Viva la Mitochondria!

Last week, I found myself in the swank ballroom of the Four Seasons Hotel in midtown Atlanta. Unlike the functions I attend for my government clients, this one had swag bags, free hors d'oeuvres and soft drinks, and an open bar for VIPs. It was a nice event.  But I wasn't there to soak up the atmosphere - I was there to listen and learn and to support  one of my clients, the Foundation for Mitochondrial Medicine, who sponsored the program.*  

And I'm so glad I went. The program was impressive: top researchers and clinicians from Harvard, the Mayo Clinic, Georgia State University, and private practice in Atlanta shared their research into how mitochondrial dysfunction is at the crux of the diseases and conditions they study, conditions ranging from autism to Parkinson's disease and that include muscular dystrophy, ALS, and more. The illustration above provides a graphic representation of the central role mitochondrial dysfunction plays in many common diseases. You can read more about it here.

A brief primer on mitochondria:  These organelles, found in almost every cell in our bodies, are responsible for many functions in the body and brain. Perhaps their main contribution to our health is taking chemical elements from the food we eat and the air we breathe and turning it into adenosine triphosphate, or ATP, which is the fuel on which our bodies run. But mitochondria perform other tasks in our bodies, as well: organ-specific ones, like working in the liver to detoxify ammonia that is created as a waste product of protein metabolism; or regulating calcium so that neurons can function smoothly; and even telling cells when to die, an important housekeeping tasks that ensures the availability of robust cells to take care of our bodies' business.

So when mitochondria become damaged, either through inborn genetic mutations or through environmental assaults, diseases and conditions can develop that range from moderate to severe, from feeling fatigued to being unable to breathe, move, see, or think clearly. Researchers also suspect that damage to our mitochondria are responsible for the aging process itself.

This is terribly exciting research. Importantly, this particular group of researchers is working not just on laying out how mitochondrial dysfunction results in disease, but how to fix the problems. Currently, the most helpful therapies, such as CoEnzyme Q, exercise, excellent nutrition, specific supplements, and rest are pretty basic. But that gives you an idea how important those aspects are, and how much we take them for granted in supporting our bodies' daily energy needs.

Of special interest to me is how fragile mitochondria are. Many things, including some drugs, pesticides, and other chemicals, including air pollution, can damage them. And, last I looked, we are all living in an increasingly polluted world, which might help explain why certain diseases are increasing. Excellent nutrition, therefore, offers a basic defense from the continuous assault of chemicals we all experience. And it's not just the protective nature of good foods that is important, but also recognition of the damaging aspects of bad fats and artificial additives, including the creation of free radicals when they are metabolized that can harm the delicate mitochondria.

This post is more "gee-whiz"than most of my posts, but I really think mitochondrial medicine is one of the great promises for understanding, preventing, and treating some of the most common and debilitating diseases and conditions of our time. If you look around your family tree and map out diseases and conditions in various family members (this post can help you get started), you might find patterns between the generations, one of which may be linked to mitochondria. That can give you a clue about how clean you need to make your personal environment, whether it's the foods you eat, the air you breathe, or how you control pests in your house and weeds in your yard, in order to support mitochondrial health. The evidence is strong that the combination of family genetics and one's personal environment can make the difference between good health and disease and now we're beginning to understand that high-functioning mitochondria may be one of the key sentinels standing guard over our well being. Therefore, since we can't do much about the genetic hand we are dealt, we need to be vigilant about creating personal environments that support these vital sources of energy and cellular protection.

###

Did you know that mitochondria are believed to be ancient bacteria that were ingested by single-celled organisms, where they eventually created a mutually beneficial relationship by providing energy to the organism in return for a safe place to live? The enhanced energy is why organisms could evolve from one cell to many.


* disclaimer: The Foundation for Mitochondrial Medicine is one of my clients. It pays me to do scientific writing and strategic communication counseling. This blog posts represents my own opinions and not those of the Foundation. I was not asked to write this post, did not have anyone from the Foundation vet it, and take full responsibility for its content. I'm just really excited about this field of medicine.

Image from the Foundation for Mitochondrial Medicine.

It's Almost Halloween!

My family attended the greatest Halloween party over the past weekend. It was for all ages, so there were toddlers entranced by motion-activated ghosts and seniors in face paint chatting it up. There were teenagers hanging out on the sofas and younger teens playing tag and flirting (which is basically the same thing for that age group). Us middle-agers had a great time dancing, imbibing, catching up, and eating. Because the party was a potluck, I realized how fortunate I am to be surrounded by people who value good food and brought their finest recipes to share. The dessert table, which could have been a disaster of artificially colored and flavored treats, was laden with homemade cupcakes with real chocolate frosting, snickerdoodles and other cookies that were crisp with real butter or coconut oil, homemade cakes decorated with naturally colored frosting, chocolates formed in the shape of rats (icky, but tasty), and other sugary, but fairly wholesome, treats.

The chilis, salads, sides, and other food were equally whole. What a treat. 

But as we sneak ever-nearer to the official trick-or-treat date, the drug-store candy is beginning its siren call to my kids, and to kids across the country. For Halloween, I take the view that I won't give away candy that I wouldn't give to my family. That makes sense because the pre-Halloween stash and post-Halloween leftovers are eaten by my family (and me). So, of course I look for alternatives that have no suspicious chemicals, items like bite-sized Cliff Bars or candy from health food stores. However, I don't stress too much about it and some people are surprised to learn that I also give out more commercial candy. But I do, after reading the labels. In this case, my goal is to minimize, rather than eliminate, artificial colors, flavors, and preservatives. So, Butterfingers are a reasonable compromise and Hershey Bars are OK. Not great, but OK for this specific holiday, especially because my kids are older, have developed good eating habits, and quickly tire of cheap candies.

I do, however, stay away from the candies that are just an compilation of chemicals, you know those brightly colored, strangely flavored ones, like those highlighted by TakePart, in its article on the worst Halloween candies. Generally, these are not only laden with chemicals, they are sticky, too, which means they stay around on teeth (and braces!).

This conversation is getting a lot of traction. Over at The Lunch Tray, blogger/lawyer Bettina Siegel is conducting a poll on what you're giving away for Halloween. She also provides some ideas to reduce the chemical intake of the holiday. These candies look great, but I have not seen them in my local stores.

In honor of Halloween, here are links to some previous HealthTwisty articles on candy.

• Don't Eat the Oil ran after Halloween 2010 and remains the most popular HealthTwisty post.
• Snack Attack is about gummy treats masquerading as healthy treats.
• Yes, Diet Affects Attention. Really. explains some of the research linking artificial colors/flavors/preservatives and other components of processed foods with attention and behavioral issues.

And I love A Story about Bees, which provides anecdotes about how we, as a society, often pay more attention to how foodstuffs affect our animals than how they affect our kids.

So happy reading, make reasonable choices, and have a ghoulish good time out there on the 31st!

###

Image from Visit Sleepy Hollow

Doping is Cool in School

A recent article in the New York Times brought up the subject of performance-enhancing drugs, but not in the way we usually think of them, which is for sports. No, this article highlighted a not-so-secret use of stimulant drugs: prescribing them for children who do not have ADD/ADHD, but who are struggling in school. The article was fairly non-judgmental and focused mainly on one doctor in rural Georgia who sees a lot of underprivileged kids, who, in his words need the drugs because they are "mismatched with their environment." For support and contrast, the article included other doctors, as well as educators, from across the country to weigh in on this surprisingly (to me) common use of stimulant drugs.

This particular doctor's rationale for prescribing ADD drugs to kids who don't have ADD is that he feels these drugs can help to make up for deficits elsewhere in the system, such as a lack of funding for tutors or aids that could address the kids' issues through more labor-intensive behavioral strategies. Another doctor was quoted as saying:

“We as a society have been unwilling to invest in very effective nonpharmaceutical interventions for these children and their families,” said Dr. Ramesh Raghavan, a child mental-health services researcher at Washington University in St. Louis and an expert in prescription drug use among low-income children. “We are effectively forcing local community psychiatrists to use the only tool at their disposal, which is psychotropic medications.”

That article was thought-provoking in and of itself. But when you combine that news with the United States Anti Doping Agency's indictment of the Lance Armstrong doping situation that emerged at roughly the same time, well, you have sort of schizophrenic situation. Apparently doping is good in some situations, and bad in others. After all, here are two different uses of performance-enhancing drugs. One is an example of professional athletes using drugs to make up for limitations of the human body. The other example is of students using drugs to make up for limitations in their school systems.

Is there a difference?

According to the doctors, educators and some parents, there is. After all, Lance Armstrong's team was stripped of all their medals and banned from their sport because they used performance-enhancing drugs. Conversely, struggling kids without ADD are being encouraged to use performance-enhancing drugs in order to compensate for shortcomings not in themselves, but in their academic settings. Performance-enhancing drugs, mind you, that are categorized by the Drug Enforcement Administration as Schedule II Controlled Substances because they are particularly addictive. From the NYT:

"The superintendent of one major school district in California, who spoke on the condition of anonymity, noted that diagnosis rates of ADHD have risen as sharply as school funding has declined. "It's scary to think that this is what we've come to how not funding public education to meet the needs of all kids has led to this," said the superintendent, referring to the use of stimulants in children without classic ADHD."

Doping kids appears, at least in the short term, to enable struggling kids who don't have ADD/ADHD to keep up with the baseline of what they need to learn. But I can't get over what it says about us as a society - that we would choose to medicate kids who don't really need those strong medications* rather than fund our schools to the extent that those students could get the appropriate support to help them learn. Support that could supply them with behavioral modification and cognitive tools that could serve them throughout their lives. And, here's a nasty truth: Even while these marginalized kids are maintaining, kids at the top of the heap are using the same drugs illegally to vault into the stratosphere of GPAs and test scores. So the drugs still are not leveling the playing field.

If we, as a society, decide that it is OK to dope some kids, how do we decide? The doctor in the article says he does not prescribe stimulants to students who make As and Bs, so he draws his lines along grades. I have not heard or read how team physicians make the distinction as to whom to dope, but I imagine it is the higher performers who have a real chance at breaking records that use performance-enhancing drugs. So if we should try to create guidelines as to when and for whom it is appropriate to dope based on that reasoning, the resulting guidelines might look like this:

• High-performing academic kids [without a diagnosis of ADD] from well-funded schools should receive drug testing, and those who are found using stimulants should be stripped of their academic awards, college scholarships, and acceptances into elite professionals schools.
• Lower-performing cyclists who have not benefited from optimal training opportunities would be able to use performance-enhancing drugs in order to make up for the deficits in their training systems.

Of course, those "guidelines" are tongue in cheek and I don't expect them to really happen (but after thinking about it, the first bullet might be worth considering). I only pose them to prove a point about our society's inconsistency when it comes to drugs.

However, what should not get lost are the needs of students who could benefit from "extras" that some schools can provide, but that many, increasingly, cannot. If we can't come up with the money and support to address their learning in the optimal way, then what are we going to do? It seems, at least to a handful of doctors, that we'll medicate those kids until they graduate from high school, then we'll let them figure it out for themselves.

###

Image courtesy of Wikimedia Commons.

* You don't have to read too far into the comments after the NYT article to read lots of testimonies from people whose lives were changed for the better once they began using medications. So, clearly, if a student has ADD/ADHD, medications are an option that should be considered.

Going to the Dogs...

Remember when I wrote that it seems as if we pay more attention to how foodstuffs affect the behavior of animals than how they affect our kids?

Well, Brianne DeRossi takes that concept one step further. In a post over at The Lunch Tray, she notes that, in many cases, dog food may be superior in quality to much of the people food that is passed off as being "nutritious."


It's a great read. Check it out.

###

Photo credit: http://bestdogfoodstoday.com

Long Live the Fireflies!

photo credit: www.firefly.org

Raise your hand if you love summer!  What can be bad about more daylight, fresher foods, and a more relaxed schedule? Even though we may all keep the same work hours in summer that we do the rest of the year, the extra daylight makes the season feel luxurious - as if you can finally get everything done on your to-do list and maybe read a book, too.

Recently, as a group of us were sitting on our porch, the fireflies came out. Winking and blinking in their ageless mating game, these specially endowed cousins of the common beetle sent us all reminiscing about chasing them in our childhood yards  or watching our own kids wonder at the "lightning bugs" when they were younger.

Then the discussion turned to how we don't see them as much as we used to. Like frogs and bees, fireflies are declining due to the effects of human activity. Evidence is mounting that lawn chemicals kill the beetles both directly by poisoning these ground and tree dwellers and indirectly by killing the grubs and other insects the fireflies use for food. Light pollution is thought to inhibit them from lighting up - which means no offspring. After all, fireflies communicate by blinking their lights and if they can't find each other to mate, well, there goes the next generation. The paving of green spaces to make way for roads, shopping centers, and suburban driveways leaves less space for the beetles to live.

Because I love fireflies, I'm hoping others will join me in trying to protect them. You can read more about how simple actions can make your yard more hospitable to fireflies here and here.

Sometimes, when I'm especially fatalistic about what is happening to the world around us, I think of the things I'll miss the most once they are gone. Tigers and elephants and rhinos, definitely. Glaciers, certainly. Fireflies? Oh yeah. How tragic to lose that tiny bit of summer magic from our lives - especially when a few alterations to how we live could preserve them.

###

Arsenic and Old Hens

Arsenic, that classic chemical that villains use to do away with people in old timey murder mysteries, continues to be in the news. First, we learned that arsenic fed to chickens (more on that in a bit) is stored in their muscles, which we ingest when we enjoy a roast bird for dinner. And if that's not enough, the arsenic-containing wastes from the chickens may be spread as fertilizer on fields, where the arsenic becomes an ecotoxin that is carried by runoff into streams, wells, and other bodies of water.

So we eat it, then we drink it.

But there is a glimmer of good news: the state of Maryland has quietly banned the use of arsenic-containing chicken feeds. Even though it is just one state, Maryland's ban is significant because there are approximately 1,700 poultry producers near the Chesapeake Bay, which, combined, produce about 11 million chickens each week. The arsenic-containing wastes from these birds is significant and has resulted in contamination of nearby wells as well as high levels of arsenic in Chesapeake Bay.

Years ago, research showed that the arsenic-treated lumber used in children's playsets and household decks was a major cause of arsenic exposure. In 2004, the EPA outlawed arsenic as a wood preservative, despite industry's pleas to place a warning label on the wood. The evidence is strong linking arsenic to all sorts of health ills, including cancer and decreased cognitive function. So why is it purposefully put into our food supply?

The answer reflects a problem inherent in factory farming: in order to supply large amounts of inexpensive food, the livestock industry needed to come up with ways to allow lots of animals to grow in close quarters. Some of those ways include dosing the animals with antibiotics to prevent infections,  supplying them with  growth hormones so that will they grow and go off to market more quickly than normal, trimming the beaks of chickens and the tails of hogs so that the animals do not injure each other, and adding arsenic to the chicken feed in order to kill intestinal parasites that inevitably grow in the feces produced by thousands of birds. It's a decidedly sad life for an animal grown in confinement, but if you're going to expect chicken to cost less per pound than a pint of good ice cream, then you should know that's the real price you pay.

So the banning of arsenic-containing feed is a positive step and should result in lowered levels of arsenic compounds in the environment and in our tummies. But the ban does not address the real problem those feeds were introduced to combat - parasites caused by extreme overcrowding. What do you think will happen next? Do you think poultry producers will opt to raise fewer chickens in a roomier environment, which will increase the price of chicken at the supermarket and likely decrease the growers' profits? Or do you think we'll see the introduction of yet another chemical to keep parasites at bay? I'm betting on the introduction of another chemical that will find its way into our food, water, and bodies. But I'd like to be proven wrong on this one, so let's watch Maryland closely to see how its poultry producers adjust to the new law. Maybe, just maybe, some truly innovative thinking will emerge.

### 

Interested in reading more about how arsenic and other environmental contaminants can harm humans at all stages of life? Here is a 2011 report from the National Research Council exploring these issues. The information about arsenic in on page 7, which includes a discussion of the research showing that early exposure to arsenic can decrease intelligence permanently. 

Childhood Vaccines: A Case of Collective Amnesia

Children in Nigeria line up to receive the smallpox vaccine, 1968.
In 1979, the World Health Organization (WHO) declared
the global eradication of smallpox and recommended
that all countries cease vaccination. 
Source: CDC

Not long ago, I was in the bleachers at one of my son's baseball games. It was one of those ordinary, and therefore quite wonderful, evenings. Nice weather, decent sports action, no place I'd rather be. Out of the corner of my eye, I saw a dad and two kids walk by and then stand by the bleachers to watch the game. Again, not unusual. However, what caused me to do a double take was the oldest child's extreme skin condition.

All of this child's visible skin was covered with angry-looking, red sores. Arms, hands, face, neck. The sores looked vaguely familiar, and then it hit me: This kid was walking around with chicken pox. Not trusting my own diagnosis, I leaned over to a physician/baseball mom near me and said, "Does that kid have chicken pox?" She nodded her head in affirmation and said, "I know his family. They don't vaccinate, and they infected him on purpose at a 'chicken pox party'."

I had to think about that for awhile.

From what I could tell, most of the kid's pox were scabbed over, which meant they weren't infectious. But I did notice some newer pox that looked more like blisters, meaning that they were potentially infectious. Even though I confess to a somewhat irrational cringe moment at being so close to this kid, I wasn't really worried about my own health. After all, I had a raging case of chicken pox in elementary school that rendered me immune. But looking around the bleachers, I saw a couple of grandparents and a baby. And that's when my noncommittal response to the chicken pox family turned into a more judgmental one. After all, the grandparents were at risk of developing chicken pox or activating shingles because of their aging immune systems, and the baby was definitely at risk because the chicken pox vaccine is not given until four or five years of age. And for all I knew, any one of the seemingly healthy middle-aged parents in attendance could have been immunocompromised from cancer treatment, HIV infection, or other conditions. Whatever thoughts I had about the chicken pox family's beliefs toward vaccination quickly became secondary to what I thought of this family being in a public venue with a perhaps-active and easily transmissible infectious disease, no matter how "certain" they were of the child's infection status.

Unfortunately, judging from vaccination trends, we can expect more and more of these exposures.

This past week, media outlets across the country carried news of the whooping cough outbreak in Washington state. The outbreak is huge - well over 1,000 cases, and one that

"could surpass the toll of any year since the 1940s, before a vaccine went into wide use," according to public health officials interviewed by The New York Times. 

The numbers are probably higher because many people with mild disease do not get a diagnosis. Further, the state is so strapped for cash that it is recommending foregoing the $400 diagnostic test and just prescribing antibiotics to those with the hallmark symptoms and exposure patterns, causing speculation that only 1 in 5 infections are being recorded.

The outbreak is directly attributable to that fact that families of 6% of school-age children in Washington have opted out of some or all of the recommended immunizations. That 6% is over the tipping point where even people with some degree of immunity through vaccination can have elevated risk of getting the disease. This is especially germane to whooping cough. Researchers have reformulated the whooping cough vaccine in recent years to reduce its side effects. As a consequence, the new vaccine is not as effective as older versions were, making the concept of herd immunity even more important for this particular disease.

In other words, individuals who received vaccinations and trusted others to do the same in order to keep herd immunity strong, were totally screwed over by families who decided to not only put their kids at risk, but also other people's kids (and grandparents, and so on).

I've written about this issue before, from an international perspective here and a link to a vaccine expert here. It is so concerning that we are exiting, voluntarily, the era of disease prevention through vaccination. Not because the vaccines don't work. No, modern vaccines work extremely well. So well, in fact, that younger generations do not remember how deadly or disfiguring certain diseases can be because they have never experienced them. If vaccination rates continue to slide, though, it's fairly clear that we all - regardless of our own vaccination status - will pay the price, either through disease or higher health care costs.

###