Health

I Wanna Live Forever

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If you’re one of those people who look the universe in the eyeball without flinching, choosing to accept uncomfortable truths when they are supported by the implacable judgment of Science, then you’ve probably acknowledged that sitting is bad for you. Like, really bad. If you’re not convinced, the conclusions are available in helpful infographic form; here’s an excerpt.

Sitting-Infographic

And, you know, I sit down an awful lot. Doing science, writing, eating, playing poker — my favorite activities are remarkably sitting-based.

So I’ve finally broken down and done something about it. On the good advice of Carl Zimmer, I’ve augmented my desk at work with a Varidesk on top. The desk itself was formerly used by Richard Feynman, so I wasn’t exactly going to give that up and replace it with a standing desk. But this little gizmo lets me spend most of my time at work on my feet instead of sitting on my butt, while preserving the previous furniture.

IMG_1173

It’s a pretty nifty device, actually. Room enough for my laptop, monitor, keyboard, mouse pad, and the requisite few cups for coffee. Most importantly for a lazybones like me, it doesn’t force you to stand up absolutely all the time; gently pull some handles and the whole thing gently settles down to desktop level, ready for your normal chair-bound routine.

IMG_1174

We’ll see how the whole thing goes. It’s one thing to buy something that allows you to stand while working, it’s another to actually do it. But at least I feel like I’m trying to be healthier. I should go have a sundae to celebrate.

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Obamacare

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Good news and bad news last night, as the House passed health care reform.

The good news is: the House passed health care reform. The work isn’t completely done yet, of course. The House had already passed a heath care bill, months ago, but this isn’t it; last night they passed the Senate’s version of the Bill, which had some glaring flaws. Under ordinary circumstances the House and Senate would get together and hammer out a compromise between their two bills. But in the meantime Republicans picked up an extra Senate seat in Massachusetts after Teddy Kennedy died, and they had promised to filibuster the compromise package. (Because, after all, what courageous moral stand could be worth invoking arcane parliamentary procedures more than the fight to prevent millions of people from getting health insurance, especially if that was the life’s goal of the Senator whose death allowed you to improve from having twenty fewer votes than the opposition to only having eighteen fewer votes?)

So Obama will sign the Senate bill that the House just approved, and then the Senate will consider a reconciliation bill also passed by the House last night. Under even-more-arcane procedures, the reconciliation measure can be passed without threat of filibuster. It requires only “majority vote,” a quaint notion in this highly baroque age.

It’s not an especially huge bill, whatever you may have heard, but it will have an impact. Here is a list of the major impacts, and an interactive graphic to figure out how you will be affected. The most important features seem to be:

  • Establish health insurance exchanges, and provide subsidies for people below four times the poverty line.
  • Guarantee insurance for people with pre-existing conditions, and eliminate “rescissions” that take away insurance from people who get sick.
  • Push business to provide insurance for their employees, and self-employed individuals to buy insurance for themselves.
  • Close the “donut hole” in the existing Medicare payout structure.
  • Implement cost controls (mostly through slowing the growth of Medicare spending), thereby lowering the budget deficit by $130 billion over the first ten years, and by another $1 trillion over the next ten years.

Overall, it’s a relatively incremental bill, placing bandages over some of the more egregious wounds in the current system, while leaving in place the essential structure through which we funnel billions of dollars to middlemen while paying far more for medical care per person than any other country without getting better results. For 90% of Americans, coverage and insurance will continue as before. Basically, this brings us a little closer to where Western Europe was a century ago.

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Defending Science Isn’t Always Pretty

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This month’s issue of WIRED features a great story by Amy Wallace: “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All.” It’s an overview of the anti-vaccination movement in the United States, a topic that should be very familiar to anyone who reads Discover‘s baddest astronomer. At ScienceBlogs, Orac and Abel Pharmboy gives big thumbs-up to the article.

The anti-vaccination movement is a little weird — they claim that vaccines, which are universally credited with wiping out smallpox and polio and other bad things, are responsible for causing autism and diabetes and other also-bad things, all just to make a buck for pharmaceutical companies. The underlying motivation seems to be a combination of the conviction that things must happen for a reason — if a child develops autism, there must be an enemy to blame — and a general distrust of science and technology. Certainly the pro-science point of view is fairly unequivocal; like any medicine, vaccines should be used properly, but they have done great good for the world and there are very real dangers of increased risk for epidemics if enough children stop receiving them. Good for WIRED for taking on the issue and publishing an uncompromisingly pro-science piece on it.

But the anti-vax movement is more than just committed; they’re pretty darn virulent. And since the article came out, author Amy Wallace has been subject to all sorts of attacks. She’s been documenting them on her Twitter feed, which I encourage you to check out. Some lowlights:

  • I’ve been called stupid, greedy, a whore, a prostitute, and a “fking lib.” I’ve been called the author of “heinous tripe.”
  • J.B. Handley, the founder of Generation Rescue, the anti-vaccine group that actress Jenny McCarthy helps promote, sent an essay titled “Paul Offit Rapes (intellectually) Amy Wallace and Wired Magazine.” In it, he implied that Offit had slipped me a date rape drug.
  • Just now, I got an email so sexually explicit that I can’t paraphrase it here. Except to say it contained the c-word. And a reference to dead fish.
  • In his book, Autism’s False Prophets, Dr. Offit writes about scientists who have been intimidated into staying silent about autism/vaccines. If scientists – who are armed with facts and trained to interpret them – are afraid, can it be any surprise that a lot of parents are, too?


It’s pretty horrifying stuff. But there is good news: Wallace also reports that the large majority of emails she has received were actually in favor of the piece, and expressed gratitude that she had written it. There are strong forces arrayed against science, but the truth is on our side, and a lot of people recognize it. It gives one a bit of hope.

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Our Health Care Problems Are More Vivid When Presented in Colorful Graphical Video Form

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Talking about health care provides a great opportunity to link to this video by Peter Aldhous, Jim Giles and MacGregor Campbell — the last of whom was once Tom Levenson’s advisee. (Also via Bioephemera, who at least was kind enough to embed the video.)

The video, also at New Scientist, takes data from studies by Dartmouth and the OECD, and uses Gapminder to make the graphs come alive. It helps explain one of the paradoxes behind health care in the U.S.: we spend more than most other developed countries, and we get less for it. The explanation — you’ll be unsurprised to hear — lies in our screwy incentive system. By making health care a matter of profit for various sets of people — doctors, hospitals, insurance companies, pharmaceutical companies — we push into the background the incentive that we’d really like the system to have, namely keeping people healthy. Changing those incentives doesn’t mean that Barack Obama decides what treatment you get from your doctor; it just means that we can focus human ingenuity on the task of making people healthier, rather than just making other people wealthier.

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Guest Post: Tom Levenson on the Iraq War Suicides and the Material Basis of Consciousness

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For his second guest post, Tom follows in our proud tradition of fearless eclecticism,
mixing neuroscience and current events with a bit of materialistic philosophizing. His first post was here, and his third is here.

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Burrowing into tragedy: a story behind the story of the Iraq War Suicides.

My thanks to all here who gave me such a warm welcome on Monday (and, again, to Sean for asking me here in the first place).

This post emerges out of this sad story of a week or so ago.

Over Memorial Day weekend this year there was a flurry of media coverage about the devastating psychological toll of the Iraq and Afghanistan wars. The single most awful paragraph in the round-up:

“According to the Army, more than 2,000 active-duty soldiers attempted suicide or suffered serious self-inflicted injuries in 2007, compared to fewer than 500 such cases in 2002, the year before the United States invaded Iraq. A recent study by the nonprofit Rand Corp. found that 300,000 of the nearly 1.7 million soldiers who’ve served in Iraq or Afghanistan suffer from PTSD or a major mental illness, conditions that are worsened by lengthy deployments and, if left untreated, can lead to suicide.”

(For details and a link to a PDF of the Army report – go here.)

This report, obviously, is the simply the quantitative background to a surfeit of individual tragedy – but my point here is not that war produces terrible consequences.

Rather, the accounts of the Iraq War suicides — 115 current or former servicemen and women in 2007 – struck me for what was implied, but as far as I could find, not discussed in the mass media: the subtle and almost surreptitious way in which the brain-mind dichotomy is breaking down, both as science and as popular culture.

How so? It is, thankfully, becoming much more broadly understood within the military and beyond that “shell shock” is not malingering, or evidence of an essential weakness of moral fiber. PTSD is now understood as a disease, and as one that involves physical changes in the brain.

The cause and effect chain between the sight of horror and feelings of despair cannot, given this knowledge, omit the crucial link of the material substrate in which the altered and destructive emotions can emerge. PTSD becomes thus a medical, and not a spiritual pathology.

(This idea still faces some resistance, certainly. I launched my blog with a discussion of the attempt to court martial a soldier for the circumstances surrounding her suicide attempt. But even so, the Army is vastly further along in this area that it was in the Vietnam era and before.)

Similarly, depression is clearly understood as a disease with a physical pathology that underlies the malign sadness of the condition. (H/t the biologist Louis Wolpert for the term and his somewhat oddly detached but fascinating memoir of depression.)

This notion of the material basis of things we experience as our mental selves is not just confined to pathology. So-called smart drugs let us know how chemically malleable our selves can be.

More broadly, the study of neuroplasticity provides a physiological basis for the common sense notion that experience changes who we perceive ourselves to be.

All this seems to me to be a good thing, in the sense that (a) the study of the brain is yielding significant results that now or will soon greatly advance human well being; and (b) that the public seems to be taking on board some of the essential messages. The abuses (overmedication, anyone?) are certainly there. But to me, it is an unalloyed good thing that we have left the age of shell shock mostly behind us.

At the same time, I’m a bit surprised that the implications of this increasingly public expression of an essentially materialist view of mind haven’t flared up as a major battle in the science culture wars.

Just to rehearse the obvious: the problem with cosmology for the other side in the culture war is that it conflicts with the idea of the omnipresent omnipotence of God. The embarrassment of evolutionary biology is that it denies humankind a special place in that God’s creation, destroying the unique status of the human species as distinct from all the rest of the living world.

Now along comes neuroscience to make the powerful case that our most intimate sense of participating in the numinous is an illusion.

Instead, the trend of current neuroscience seems to argue that the enormously powerful sense each of us has of a self as distinct from the matter of which we are made is false. Our minds, our selves may be real—but they are the outcome of a purely material process taking place in the liter or so of grey stuff between our ears.

(There are dissenters to be sure, those that argue against the imperial materialism they see in contemporary neuroscience. See this essay for a forceful expression of that view.)

I do know that this line of thought leads down a very convoluted rabbit hole, and that’s not where I am trying to go just now.

Instead, the reports of the Iraq suicides demonstrated for me that the way the news of the materiality of mind is is slipping into our public culture without actually daring (or needing) to speaking its name.

That the problem of consciousness is still truly unsolved matters less in this arena than the fact of fMRI experiments that demonstrate the alterations in brain structure and metabolism associated with the stresses of war or the easing of the blank, black hole of depression. The very piecemeal state of the field helps mask its potentially inflammatory cultural implications.

To me this suggests two possibilities. One is that it is conceivable that when the penny finally drops, we might see backlash against technological interventions into the self like that which has impeded stem cell research in the U.S.

On the other hand, I don’t think that the public can be motivated or even bamboozled into blocking the basic science in this field. Too much rests on the work; any family that has experienced Alzheimers knows just how urgent the field may be — not to mention anyone with a loved one in harms way.

This actually gives me hope for a shift in the culture war. For all the time and energy wasted over the last several years defending the idea of science against attacks on evolution, with the cosmologists taking their lumps too – the science of mind could force a shift in the terms of engagement decisively in the right direction.

Or I could be guilty of another bout of wishful thinking. Thoughts?

Image: Brain in a Vat, article illustration. Offered in homage to my friend and source of wisdom, Hilary Putnam, who introduced the brain-in-a-vat thought experiment in this book. Source: Wikimedia Commons.

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Cheap, Crappy Calories

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You know what’s a really big problem? The Farm Bill. The quintennial piece of legislation that steers billions of dollars into subsidies for farmers who mass-produce the raw materials of which junk food is made. Yeah, I know, not exactly a hot topic, nor our normal fare. But Michael Pollan in the Times lays out a devastating indictment of the current system, which encourages our economy to overproduce food that is incredibly bad for us, while busting the federal budget, ruining the environment, and hurting small farmers and developing countries to boot. (Via Marginal Revolution.)

Here is the basic econo-physics of the situation:

As a rule, processed foods are more “energy dense” than fresh foods: they contain less water and fiber but more added fat and sugar, which makes them both less filling and more fattening. These particular calories also happen to be the least healthful ones in the marketplace, which is why we call the foods that contain them “junk.” Drewnowski concluded that the rules of the food game in America are organized in such a way that if you are eating on a budget, the most rational economic strategy is to eat badly — and get fat.

This perverse state of affairs is not, as you might think, the inevitable result of the free market. Compared with a bunch of carrots, a package of Twinkies, to take one iconic processed foodlike substance as an example, is a highly complicated, high-tech piece of manufacture, involving no fewer than 39 ingredients, many themselves elaborately manufactured, as well as the packaging and a hefty marketing budget. So how can the supermarket possibly sell a pair of these synthetic cream-filled pseudocakes for less than a bunch of roots?

For the answer, you need look no farther than the farm bill. This resolutely unglamorous and head-hurtingly complicated piece of legislation, which comes around roughly every five years and is about to do so again, sets the rules for the American food system — indeed, to a considerable extent, for the world’s food system. Among other things, it determines which crops will be subsidized and which will not, and in the case of the carrot and the Twinkie, the farm bill as currently written offers a lot more support to the cake than to the root. Like most processed foods, the Twinkie is basically a clever arrangement of carbohydrates and fats teased out of corn, soybeans and wheat — three of the five commodity crops that the farm bill supports, to the tune of some $25 billion a year. (Rice and cotton are the others.) For the last several decades — indeed, for about as long as the American waistline has been ballooning — U.S. agricultural policy has been designed in such a way as to promote the overproduction of these five commodities, especially corn and soy.

I remember the moment it first dawned on me that Coke was significantly less expensive than orange juice. But making soda is a complicated chemical process, while oranges literally grow on trees! Of course, once you master that process, mass-producing the chemicals is fairly straightforward, while growing oranges requires a certain amount of patience. At the time I didn’t really appreciate the other aspect of the puzzle: we pay people to grow corn, which is turned into high-fructose corn syrup, which sweetens all of the processed food we find on our supermarket shelves.

Now, there does seem to be an obvious point missing in the article: the popularity of Twinkies over carrots cannot be put down solely to the greater density of calories per dollar. A lot of people like how Twinkies taste, deep-fried or not. But that doesn’t mean we should be actively subsidizing their production.

Pollan strikes an optimistic note at the end of his piece, suggesting that the importance of the Farm Bill may finally be percolating up to the national consciousness. (At least until the next time that a celebrity with fake boobs dies of a drug overdose.) It’s long been considered political suicide to even suggest messing with farm subsidies, especially with the Iowa caucuses playing such a large role in Presidential primaries. We’ll see if next year is any different.

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Sex in space!

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No, this isn’t one of those bait-and-switch titles. It really is about sex in space. Via Deepen the Mystery, a Guardian story on the hazards of sexual encounters on long-duration space missions.

They should be out-of-this-world experiences. But US experts have warned that sex in space will bring problems not pleasure for men and women heading to the moon and Mars.

A panel of scientists has told Nasa interplanetary passion could cause chaos to its latest plans to send humans on long missions.

Cramped in spaceships for years, surrounded by the starry void, astronauts thoughts are bound to turn to romance, states the report, ‘Bioastronautics Roadmap: a risk reduction strategy for human exploration of space’.

The resulting close encounters could have profound consequences, it adds. Without supplies of the necessary precautions, zero-gravity romps could lead to zero-gravity pregnancies.

Snickering aside, I’m sure it’s a real problem — send a bunch of people into isolation in close quarters for a period of years, and something will happen.

Now, I know that certain of my co-bloggers are reliable readers of the Guardian science section, but apparently they were going to keep this story to themselves. The extra value-added you get from Cosmic Variance, of course, is that we will actually link directly to the NASA Bioastronautics Roadmap from which the story derives. Although, as it turns out, a cursory inspection didn’t turn up anything nearly as off-color as you’d find in a novel by a recently indicted former high-ranking White House staffer. But this bit was interesting:

Serious interpersonal conflicts have occurred in space flight. The failure of flight crews to cooperate and work effectively with each other or with flight controllers has been a periodic problem in both US and Russian space flight programs. Interpersonal distrust, dislike, misunderstanding and poor communication have led to potentially dangerous situations, such as crewmembers refusing to speak to one another during critical operations, or withdrawing from voice communications with ground controllers. Such problems of group cohesiveness have a high likelihood of occurrence in prolonged space flight and if not mitigated through prevention or intervention, they will pose grave risks to the mission. Lack of adequate personnel selection, team assembly, or training has been found to have deleterious effects on work performance in organizational research studies. The duration and distance of a Mars mission significantly increases this risk. The distance also reduces countermeasure options and increases the need for autonomous behavioral health support systems.

Oh, great. I see a Stranger in a Strange Land scenario on our horizon.

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