Category Archives: depression

Of Mice and Chocolate (with apologies to John Steinbeck)

Have you ever struggled with your weight?  If you have, here’s another question:  How’s your sense of smell?

Get ready for some startling news.  A study by researchers at UC Berkeley recently found that one’s sense of smell can influence an important decision by the brain:  whether to burn fat or to store it.

In other words, just smelling food could cause you to gain weight.

But hold on.  The researchers didn’t study humans.  They studied mice.

The researchers, Andrew Dillin and Celine Riera, studied three groups of mice.  They categorized the mice as “normal” mice, “super-smellers,” and those without any sense of smell.  Dillin and Riera found a direct correlation between the ability to smell and how much weight the mice gained from a high-fat diet.

Each mouse ate the same amount of food, but the super-smellers gained the most weight.

The normal mice gained some weight, too.  But the mice who couldn’t smell anything gained very little.

The study, published in the journal Cell Metabolism in July 2017 was reported in the San Francisco Chronicle.  It concluded that outside influences, like smell, can affect the brain’s functions that relate to appetite and metabolism.

According to the researchers, extrapolating their results to humans is possible.  People who are obese could have their sense of smell wiped out or temporarily reduced to help them control cravings and burn calories and fat faster.  But Dillin and Riera warned about risks.

People who lose their sense of smell “can get depressed” because they lose the pleasure of eating, Riera said.  Even the mice who lost their sense of smell had a stress response that could lead to a heart attack.  So eliminating a human’s sense of smell would be a radical step, said Dillin.  But for those who are considering surgery to deal with obesity, it might be an option.

Here comes another mighty mouse study to save the day.  Maybe it offers an even better way to deal with being overweight.

This study, published in the journal Cell Reports in September 2017, also focused on creating more effective treatments for obesity and diabetes.  A team of researchers at the Washington University School of Medicine in St. Louis found a way to convert bad white fact into good brown fat—in mice.

Researcher Irfan J. Lodhi noted that by targeting a protein in white fat, we can convert bad fat into a type of fat (beige fat) that fights obesity.  Beige fat (yes, beige fat) was discovered in adult humans in 2015.  It functions more like brown fat, which burns calories, and can therefore protect against obesity.

When Lodhi’s team blocked a protein called PexRAP, the mice were able to convert white fat into beige fat.  If this protein could be blocked safely in white fat cells in humans, people might have an easier time losing weight.

Just when we learned about these new efforts to fight obesity, the high-fat world came out with some news of its own.  A Swiss chocolate manufacturer, Barry Callebaut, unveiled a new kind of chocolate it calls “ruby chocolate.”  The company said its new product offers “a totally new taste experience…a tension between berry-fruitiness and luscious smoothness.”

The “ruby bean,” grown in countries like Ecuador, Brazil, and Ivory Coast, apparently comes from the same species of cacao plant found in other chocolates.  But the Swiss company claims that ruby chocolate has a special mix of compounds that lend it a distinctive pink hue and fruity taste.

A company officer told The New York Times that “hedonistic indulgence” is a consumer need and that ruby chocolate addresses that need, more than any other kind of chocolate, because it’s so flavorful and exciting.

So let’s sum up:  Medical researchers are exploring whether the scent of chocolate or any other high-fat food might cause weight-gain (at least for those of us who are “super-smellers”), and whether high-fat food like chocolate could possibly lead to white fat cells “going beige.”

In light of these efforts by medical researchers, shouldn’t we ask ourselves this question:  Do we really need another kind of chocolate?

A Day Without a Drug Commercial

Last night I dreamed there was a day without a drug commercial….

When I woke up, reality stared me in the face.  It couldn’t be true.  Not right now.  Not without revolutionary changes in the drug industry.

Here are some numbers that may surprise you.  Or maybe not.

Six out of ten adults in the U.S. take a prescription medication.  That’s up from five out of ten a decade ago.  (These numbers appeared in a recent study published in the Journal of the American Medical Association.)

Further, nine out of ten people over 65 take at least one drug, and four out of ten take five or more—nearly twice as many as a decade ago.

One more statistic:  insured adults under 65 are twice as likely to take medication as the uninsured.

Are you surprised by any of these numbers?  I’m not.

Until the 1990s, drug companies largely relied on physicians to promote their prescription drugs. But in 1997, the Food and Drug Administration revised its earlier rules on direct-to-consumer (DTC) advertising, putting fewer restrictions on the advertising of pharmaceuticals on TV and radio, as well as in print and other media.  We’re one of only two countries–New Zealand is the other one–that permit this kind of advertising.

The Food and Drug Administration is responsible for regulating it and is supposed to take into account ethical and other concerns to prevent the undue influence of DTC advertising on consumer demand.  The fear was that advertising would lead to a demand for medically unnecessary prescription meds.

It’s pretty clear to me that it has.  Do you agree?

Just look at the statistics.  The number of people taking prescription drugs increases every year.  In my view, advertising has encouraged them to seek drugs that may be medically unnecessary.

Of course, many meds are essential to preserve a patient’s life and health.  But have you heard the TV commercials?  Some of them highlight obscure illnesses that affect a small number of TV viewers.  But whether we suffer from these ailments or not, we’re all constantly assaulted by these ads.  And think about it:  If you feel a little under the weather one day, or a bit down in the dumps because of something that happened at work, or just feeling stressed because the neighbor’s dog keeps barking every night, might those ads induce you to call your doc and demand a new drug to deal with it?

The drug commercials appear to target those who watch daytime TV—mostly older folks and the unemployed.  Because I work at home, I sometimes watch TV news while I munch on my peanut butter sandwich.  But if I don’t hit the mute button fast enough, I’m bombarded by annoying ads describing all sorts of horrible diseases.  And the side effects of the drugs?  Hearing them recited (as rapidly as possible) is enough to make me lose my appetite.  One commercial stated some possible side effects:  suicidal thoughts or actions; new or worsening depression; blurry vision; swelling of face, mouth, hands or feet; and trouble breathing.  Good grief!  The side effects sounded worse than the disease.

I’m not the only one annoyed by drug commercials.  In November 2015, the American Medical Association called for a ban on DTC ads of prescription drugs. Physicians cited genuine concerns that a growing proliferation of ads was driving the demand for expensive treatments despite the effectiveness of less costly alternatives.  They also cited concerns that marketing costs were fueling escalating drug prices, noting that advertising dollars spent by drug makers had increased by 30 percent in the previous two years, totaling $4.5 billion.

The World Health Organization has also concluded that DTC ads promote expensive brand-name drugs.  WHO has recommended against allowing DTC ads, noting surveys in the US and New Zealand showing that when patients ask for a specific drug by name, they receive it more often than not.

Senator Bernie Sanders has repeatedly stated that Americans pay the highest prices in the world for prescription drugs.  He and other Senators introduced a bill in 2015 aimed at skyrocketing drug prices, and Sanders went on to rail against them during his 2016 presidential campaign.

Another member of Congress, Representative Rosa DeLauro (D-Conn.), has introduced a bill specifically focused on DTC ads.  Calling for a three-year moratorium on advertising new prescription drugs directly to consumers, the bill would freeze these ads, with the aim of holding down health-care costs.

DeLauro has argued, much like the AMA, that DTC ads can inflate health-care costs if they prompt consumers to seek newer, higher-priced meds.  The Responsibility in Drug Advertising Act would amend the current Food, Drug, and Cosmetic Act and is the latest effort to squelch DTC advertising of prescription meds.

The fact that insured adults under 65 are twice as likely to take prescription meds as those who are not insured highlights a couple of things:  That these ads are pretty much about making more and more money for the drug manufacturers.  And that most of the people who can afford them are either insured or in an over-65 program covering many of their medical expenses.  So it’s easy to see that manufacturers can charge inflated prices because these consumers are reimbursed by their insurance companies.  No wonder health insurance costs so much!  And those who are uninsured must struggle to pay the escalating prices or go without the drugs they genuinely need.

Not surprisingly, the drug industry trade group, the Pharmaceutical Research and Manufacturers of America, has disputed the argument that DTC ads play “a direct role in the cost of new medicines.”  It claims that most people find these ads useful because they “tell people about new treatments.”  It’s probably true that a few ads may have a public-health benefit.  But I doubt that very many fall into that category.

Hey, Big Pharma:  If I need to learn about a new treatment for a health problem, I’ll consult my physician.  I certainly don’t plan to rely on your irritating TV ads.

But…I fear that less skeptical TV viewers may do just that.

So please, take those ads off the air.  Now.

If you do, you know what?  There just might be a day without a drug commercial….

 

[The Wellness Letter published by the University of California, Berkeley, provided the statistics noted at the beginning of this post.]

 

Take a hike

The lure of “the gym” has always escaped me. I’ve joined a few fitness centers in my day, but I consistently end up abandoning the gym and resorting to my preferred route to fitness: walking. Whenever possible, I walk and hike in the great outdoors.

A host of recent studies has validated my faith in the benefits of walking. And some of these benefits may surprise you.

First, being active is better for your health. Duh. We’ve all suspected that for a long time. But here’s a new finding: sitting may be the real problem. Studies show that the more you sit, the greater your risk for health problems. In a study of more than two thousand adults ages 60 and older, every additional hour a day spent sitting was linked to a 50 percent greater risk of disability. Even those who got some exercise but were sitting too much were more likely to get dumped in the pool of disabled people.

Dorothy Dunlop and her colleagues at Northwestern’s McCormick School of Engineering and Applied Science concluded that sitting seems to be a separate risk factor. Getting enough exercise is important, but it’s equally important not to be a couch potato the rest of the time. Their study appeared in the Journal of Physical Activity & Health in 2014.

Another study, published in Medicine & Science in Sports & Exercise, noted something else about prolonged sitting: taking “short walking breaks” at least once an hour may lessen or even prevent some of the adverse effects, especially on the cardiovascular system. When healthy young men sat for 3 hours without moving their legs, endothelial function—the ability of blood vessels to expand and contract—dropped significantly from the very beginning. But when they broke up their sitting time with slow 5-minute walks every 30 or 60 minutes, endothelial function did not decline.

Here’s another benefit: Exercise, including walking, can keep you from feeling depressed. A British study, reported in JAMA Psychiatry, followed over 11,000 people (initially in their early 20s) for more than 25 years. It found that the more physically active they were, the less likely they were to have symptoms of depression. For example, sedentary people who started exercising 3 times a week reduced their risk of depression 5 years later by almost 20 percent. The researchers concluded that being active “can prevent and alleviate depressive symptoms in adulthood.”

Ready for one more reason to walk? A study described in The Wall Street Journal in 2014 found that walking can significantly increase creativity. This is a brand new finding. In the past, studies have shown that after exercise, people usually perform better on tests of memory and the ability to make decisions and organize thoughts. Exercise has also been linked anecdotally to creativity: writers and artists have said for centuries that their best ideas have come during a walk. But now science supports that link.

Researchers at Stanford University, led by Dr. Marily Oppezzo, decided to test the notion that walking can inspire creativity. They gathered a group of students in a deliberately unadorned room equipped with nothing more than a desk and a treadmill. The students were asked to sit and complete “tests of creativity,” like quickly coming up with alternative uses for common objects, e.g., a button. Facing a blank wall, the students then walked on the treadmill at an easy pace, repeating the creativity tests as they walked. Result: creativity increased when the students walked. Most came up with about 60 percent more “novel and appropriate” uses for the objects.

Dr. Oppezzo then tested whether these effects lingered. The students repeated the test when they sat down after their walk on the treadmill. Again, walking markedly improved their ability to generate creative ideas, even when they had stopped walking. They continued to produce more and better ideas than they had before their walk.

When Dr. Oppezzo moved the experiment outdoors, the findings surprised her. The students who walked outside did come up with more creative ideas than when they sat, either inside or outside, but walking outside did not lead to more creativity than walking inside on the treadmill. She concluded that “it’s the walking that matters.”

So a brief stroll apparently leads to greater creativity. But the reasons for it are unclear. According to Dr. Oppezzo, “It may be that walking improves mood,” and creativity blooms more easily when one is happier. The study appeared in The Journal of Experimental Psychology: Learning, Memory, and Cognition in 2014.

In truth, I don’t need these studies to convince me to keep walking. It helps that I live in San Francisco, where the climate allows me to walk outside almost every day. Walking is much more challenging when you confront the snow and ice that used to accompany my walks in and around Chicago. So I’m not surprised that walkers in colder climes often resort to exercising indoors.

It also helps that San Francisco has recently been voted the second most walkable city in America. According to Walk Score, an organization that ranks the “walkability” of 2,500 cities in the U.S., SF placed just behind New York City as the most walkable major American city.

SF’s high score is especially impressive in light of the city’s hills. Although I avoid the steepest routes, I actually welcome a slight incline because it adds to my aerobic workout. Why use a Stairmaster in a gloomy gym when I can climb uphill enveloped in sunshine and cool ocean breezes?

But whether you walk indoors or out, do remember to walk! You’ll assuredly benefit health-wise. And you just may enhance your creativity quotient. Someday you may even find yourself writing a blog like this one.