanol is not present in aspartame. Our regulators appear ignorant of this elementary fact.
FSANZ and NZFSA deny that aspartame toxins can pass over the blood/brain barrier – a crucial point in understanding how aspartame toxins circulating in the blood can cross into brain cells and interfere in brain chemistry. Their assertion is based on seriously out-of-date aspartame “science” held in their standard database and used to answer public queries. The problem is that this “science” is based on shonky data proven some years ago to be the work of paid science hacks working for the aspartame industry. (11) However, the very fact that all aspartame products must – in theory – carry the “PHENYLKETONURICS: Contains phenylalanine” warning gives the lie to this claim from our regulators.
The synthetic phenylalanine overdose contained in aspartame easily crosses the blood/brain barrier just as the ordinary ethanol alcohol in our booze does and just as the toxins in all the other recreational drugs we consume, like “P”, Ecstasy, heroin, cocaine, etc, do. Our drugs of choice, in fact, would lose their popularity straight away if this mystical “blood/brain barrier” wasn’t so easily breached in the first place.
Under detailed cross-examination NZFSA and FSANZ representatives invariably fudge these issues and display denial symptoms and ignorance of the most basic facts about this toxin.
And it’s not just our own poorly-educated regulators and the American FDA who approve the product.
Tens of thousands of tonnes of aspartame are poured into the world food chain with the full approval of the World Health Organisation, European Union, and in fact every regulatory agency from here to China – the country which is presently competing with the USA to become the top supplier of aspartame on the planet. It seems we all can’t get enough of aspartame.
Aspartame, of course, is highly addictive, just like our other legal drugs, nicotine and ethanol/alcohol. What better way of ensuring huge annual profits to the food and additive chemical industries than by inserting a guaranteed, legally permitted and “scientifically approved” additive like aspartame into our supermarket food chain?
But it doesn’t get the rat vote! And with that curious intelligence displayed by “lower” species everywhere, cockroaches won’t eat it, cats and dogs won’t eat it, ants won’t eat it and flies won’t eat it – but politicians, food regulators and medical professionals worldwide consider it safe enough for us, and dutifully out here in God’s Own Country many of us are consuming it in such large quantities that the products are among top-selling supermarket items and the food industry is laughing all the way to the bank.
“Hundreds of thousands of consumers, more likely millions, currently suffer major reactions to products containing aspartame. Today, every physician probably encounters aspartame disease in everyday practice, especially among patients with illnesses that are undiagnosed or difficult to treat”.
Many diet products contain aspartame, though it's health effects have been debated throughout the years. Get some health information on artificial sweeteners to see how they may cause serious health problems like diabetes and obesity.
Of course the main reason aspartame is approved in New Zealand is because aspartame is approved in the United States. Aspartame is a heavily politicised issue because it is a major American corporate profit base worth billions of dollars and, as every New Zealand adult should know by now, we usually bend over backwards to please Uncle Sam.
We may pretend to be anti-nuclear, but even George Bush knows that’s a snow job kept in circulation to fox the natives. The USA maintains a major US National Security Agency spy base down at Black Birch Stream near Blenheim and US Central Intelligence Agency planes involved in “renditioning” suspected “terrorists” to torture chambers in North Africa and Afghanistan have been spotted flying in and out of the US Deep Freeze programme’s Harewood, Christchurch air base.
Sucking up to the USA is good politics. Monsanto and the corporate chemical industry have helped put every American president in power since the 2nd World War and good relations with the USA means keeping American corporates happy and ensuring their products pass through our regulatory process virtually automatically providing they have the FDA stamp of approval. In that respect NZFSA’s present acting CEO, Sandra Daly is kept completely in the dark. FSANZ is in the same position.
The immediate former US Secretary of Defence, Donald Rumsfeld, is a central player in the aspartame approval drama, funnily enough, and the full story of what happened is like an episode out of The Sopranos, but I’ll try to keep it brief.
The scene opens on January 10, l977. FDA Chief legal Counsel Richard Merrill has been considering the huge list of violations of the Federal Food, Drug and Cosmetic Act, committed by G. D. Searle under the administration of former Ford White House Chief of Staff, Donald Rumsfeld.
Rumsfeld has been trying to get his pet project, the super-sweet chemical aspartame, through the FDA’s approval process for a new food product.
Approval of the product is worth billions of dollars to Searle and a huge bonus for Rumsfeld. The problem is, the FDA’s scientific team consider the sweetener is a dangerous poison with the potential to kill. Not only this, but they have amassed a pile of evidence that Searle, with Rumsfeld’s obvious approval, have gone through vital laboratory test reports on aspartame safety, eliminating evidence that the product maimed, disabled and killed test animals.
All the evidence for Searle malpractice has been assembled by the FDA’s Jerome Bressler into an important document – now known as the Bressler Report – that anyone can read (it’s on the official Federal record and available on www.dorway.com). As a consequence, a Richard Merrill writes a 33-page letter, recommending to U.S. Attorney Sam Skinner that a grand jury investigate Searle for “apparent violations of the Federal Food, Drug and Cosmetic Act, 21 U.S.C.331(e), Act 18 USC 1001, for “their willful and knowing failure to make reports to the Food and Drug Administration required by the Act 21, U.S.C. 355 (i) and for concealing material facts and making false statements in reports of animal studies conducted to establish the safety of (aspartame).” The legal machinery creaks into action, but the whole process is hampered by the fact that the corporate chemical industry pretty effectively controls Washington.
In the meantime it’s suddenly January 21, 1981, the day after Ronald Reagan, a former B-grade Hollywood actor takes office as U.S. President.
He’s sailed into the White House on a huge raft of election funding from corporate America and G. D. Searle in particular and the word is out that he will not forget his friends. Donald Rumsfeld is still G.D. Searle’s president and a firm Reagan favourite. Rumsfeld has been greasing Republican palms all round Washington for the past few years and telling the Searle sales force “he would call in all his markers and that no matter what, he would see to it that aspartame would be approved that year.” (5)
That same day G.D. Searle reapplied to the FDA for the approval of aspartame despite the fact that up-to-date this approval has been denied pending the prosecution of the company. No problem.
Reagan and Rumsfeld already have a staunch Republican hack ready for the job as new FDA Commissioner – Arthur Hayes, who in short order overrules the FDA’s own board of inquiry who have refused to approve aspartame and gives the product the FDA’s stamp of approval.
It’s well-known in Washington circles, however, that aspartame is not just any old political FDA approval, but is, in fact, a general signal to corporate America that Reagan means business and Big Business at that. The signal in particular, tells Big Business that from now on all the brakes are off, tricky regulations about silly things like public health and safety are gone for good and “Let’s get together and make money, boys!”
Arthur Hayes is quickly bored by his job at the FDA, at any rate, and before too long goes off to work for notorious PR flack firm Burson-Marsteller, who just coincidentally, you understand, happen to be retained by G.D. Searle! At about the same time, Federal attorney Sam Skinner – remember, he’s the one who’s been assigned to prosecute Searle for fraudulent tests in their original aspartame application? – gets “an offer he can’t refuse” from – Guess who! – Searle’s lawyers! – and goes off to work for them for a reputed $US1,000 per day, effectively sabotaging the whole Federal case and, of course, effectively ending any litigation threat against Searle for its deliberately falsified aspartame data.
The whole debauched exercise is the start of a long-standing criticism of US federal authorities – and the FDA in particular – that they have a “revolving door” relationship with G.D. Searle, Monsanto and the chemical industry in general. And, of course, as far as NZFSA and FSANZ is concerned this whole shoddy exercise just never happened. But it did, and it’s recorded in US Senate records. (5)
1. Russell L. Blaylock, M.D., “Excitotoxins; The Taste That Kills”,
Health Press, Santa Fe, N.M. 87504, 1994.
2. John W. Olney and others, “Increasing Brain Tumor Rates: Is There a Link to Aspartame?” Journal Of Neuropathology And Experimental Neurology Vol. 55, No. 11 (November 1996), pgs.
1115-1123. James Bowen, M.D. “Aspartame Murders Infants in violation of Title 18, Chapter 50A, Sec 1091-3 of the Domestic Genocide Code” see
3. The suits were filed in Shasta, Sonoma and Butte County, California early in 2004. They allege that the food companies committed fraud and breach of warranty by marketing products to the public such as diet Coke, diet Pepsi, sugar free gum, Flintstone’s vitamins, yoghurt and children’s aspirin with the full knowledge that aspartame, the sweetener in them, is neurotoxic. Defendants in the lawsuits include Coca-cola, PepsiCo, Bayer Corp., the Dannon Company, William Wrigley Jr. Company, Walmart, ConAgra Foods, Wyeth, Inc., The NutraSweet Company, and Altria Corp. (parent company of Kraft Foods and Philip Morris).
4. Morando Soffritti, Fiorella Belpoggi, Davide Degli Esposti, Luca Lambertini, Eva Tibaldi, and Anna Rigano, Cesare Maltoni Cancer Research Center, European Ramazzini Foundation of Oncology and Environmental Sciences, Bologna, Italy, “First Experimental Demonstration of the Multipotential Carcinogenic Effects of Aspartame Administered in the Feed to Sprague-Dawley Rats,” Environmental Health Perspectives, Volume 114, Number 3, March 2006;
5. Gordon, Gregory, 1987. “NutraSweet: Questions Swirl,” UPI Investigative Report, 10/12/87. Reprinted in US Senate report (1987, page 483-510).
6. Dr. Woodrow C. Monte, “Aspartame: Methanol and the Public Health,”
Journal of Applied Nutrition, Volume 36, 1984, No. 1, page 42-54.
7 See Dr James Bowen on www.dorway.com aspartame website.
8. “Aspartame – Not for the Dieting Pilot?” Aviation Safety Digest, Spring 1989; Hicks, M., “Nutrasweet … too good to be true?” General Aviation News, July 1989; “High on High”, Plane & Pilot, January 1990.
9. ASPARTAME AND PILOTS – Position paper by Russell Blaylock, M.D., neurosurgeon on www.dorway.com in section “Aviation Dr. Blaylock’s position paper on aspartame and pilots.” Also see http://www.russellblaylockmd.com.
10. Pat Thomas, “Aspartame – The Shocking Story of the World’s Bestselling Sweetener,” The Ecologist, Vol. 35, No.7, September 2005, pages 35 – 46.
11. Nisperos-Carriedo, Myrna O., Philip E. Shaw, 1990. “Comparison of Volatile Flavour Components in Fresh and Processed Orange Juices,” Journal of Agriculture & Food Chemistry, Volume 38, page 1048-1052.
CHECK THESE RESOURCES FOR FURTHER INFORMATION
For details of how to get aspartame out of your system check the Websites – www.dorway.com, www.wnho.net, and the Aspartame Toxicity Center, www.holisticmed.com/aspartame. A new video exposing the aspartame industry is “Sweet Misery: A Poisoned World”, available from Email: email@example.com, Tel (USA) – 520 – 624 -9710. Also see the medical text on aspartame: “Aspartame Disease: An Ignored Epidemic”, available online from www.sunsentpress.com or Tel (USA) 1 800 827 7991 H. J. Roberts, M.D. (along with other books and tapes). Dr Roberts’ book contains a chapter on trial lawyers and drug interactions since aspartame is a severely neurotoxic drug and class action litigation has already begun. See also books on aspartame by neurosurgeon Russell Blaylock, MD, “Excitotoxins: The Taste That Kills”, and “Health & Nutrition Secrets To Save Your Life.” See websites above for details. The latter book tells aspartame victims what they have to avoid and why, and explains how a victim can re-build their immune system. Dr. Blaylock also has a book on Cancer Strategies.
With aspartame having caused so many tumours in original studies this is a helpful resource.
February 28, 2007
Claire Morrow seems to have been given some Tony Robbins CDs for Christmas
2007, Year of the Car. I know, I know, it’s not very United Nations; in 2007 I plan to in-crease my ecological footprint. I have been telling everyone (for most of 2006) about my new year’s resolution. I have a small page in the back of my to-do book that lists the indi-vidual steps involved in learning to drive. Step one - purchase learner’s handbook (check). Step two - find said learner’s handbook (it’s in this house somewhere!), step three - get learner’s permit. Step four - if no progress has been made by the end of March, consider behavioral therapy...and so forth.
The most popular new year’s resolution is to get more exercise. About 60-70% of people make three or more resolutions. About 40% of people succeed, and maintain their success for more than two months on the first attempt. About 17% fail 6 or more times, but still achieve their goal in the end. So that should inspire you.
I am always somewhat surprised by people who don’t make new year’s resolutions - most people are just busy doing other things or have goals privately in place that they don’t feel the need to discuss at length, but there are two interesting sub-groups I have noticed. The “I’m so fine the way I am” group (may I suggest honest and searching appraisal as an appropriate goal for 2007) and the “I can’t change” group. The latter have things they reckon they would like to change but they couldn’t actually be bothered changing them. It’s like saying “I want to earn lots of money...but I don’t want to work for it”. Psychotherapy might be a good suggestion, or antidepressant medication. If you couldn’t be bothered changing it...stop complaining about it. C’mon. Get with - I detest this phrase - the programme.
Research has actually been done – repeatedly - showing that in spite of the gut scorn we might feel about the overly optimistic on New Year’s Day, new year’s resolutions are actu-ally a useful thing, and most people use them to improve their lives. A shock, I know. You decide you want to achieve something, then you do what you need to achieve it, and then - as if by magic - it’s achieved. Not as much is known about what divides those who don’t achieve their goals from those that do, but enough is known about what constitutes a good behavioral modification plan that broad outlines of what will be most likely to work can be offered. Do you have your pencils ready?
(many “New Years” resolutions are actually made around the end of January or beginning of February, when things are settling down after the silly - or flat out stupid - season)
You must have put some thought into what you want to achieve, and be fairly motivated to achieve it. It is no good declaring that you will quit smoking (because you know you should and are tired of being hassled) when in your heart of hearts you know you like smoking and want to keep smoking, but figure you can white knuckle it through a few weeks to teach the hassler a lesson, and then light back up when they’re not looking. That is acting, but it is not a realistic goal. In that case a realistic goal might be “I would like to smoke less, exercise more and be more assertive”. You are looking for something you want to achieve for your own sake.
You need realistic expectations. You don’t just learn to drive in January. Frankly, I will be lucky if I find the book in January. You can lose 10 kilos by February, but it will make you ill. Best aim for lose 1 or 2 kilos a month so I can wear a bikini next summer. Priorities again. I would like to lose 10 kilos, but I have other things I want more. Losing 10 kilos is not something I am highly motivated to do. Weight loss didn’t even make my list. A com-mon resolution is to spend more time studying or working (23%). Aside from the obvious question (why?) the next really good question is - where will this time come from? You can’t just make more (if only!). So more time studying is not going to be much use to you in the long term if you achieve it by sleeping less (although this is a common short term strategy, and very effective for some people, it’s not going to work long term). Likewise if your mission is to spend more time working, you might want to check with your kids before you start skipping soccer practice to analyse flow variables. Ideally, you would actually find a way to work or study so that you achieve more in the same time. Or you would like to have a flexible timetable that you stick to. Or you would rather study on the train than listen to your iPod on the train this year. You get the idea.
You need a plan. Well, not everyone does, some people just do it, as the slogan says. But the most effective goals (the ones that stick), tend to be better planned. You make a mini list of things you need to do to achieve your goal. Going out and buying the hand-book is a first step. It has a date attached to it (The goal does. I haven’t seen the hand-book in months so who knows what it has attached to it.) When you achieve that part, you move on to the next bit. You can’t overdo it to the extent that your first step is to order 5 or 6 books on reducing clutter. Ordering 5 or 6 books on reducing clutter does not reduce clutter. One book might, so long as you read it. Your goal needs to be very specific and have a date or series of dates attached to it. There is no need to quit smoking on January one. You can make quitting smoking your goal, and set a date to quit. Then you spend a few weeks preparing, then you quit. A goal of “be a better person” is hard to measure. Clarify what you mean. You might mean volunteer work or you might mean baking for the bake sale. You might mean you will stop throwing rocks at puppies. “Wear a bikini next year” isn’t specific enough, and you can’t measure it. Nothing to stop you. You mean “lose 1-3 kilos a month until I reach my goal weight of_____”
And of course the other 2 stalwarts - if at first you don’t succeed, try try try again. People should have a plan B (what to do when things go wrong - and there will be stumbling blocks, practically guaranteed) and get support if you need it. Including, of course, tell people your plan. So I’ll let you know how the driving goes.
January 29, 2007
The Case for ADHD: Jan 07 issue
THE CASE FOR ADHD
Claire Morrow examines the Attention Deficit controversy
Q: How many kids with ADHD does it take to change a light-bulb?
A: Let’s ride our bikes!
Of course children like to ride bikes (a great mystery), and they are rarely called upon to change light-bulbs. But what happens to the kids in the joke when they are old enough to change light-bulbs? “OK...here I am...I’m at the shop...I’m going to buy light-bulbs and milk...great...I can do this.” By some miracle the adult with ADHD has their bank card with them and it’s not maxed out.
Gleefully arriving home - stopping briefly at the neighbour’s to pick up the spare keys so they can let themselves in (stepping carefully around the pile of junk in the hallway) - with bread, eggs and all the things to fix that crack in the wall and...no light-bulbs.
Everyone has those “senior moments” from time to time, and most of us can say “oh, that happens to me too”. But for some people it happens...a lot. Too much. Even if you haven’t been paying attention, you could hardly have failed to notice that there is a condition called Attention Deficit / Hyperactivity Disorder. It is the most common psychiatric diagnosis in children (in adults, depression is the most common) and it receives the kind of media attention that your average cancer charity would kill for. Not normally positive media attention though. Not your Here-are-the-warning-signs-see-your-doctor-now-for-help- thanks-to the-miracle-of-science kind of publicity, as a general rule. More your bad-kids-or-bad-parents-you-be-the-judge kind of attention. Children do not have ADHD because their parents smack them, or don’t smack them, because dad’s not around, because they’re poor or because they eat too much sugar/wheat/dairy products.
True, the odd child who is badly behaved, impulsive and super-active may be misdiagnosed with ADHD when there are in fact “problems at home”. But a good, thorough assessment would rule that out. An ADHD diagnosis is usually made very, very carefully with the involvement of several specialists, teachers and parents. One cannot simply front up to the family doctor, complain about the child and get a pill to make it go away.
Attention Deficit / Hyperactivity Disorder is primarily a disorder of attention. It comes in 3 flavors - hyperactive, inattentive and mixed (one scoop of each). The primary symptoms revolve around the ability to focus, concentrate, remember, control impulses and do what needs to be done. Inattentive type (with the clumsy diagnostic label “Attention Deficit/Hyperactivity Disorder - without significant hyperactivity”) results in a daydreamer who may not be diagosed until later because their inattentive style is hard for them, but doesn’t disrupt the class. Hyperactive type...well, we know hyperactive when we see it. A hyperactive child is not merely a colossal pain in the backside to take care of (babysitters-won’t-return syndrome) - they need extra time, love, humour, consistency and attention from someone who understands them. And to be protected from themselves - because impulse control is poor, they are not deliberately doing foolish things, they are just so focused on getting their ball that the “don’t go on roads” bit drops out of their mind. Which is very normal at 2 and 3 years old, not so normal in an 8 or 10 year old. And these kids have to grow up.
Although it used to be thought that children grew out of ADHD, increasing numbers of adults are now being diagnosed with the condition. You do not catch ADD at 30, of course, it is a pervasive, perhaps lifelong neurological condition. Adults with ADHD are either people who were diagnosed as children or who - later in life - hit upon some hope-fully friendly person who said “Could you have ADD?”
You might get through school because your parents are supportive, and you are yourself very bright, even though you constantly lose the things you need for your assignments. Maybe even with good marks. But when you enter the less structured, less supported, more competitive environment of work or university, things start to fall apart. Many adults with ADHD have been under the impression for most of their lives that they are lazy, stupid, space cadets. If one of their children is diagnosed with ADHD suddenly the light-bulb (which they have finally re-membered to buy) goes on - “They can’t have ADHD...I was exactly the same as a child...still am like that...and I don’t...unless...?” (ding!).
Some people object to ADHD on religious grounds - Scientologists for example do not believe in psychiatry at all. Others are worried about “labeling” children. Children are smarter than you think, in that case. Labeling a child as “A wonderful, artistic sensitive lit-tle person who happens to have ADHD, a neurobiological condition which sometimes causes her to have problems that we can work out together” is a whole lot better than the labels a child will apply to themselves if they don’t have a clear understanding of why they have trouble in class, forget things, and ‘drift off”. You don’t want a label; “stupid”, “space cadet”, “thoughtless”, “lazy”, “bad”. If not enough information is given about what’s happen-ing and why, these are the labels children with ADHD come up with by themselves (with a little help from their friends).
Correctly diagnosed ADHD is caused by insufficient dopamine in the brain. That is all. The synapses in the brain need dopamine. If you have enough dopamine, then taking amphetamine will make you have too much and you will become edgy, difficult and anx-ious. Too little and you have ADHD. Stimulant medications such as amphetamines (and drugs such as ritalin are no more closely related to ice or speed, than codeine is related to heroin) increases the amount of dopamine in the brain - focus improves. At any age, Attention Deficit Disorder is managed, not cured. It can be managed through cognitive behavior therapy (using a day planner, timers, alarm and so forth), and some people find special diets help a little (if they have food intolerance in addition to their ADHD). There are (aren’t there always?) a great number of unproven treatments, exercise has proven to be fairly helpful. Newer medications are not as well established, but there are long-acting and non-controlled medication treatments now available. Medication, particularly the stimulants, far and away outperforms any other treatment. Just as no one expects the severe diabetic to control their sugar level without insulin, children and adults with ADHD have some control and can exert some effect on their behavior, but medication does have a significant place in treatment.
If you think you may be an adult with ADHD or you would just like to know more about the condition, you can find information and a self assessment scale at: http://www.addresources.org . As always; exercise more, and see your doctor if chronic lateness, underachievement and disorganization persist. Oh yes, make a list. Lists help a great deal. Light-bulbs.
January 26, 2007
Dioxin's Toxic Legacy: Jan 07 issue
A TOXIC LEGACY
UPI’s Christine Dell’amore profiles new research on Dioxin's reproductive dangers
New evidence on the effects of dioxin in the Vietnam-era herbicide Agent Orange suggests the chemical interferes with the reproductive systems of men. The research, led by Dr. Amit Gupta, is one of the first studies to find that men exposed to a type of dioxin called TCDD experience smaller prostate glands and lower testosterone levels -- even at minimal exposure to dioxin.
“Now we now know dioxins have an effect on the prostate, and it's somehow affecting normal development,” says Gupta, a urologist at UT Southwestern Medical School in Dallas.
The study, published in the November issue of Environmental Health Perspectives, also offers new insight into whether lower doses of dioxin are dangerous to human health. Previous studies have observed dioxin's effects only in highly exposed populations; some research has found a link between these populations and development of cancer.
However, because the study was not a true experiment, it's not known whether it was really dioxin that led to the effects.
Gupta and colleagues followed participants of the Air Force Health Study for more than 20 years, beginning in 1987. The study had two groups: About 1,200 ranch hands, or veterans who sprayed Agent Orange in Asia between 1962 and 1971, and a comparison group of about 2,400 Air Force veterans not involved in herbicide spraying during the war, says co-author Dr. Arnold Schecter, a professor of environmental sciences at the University of Texas School of Public Health in Dallas. The two groups were matched on age, race and military occupation.
The researchers examined the men in 1982, 1985, 1987, 1992, 1997 and 2002, recording their prostate and reproductive health. In 1987 the research team measured the level of TCDD dioxin in their blood.
As expected, the levels of TCDD -- the most toxic form of dioxin -- were higher in the ranch hand group than the comparison group, although both groups in the study experienced changes in their reproductive function. These higher levels were associated with a lower risk of diagnosis of a prostate condition called BPH, in which the prostate grows in size. TCDD somehow inhibits the prostate from growing, although scientists are unsure of the mechanism of how it happens, Gupta said.
Of course, most men would want to avoid BPH, since a larger prostate can create several uncomfortable side effects, such as frequent urination.
Yet dioxin's ability to thwart prostate growth isn't exactly cause to celebrate, says Gupta -- rather, it's a worrisome indication that dioxins are altering the reproductive system's natural course.
A reduction in testosterone due to dioxin can also cause several health problems, such as loss of muscle strength, infertility, drop in sexual function and depression.
Since the comparison group had exposures consistent with the exposures of the general American population in 1987, even lesser amounts of dioxin present in the United States may impact Americans who never stepped foot in Vietnam.
“Most of the 30 types of dioxin produced in the United States come from industrial processes such as waste incineration, chlorine bleaching of pulp and paper and other chemical processes. It's also a component of pesticides and herbicides, which move up the food chain from contaminated crops, to poultry and beef, to humans. Once inside the body, the chemical settles into the fat. That's why, sadly, human babies get dioxin from their mother's dioxin-laden milkfat,” says Gupta.
In the United States, the Environmental Protection Agency -- which is close to issuing a new scientific reassessment of the health risks of dioxin and dioxin-like compounds exposure -- has successfully cut down on much of the dioxin pollution since the 1970s. In fact, quantifiable industrial emissions of dioxin in the United States have fallen more than 90 percent from 1987 levels, according to the EPA.
Since Gupta and colleagues used a 1987 marker of TCDD in their research, the risk could have gone down for the U.S. population exposed to dioxin.
In addition, it may be difficult to compare one type of dioxin -- TCDD -- to the effects of other types of the chemical. “In the case of Vietnam, where people were exposed almost exclusively to TCDD through Agent Orange, it's reasonable to attribute any irregularities in the reproductive system to that chemical,” says Dr. John Constable, a former surgeon at Harvard Medical School and one of the first Americans to study the effects of herbicides in Vietnam in the 1960s.
“But if someone has a ragbag of chemicals in their bodies, as Americans likely do, it's harder to parse out which dioxins really caused the abnormalities.”
Indeed, the number of male reproductive tract disorders, such as testicular cancer, has risen sharply over past decades. “Some scientists have suggested dioxins might be partially responsible for the spike,” the authors wrote. But there could be other endocrine disruptors at play, substances that have already been shown to alter reproductive processes in rat models.
“Although more research could help in nailing down some of the causes of dioxin, the government has decided to discontinue the Air Force Health Study,” Schecter says.
The next 20 years will answer the question as to how much damage Agent Orange did to our Vietnam vets, says Schecter. “With the program now out of existence, that's really most unfortunate for the health of our vets, and for anyone exposed to dioxins -- which is anyone in the industrial world.”