Colleen Carroll Campbell, a fellow at the Ethics and Public Policy Center, is the author of The New Faithful: Why Young Adults Are Embracing Christian Orthodoxy (Loyola, 2002). She is working on a book based on her father’s experience of Alzheimer’s disease, and this New Atlantis article provides an outstanding overview of her research into the subject. There is no question that Alzheimer’s is becoming an increasingly important health care issue:

. . . [E]very once in awhile, we face a situation that forces us to collectively consider what it means to be human persons who grow old, suffer, and die.
The looming Alzheimer’s epidemic is just such a situation. This disease embodies everything we fear most about aging — weakness and dependence, humiliation and oblivion. Its insidious onset and relentless progression have penetrated our collective consciousness, and nearly half of Americans over the age of 35 know someone personally whose brain has been ravaged by it. As Americans are living longer and more physicians are recognizing dementia as a disease to be diagnosed, Alzheimer’s is claiming more victims. Some 4.5 million Americans suffer from Alzheimer’s today, more than double the number who had the disease in 1980. Alzheimer’s has become the eighth-leading cause of death in America, and its impact is expected to mushroom as 77 million Baby Boomers head into retirement. By 2050, if no cure is found, 16 million Americans could have Alzheimer’s. As they bid their long goodbye — Alzheimer’s can take up to 20 years to run its devastating course — we will no longer be able to ignore the human questions raised by this disease. Such questions, about the basis of our human dignity and our identity as persons, cannot be answered by science or technology. We must grapple with them the old-fashioned way, drawing on both reflection and lived experience to find the meaning in this way of dying.

For anyone dealing with the onset of dementia in a loved one, this piece is essential reading. Read the entire article.

THis long NY Times article about end-of-life decision making provides an excellent overview of the issues that confront families and health care professionals in making those decisions. Check it out.

Sandy Szwarc is an editor and a prolific writer on food, health and science issues for various print and internet media. She is also a registered nurse with a science degree from the University of Texas at Austin, and over twenty years in critical-care nursing, emergency triage, and medical outreach education with a focus on nutrition, weight and eating issues, and preventative health. Ms. Szwarc is a leading advocate in debunking junk science as it pertains to food and health, and she is currently completing an upcoming book entitled “The Truth About Obesity and Dieting-Dangers and Good News We’re Never Told.”
In this Tech Central Station op-ed, Ms. Szwarc takes dead aim at the junk science industry and the mainstream media for providing muddled information to the public regading the health risks of obesity:

Consumers were left more confused than ever when the media reported on two obesity-related studies from the Journal of the American Medical Association last week. One seemed to find it was more important to be fit than thin for your heart health; the other that it was more important to be thin than fit to prevent diabetes . . .
But in fact, the controversy has already been repeatedly answered in the scientific literature. The trouble is, it’s not what a lot of people want to hear…and others without science backgrounds don’t realize.
These side-by-side JAMA studies provided an invaluable opportunity for the media to help consumers sort through medical information and come away with a very important message: not all studies are created equal.

Ms Szwarc goes on to explain how some medical researchers are misleading the public with spurious conclusions drawn from “dredge data research,” and that the conclusions of such studies are of dubious merit:

Sadly data dredge studies are increasingly being misused and misinterpreted. Most noteworthy is that [the Weinstein study correlating obesity with diabetes] findings contradict many stronger clinical and epidemiological studies that have found that exercise reduces type 2 diabetes and improves insulin resistance, unrelated to weight.
For example, researchers at the Cooper Institute in Dallas, Texas led by Timothy S. Church, MD, PhD, followed over 2,000 diabetics for 25 years, using a range of health assessments, including treadmill tests to gauge their fitness levels. They found that premature deaths from all causes were significantly lower among the fit. Weight was irrelevant. Researchers at the Veterans Affairs, Palo Alto Health Care System, Stanford University studied over 6,000 men for six years and found exercise capacity was more important in risks of dying than “known” risk factors including obesity, cholesterol, hypertension, smoking and even diabetes. Even a small clinical study at Queen’s University, Kingston, Ontario, Canada following 54 obese women found daily exercise, without dieting or weight loss, substantially reduced insulin resistance in just 14 weeks.

In the mainstream media’s rush to embrace the American delusion that a svelte physique equates with good health, Ms. Szwarc points out that the media ignores scientifically proven reality:

Most significant, [another recent study] is just one of dozens of clinical studies over decades which have found the exact same thing in men and women: when fitness is considered, weight is irrelevant to long-term health, heart disease, diabetes or premature death from all causes.
The list is too extensive to cite here, but clinical studies concluding ‘fitness not weight is what counts’ include the Harvard Alumni Health Study of 12,516 men followed for 16 years; the St. James Women Take Heart Project of 5,721 women studied for 8 years; and the Aerobics Center Longitudinal Study, an ongoing study that includes 25,389 patients examined at the Cooper Clinic in Dallas from 1970 to 1989. Even the Women’s Health Study published findings in 2001 that found merely light to moderate activity was dramatically associated with lowered heart disease in women, including those who were overweight, had high cholesterol or smoked.

Ms. Swzarc concludes by pointing to a recent op-ed by two researchers at the Dallas-based Cooper Institute, which has an outstanding record of performing landmark research on fitness and preventative health:

[Drs. Blair and Church, the Cooper researchers] chastised today’s obesity researchers, saying that “failure to adequately quantify physical activity when examining the risks of obesity is similar to exploring risk factors for cancer and misclassifying tobacco use.”
Drs. Blair and Church emphasized that death rates and heart disease among obese people, with just moderate fitness, are half that of “normal” weight people who aren’t fit. The amount of exercise to attain this health-giving level of moderate fitness isn’t much, either, and has been proven in 24 clinical studies: it’s merely 150 minutes of moderate-intensity activity a week. They say that’s equivalent to 30 minutes, 5 times a week of: walking, gardening, housework, bicycling, swimming or other activities enjoyed in daily life.

Read the entire article.

This Wall Street Journal ($) article reports on the reaction of pharmaceuticals giant Merck & Co. to the disappointing study involving Zocor, its top-selling cholesterol drug.
The study found that high doses of the drug did not benefit patients at high risk of a heart attack compared with both placebo and less-aggressive Zocor treatment. Researchers presented the 4,500-patient Zocor study at the annual meeting of the European Society of Cardiology in Munich, Germany, and it also was published online by the Journal of the American Medical Association.
Even before this news, Merck had been losing in the competition with Pfizer‘s Lipitor, which is the world’s biggest-selling statin drug with sales of $9.2 billion in 2003. A clinical trial reported earlier this year that Lipitor was was much better than another statin — Bristol-Myers Squibb Co.’s Pravachol — at reducing the risk of death, heart attack or other serious complications within two years of treatment. Here is an earlier post on that study.
The 4,500-patient study tested an aggressive cholesterol-lowering strategy compared with a moderate approach for patients hospitalized with severe unstable chest pain. The aggressive treatment was 40 milligrams of Zocor for a month followed by 80 milligrams for the next 23 months. The moderate approach was four months of a placebo followed by 20 milligrams of Zocor.
In the earlier Lipitor/Pravachol study, Lipitor at a dose of 80 milligrams proved significantly more effective in reducing LDL and the risk of serious heart problems than Pravachol at 40 milligrams. The benefit for Lipitor was evident within 30 days of starting the drug and the study was an important reason why cardiology experts are now recommending that doctors consider aggressive therapy with statins to enable patients at very high risk of a heart attack to reduce their levels of LDL to below 70. Previously, the target for such patients was below 100.
Cardiologists expected aggressive treatment with Zocor to reflect the Lipitor findings, especially because the control group was treated with a placebo during the first four months of the two-year trial. But even though their LDL levels fell to 62, aggressively treated patients at the end of four months had no difference in heart attacks, death from heart attacks, or strokes for heart problems than patients on placebo whose LDL was twice as high. After two years, 14.4% patients on aggressive therapy had suffered negative outcomes compared with 16.7% on the moderate regimen, but the difference was not considered statistically significant.

Clinical psychologist Gerard Musante was the first person to adapt the principles of behavior modification to the eating habits of significantly overweight people. For the past 30 years, Dr. Musante has taught these principles at Structure House, the residential weight loss facility he founded in Durham, N.C.
In this Tech Central Station op-ed, Dr. Mustante addresses that the national debate over responsibility for our society’s obesity overlooks the effect that the debate has on how individuals perceive their personal battles with being overweight or obese:

[O]ur national debate on obesity is evolving into two camps. One emphasizes that obesity results from such factors as genes, a disease state or physiology. The other focuses on the role personal responsibility plays and possibly defines obesity as a personal failing.
While the first camp paints the individual as a victim of forces beyond his control, the latter argues from a moral or social viewpoint. While I strongly support personal responsibility, even the discourse to this effect fails to address the most critical reason for espousing such a perspective. What is too often absent from both viewpoints is a direct consideration of the ramifications these arguments themselves can have on how individuals view their personal battles with overweight and obesity.

Dr. Mustante points out that the biggest problem is defining the issue as being out of an individual’s control:

If one defines a problem as out of his control, then he remains powerless to influence it. However, nearly all experts acknowledge obesity ultimately results from violating a simple principle: calories consumed should equal calories expended. The idea that individuals are victimized by their own bodies or a toxic environment is problematic. For starters, it’s untrue. But as importantly, it stymies their motivation and perceived ability to control their weight loss.

The key lies in a related psychological concept called self-efficacy, which was defined by Albert Bandura, a noted Stanford University psychologist, in 1977. He theorized that people’s expectations of their ability to be effective influence whether and how they will act. It will affect how much effort they expend, and how long they will sustain their efforts in the face of challenges. If a person believes he lives in a “toxic food environment” or is suffering from a disease state, how can he have confidence in his ability to change his predicament?

Dr. Mastante then points out that “quick fix” diet plans are usually counterproductive to obesity because the personal sense of failure that an individual experiences triggers a false sense that the individual is powerless to overcome the problem. And that false sense of powerlessness is becoming more popular:

Worsening the problem, we now are seeing efforts to sue food establishments, to demonize various industries, and to rid schools of vending machines. By blaming industries and products, society only makes individuals feel increasingly powerless about their ability to lose weight, and that perceived lack of control makes them less likely to attempt or experience success. Frivolous lawsuits against the food industry and the classification of obesity as a disease only reinforce the idea that obesity is something people cannot control.

Read the entire article, and then take a look at this piece in which the authors point out that the obestiy epidemic is partly the unintended consequence on the anti-smoking campaign over the past generation.

Many Houston business litigation attorneys know Ken Klee as a Los Angeles-based corporate reorganization and bankruptcy law expert, as well as a UCLA Law School professor. However, this LA Times article reports that Ken is also up to something completely different from representing parties in reorganizations or teaching students the intricacies of bankruptcy law:

Brentwood real estate broker Joan Gardner was suffering such excruciating pain with a swollen knee, months after a fall, that she was homebound, depressed and unable to work. Her doctor and orthopedic physical therapist encouraged her to have surgery, but Gardner declined because, “I’m stubborn and vain.” Instead, she decided to try something different.
Digging up a number her grocery clerk had given her, Gardner dialed Ken Klee, a UCLA law professor and prominent corporate bankruptcy lawyer who practices energy healing on the side. A seven-year student of more than half a dozen healing methods including reiki’s radiance technique, pranic healing and Theta Healing, Klee practices eight hours a week out of his Brentwood home office, stacked high with stones and crystals, massage table at the center.
Without touching her body or charging her a fee, Klee waved his hands over Gardner for three hours last December, channeling divine healing energy and helping her clear out anger and other blocks. The next day the swelling in Gardner’s knee was gone.
“I was in shock. It sounds probably crazy, but it’s the truth,” she said. “I feel like a million dollars, and I have since that day.”
Stories like Gardner’s raise eyebrows among those in the medical establishment and Klee’s academic colleagues. Once the provenance of faith healers, shamans, ancient and New Age mystics, however, energy healing is increasingly going mainstream.

And what on earth is energy healing?

Methods vary, but principles generally stem from ancient concepts of a life force ? called chi or qi in traditional Chinese medicine (prana in Indian medicine) ? that moves through pathways called meridians. Acupuncture, qigong, tai chi, yoga and shiatsu massage are all based on the idea that free-flowing energy throughout the body leads to optimal health.
Energy healers contend that people have an etheric, or energy, body, often called an aura, surrounding and penetrating the physical body, and energy fuel centers inside the body called chakras.
Because bodies are made up of subatomic particles in constant motion, many physical ailments manifest first in this energy body, like a blueprint, healers say. Stress and painful emotions, for instance, can cause energy to get stuck or depleted, inhibiting the body’s natural healing processes.
Healers claim to be able to detect and repair these problems with or without touching the body, sometimes from great distances. “All we are at our essence is vibration, and all disease is dissonance in vibration,” Klee says. “If we alter the vibration through crystals, color, sound, prayer or bringing energy through the hands, it all has to do with vibration.”
By harnessing the power of the mind-body connection, many energy healers say they are simply promoting the innate ability to heal oneself, meaning receptivity can affect whether it works, as can the intent and state of mind of the healer.
The line between energy healing and faith healing can get blurry. Some practitioners invoke a higher power, while others align cosmic healing symbols or gather and project healing energy from nature. Some tout extraordinary gifts; others say they are simply conduits, and anyone can learn to heal themselves and others with a little practice.

Altough the article notes that some clinical research into energy hearling is underway, the medical community retains a healthy dose of skepticism regarding the benefits of energy healing:

Stephen Barrett, a retired psychiatrist and founder of the health fraud guide Quackwatch, holds the “sheer quackery” point of view. He dismisses such research, saying, “There is nothing there.”
Barrett is coauthor of an article published in the Journal of the American Medical Assn. in 1998 debunking the effectiveness of Therapeutic Touch, an energy healing method often used by nurses.
“They claim they can, by concentrating, feel a person’s energy field and go through certain maneuvers to modify it and create a healing force,” he said. “We feel that’s preposterous. It’s a figment of their imagination.”
Barrett’s JAMA article publicized the results of a science fair project of a 9-year-old girl named Emily who tested Therapeutic Touch practitioners’ ability to detect her energy field. The experiment was similar to Schwartz’s, but the practitioners correctly guessed which of their hands the girl’s hand was hovering over only 44% of the time, less than chance would suggest.
Barrett, one of the nation’s most outspoken critics of alternative medicine, says energy healers and those who bolster them through studies are delusional or dishonest.

But Mr. Klee remains a true believer:

“If I can do it, anybody can do it. I’m a conservative guy, a lawyer, a skeptic. I believe in verifying things. Seven years ago, I would have thought this was completely nuts. Now I’m convinced science is going to validate this. It’s going to happen in my lifetime.”

Hat tip to Professor Bainbridge for the link to this story.

Dr. Rangel has insightful comments on the recently published study linking artificial sweeteners with obesity in rats.

This Wall Street Journal ($) article reports on a significant advancement for the next generation of Alzheimer’s treatments, Neurochem Inc says it will begin recruiting patients for a large efficacy trial of its drug Alzhemed in the next few weeks.
Unlike current drugs that generally treat the symptoms of Alzheimer’s, the new drugs target the underlying illness itself. The goal of these new these new medicines are to halt the devastating progression of the disease or prevent it entirely. Alchemed is at the cutting edge of the new medicines that offer hope to the 4.5 million Americans struck with the memory-robbing illness.
Alzhemed, which helps prevent the formation of the plaques many scientists believe are the culprit in Alzheimer’s disease, could be on the market within four years. The new study will enroll 950 patients over 18 months at 70 sites in the U.S. and Canada.
For a long time, Alzheimer’s research was a depressing area that simply was not producing any insights to a possible cure for the disease. That is changing, as the clinical trials described in this article appear quite promising.

Both the Chronicle and the Wall Street Journal ($) have front page stories on the research project that Dr. Wadih Arap, a cancer biologist at the University of Texas M.D. Anderson Cancer Center in Houston’s Texas Medical Center, is leading a study that offers a potential new approach to treating obesity and is also showing promise in cancer treatment. The results are being published in the June issue of the journal Nature Medicine.
Such research is becoming increasingly important because several recent studies are revealing that many of the improvements in health that medical advances have bestowed upon middle-aged and older Americans will likely be effectively erased over the next 20 years if Americans’ weight continues to increase.
The researchers said they melted away body fat in laboratory mice by cutting off the blood supply to fat cells. The agent is a drug the researchers designed to home in on blood vessels cells linked to fat tissue and then deliver an agent that induces the cells to self-destruct. As the blood vessel cells died, the fat tissue essentially vanished.
Weight-loss drugs typically seek to suppress appetite or increase the body’s metabolism to make it burn more calories. However, the body can quickly compensate for the effects of such drugs, making it difficult to lose and keep off weight. Accordingly, the new research is important because it could decrease the amount of fat in a completely novel way.
Dr. Arap cautions that only mice have been studied so far and that what works in mice often fails in people. Even if additional research goes well, it would probably be several years before any treatment could reach the market.
No corporate sponsors were involved to date in the study. The research has been funded with grants from the National Institutes of Health and several philanthropies. M.D. Anderson has filed patents related to the approach, and its institutional policies enable Drs. Arap and other researchers in the project to benefit financially if the strategy is commercially developed.
As far as potential corporate sponsors go, I recommend highly that the researchers get in touch with a certain doughnut makere.

This NY Times article reports on a preliminary University of Pennsylvania and Tufts University study that found that an experimental drug can sharply increase levels of H.D.L. — the so-called “good” cholesterol — and, thus, potentially offer an entirely new way to help prevent heart attacks. The new drug — called torcetrapib — also reduced low density lipoprotein, or L.D.L. in the tests.
Doctors currently concentrate on lowering bad cholesterol by giving patients statin drugs, which are researchers believe have reduced heart attacks in Americans by about one-third. This new study is a part of an initiative to reduce heart disease further by increasing good cholesterol.
This related Wall Street Journal article relates how Pfizer Inc. is investing $800 million on human tests of torcetrapib, which is the most that any drug company has ever committed to spend on a clinical test in an effort to obtain regulatory approval of a drug.