Rootstohealth's Blog


Fun fact: Food and the Poverty Line
October 28, 2013, 7:27 pm
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Fun fact: Food and the Poverty Line

Did you know that the federal poverty line was defined in the 1960s by economist Mollie Orshansky? She looked at the cost for the amount of calories deemed necessary for survival in the USDA’s “thrifty” diet plan, and multiplied by three (because at that time, Americans were spending approximately one third of their income on food). The crazy bit? Beside for inflation, this number hasn’t been updated since, despite the very different world we live in than the 1960s! Food is integral to our definition of poverty in this country. 

 

Listen to this awesome planet money podcast for more.



What would a polypill mean for public policy?
October 28, 2013, 7:21 pm
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in The Jouranal of Epidemiology and Community Health,  Drs. Holmes and Bhala (2013; 67:897-902 doi:10.1136/jech-2013-202690) lay out a cogent and interesting argument for the allocation of a polypill to the general adult population – one that includes low doses of drugs against cardiovascular diseases, hypertension, and potentially Alzheimer’s, diabetes, and certain forms of cancer (were appropriate and effective drugs for prevention made available). Though I appreciated many of the arguments, for example, that a polypill would reduce risk of diseases in all people uniformly, addressing genetic and environmental causes of diseases, that a polypill has similarities to vaccine programs and certainly to food supplementation programs, which rely on herd immunity or are used to benefit only a small proportion of the population, I found myself wondering about critical societal factors which are important determinants of the chronic diseases which would be addressed by a polypill.

 

Vaccination programs or micronutrient supplementation is employed because there is no other way for the government or society to intervene on the causes of these diseases. Indeed, efforts to reduce infectious diseases like cholera or influenza begin with environmental changes – cleaning the water supply or quarantining individuals – in conjunction with vaccination.

 

While governmental efforts to reduce chronic diseases have been established (Eat Smart, Move More for obesity, or dietary guidelines for sodium reduction for hypertension), there has not been the large-scale shift towards physical infrastructure, food system, or health system change needed to significantly reduce the burden of these diseases in the population. Until the government efforts to lower the risk of these diseases reaches businesses and their own strategies, rather than relying on recommendations to individuals, it does not seem that we have done enough to warrant a polypill as the most viable strategy.



Nature vs Nurture
October 17, 2013, 9:32 am
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Reblogged from my tumblr

We do a lot of studies in nutrition epidemiology about gene environment interactions, the general hypothesis that some individuals have a genetic predisposition towards a certain health outcome, but that certain behaviors may enhance or diminish the effects of this genetic disposition (and thus, are good targets for public health policy).

I’ve been reading Health Wars by Richard Horton, which is full of beautiful gems and new thoughts about health issues that I had taken for granted as fixed and known. He includes a discussion of our approach to genetic research, and he mentions an interesting book by scientist Matthew Ridley called Nature via Nurture, saying

“he argues that…it is nurture that is less amenable to change than nature….it is our environment that governs which genes are switched on and when, and so ‘genes are at the mercy of our behavior’. They exist simply to extract information from our surroundings.”

In a world that love quick fixes and easy answers, we want to believe that we are not in control of our destiny, that we are fighting an impossible fight, and we allay our fears by convincing ourselves that a doctor or science will be able to provide a quick fix. Thus far, genetic answers to complex diseases have not come. Obviously, it would be great to find genetic explanations for diseases, but we also seem to find it easier to address issues of biology than to address issues related to environment, social structure, nutrition, infrastructure.

The biologic and social sciences are both needed, but competitive quests to find social solutions to health issues are not popularized and publicized on the scale of the excitement surrounding the Human Genome Project. Sometimes  I wonder if our social environment may actually be more complex than our genome.



Proteomics and Micronutrient Deficiencies
October 16, 2013, 7:49 pm
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Proteomics and Micronutrient Deficiencies

In a study published in the Journal of Nutrition, Robert Cole, et al., used proteomics to examine the use of protein biomarkers for micronutrient deficiencies. The authors themselves comment that it is a “proof of concept” paper, but better ways of assessing micronutrient levels would drastically alter nutrition epidemiology for the better. Micronutrients are much harder than macronutrients to assess in a population study – within-person variability in intake is much larger than that of macronutrients, meaning that we have to measure the diet in more costly ways and for a longer period of time in order to get an accurate measure of a person’s true level of intake. Further, each apple or piece of broccoli can have variable levels of micronutrients depending on where it’s grown. Complex biochemistry in our bodies means that complementary and competing micronutrients can enhance or hinder absorption of these nutrients. And lastly, populations where it is particularly difficult to obtain accurate dietary data – namely, young children and in populations with low literacy, are precisely the subgroups where we would expect the greatest rates of micronutrient deficiency.

Therefore, the approach the authors take in this study – to examine levels of specific proteins known to be necessary for the metabolism of certain micronutrients, is an innovative way to bypass all of these issues and get down to the fact of the matter: what is the circulating level of a macronutrient in your body, and is it sufficient for its associated bodily functions to work properly?

The promise of proteomics and metabolomics for nutrition epidemiology is huge. Such work help explain discrepancies in response to treatment, allow us to understand underlying physiology, and assess adherence to nutrition interventions. Most importantly for the setting discussed in the article, it can help us accurately assess and divert resources to those at greatest risk of micronutrient deficiency-related comorbidities.

(via SciDev)

Full text of the article is here: http://jn.nutrition.org/content/143/10/1540.abstract?sid=b2f4983c-31dd-4356-9cf9-3261f99e23b9

 



Surveys of opin…
October 16, 2013, 7:35 pm
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Surveys of opinions, of the prevalence of disease, of habits or of environmental exposures may be informative, but they are not science in the same way that causal studies about how nature operates are science.

Ken Rothman, JE Gallacher, and EE Hatch in “Why representativeness should be avoided” Int J Epidemiology (2013) 42(4): 1012-1014



Unforseen consequences
August 28, 2009, 10:48 am
Filed under: Corn, NPR, Renewable Energy, Uncategorized

I heard this great piece on NPR this morning about the land usage required to get the same amount of energy out of some renewable sources compared to traditional power plants. The numbers were staggering. It takes 72 more times the square acres for wind and (here’s the big one) 300+ times for ethanol production for every square acre of traditional power plant.

I’m currently reading The Omnivore’s Dillema, and Michael Pollen spends a lot of time discussing the monoculture of corn in the mid-west and it’s negative impact on the ecology of those areas, the farmer’s economic situation, oil usage to grow the corn at such high yields, pesticide application, and the fact that other crops are not being grown. I feel like adding government pressure to grow this heavily subsidized crop for fuel will exacerbate these problems. Plus I find of scary to have our food system so intimately tied to our energy generation. This piece struck me because the legislation to increase ethanol production is having a great effect on what is grown in this country, and how it is grown. Corn for ethanol production can be Genetically modified, sprayed heavily with pesticides, and most consumer’s won’t know or care. But all the while it will be having an effect, and we shouldn’t be ignoring it.

One great thing about the story on NPR was that the big solutions presented to our energy problem was greater efficiency (i.e., low energy consumption appliances/higher miles per gallon cars) and curbing consumption. Hopefully more people will jump on that bandwagon.



Soy Milk Update
July 19, 2009, 4:17 pm
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Nothing too crazy…but just wanted to mention that Starbucks stopped using Silk Soymilk because of they are no longer organic.  Hopefully consumers will notice and make similar changes to their soymilk consumption.