Advice : What to eat to stay healthy

Hardly a day goes by when I don't see an article or an ad claiming that a new study shows that we should eat a lot of something, or avoid something, to live longer. I've seen studies or reports claiming that we should eat huge amounts of everything from vitamins to trace minerals to random foods to herbal supplements. I have also seen reports claiming that we should avoid everything from vitamins to minerals to random foods to herbal supplements. Many(like my parents) make up diets by picking certain info that the like and ignoring the rest. Others have the attitude of simply throwing their hands in the air and just eating whatever they want, because experts cannot agree on what is good and what is bad for you. This is not really true however. There is one piece of diet advice that has never been disproven or contradicted and is pretty much guaranteed to keep you healthy: All things in moderation.

Now there are two parts to the 'all things in moderation' diet. First is the all things. This means eat a wide variety of foods. Do not leave random things out such as meat or dairy products or even sweets. Vegetarians often become anemic for lack of B12 and protein, and women who avoided dairy fat are less fertile. Studies have shown health benefits for things ranging from beer to chocolate, proving that to get all benefits, you simply have all things.

Now before you run out and gorge, keep in mind the second part, in moderation. This means that while you can eat some chocolate and have some beer you should not eat large amounts of anything. It is large amounts of bad foods (such as fat, cholesterol, and sodium) that make them bad for you. This moderation also includes healthy foods however. It turns out that too much fiber has the same side effect is too little, so if you eat a lot of bread, you'd better make sure it is not all whole-grain. Also healthy foods such as fruit have a surprising amount of simple sugar, so while it is certainly healthy to eat some, that cannot be the only thing in your diet. In addition, no legitimate scientific study has ever shown that megadoses of anything are healthy for you. It is a medical fact that excesses of vitamins and minerals are simply washed out by your kidneys, and do no benefit to your health whatsoever.

All things in moderation happens to be the guideline that I follow for my everyday diet, and it has certainly kept me healthy and thin while eating lots of food that I enjoy.

Opinion : Women in sports

I am amused by the current Nike ads for the women's soccer team. The commercials make an interesting point, but don't make a lot of sense. They are amusing but they don't make me want to watch women's soccer or buy Nike's products. The issue that is the punchline of the commercials is that nobody cares about women's sports, however the commercial makes no serious argument as to why we should; it only makes fun of other efforts to get people to pay attention. The reality of the women's World Cup, is that the US has very little competition as most countries simply have very little female participation in sports. I was discussing this fact the other day with my girlfriend, who for some reason wants to play club hockey this semester. We were debating the reasons why women don't play many sports and one reason struck me that seemed worth exploring.

When a boy plays sports such as baseball or basketball at a young age, his social standing is not really that important. If his friends don't already play, he either makes friends on the team (as team sports are a great way to bond and meet people), or gains status by out playing his peers. Females on the other hand are often discouraged from sports by their peers. It is not however simply the attitude in society that women don't play sports. It is a more insidious effect that young women seem to have on each other. When my sister was in her early teens, she was a promising competitive swimmer. She gave this up at random one day not because she lacked in skill, or because it was too much. She gave up because her only friend in the program had an argument with her. The other girls that she hung around with didn't swim competitively so she simply give it up. My girlfriend had similar experiences with soccer. This would simply not happen with the guy, as several of my friends played different sports and we didn't seem to care less about what other people thought of us. We often enjoy bragging about our acomplishments. It seems to me that young women play sports more for a social aspect then for the love of sport or for a competitive sense.

The problem with all this is that many very talented women leave sports that they might be good at, and for silly reasons. Imagine if Michael Jordan had given up basketball in high school because the kids he sat with at lunch didn't play it, or if Tiger Woods gave up golf because the kids down the street preferred to play basketball. It seems to me that if more girls ignored what other people thought of them and continued their athletic development into high school and college, all of women's sports would be improved. This also suggests a much better way than title VI to improve female participation in sports. Simply making more spots available without increasing the demand will only watered-down the competition, and further drive away fans. Campaigns that educate parents and coaches as to the social pressures facing girls might dramatically increase competition in lower levels of women's sports. Over time this would likely filter and to the professional levels of competition and make the sports more exciting. I have little doubt that my sister would've been a fantastic high school swimmer and probably could've gone to a mid-level college for it as well. Instead she took up cheerleading and smoking.

TV review : House MD

Tonight is a season premier of my favorite TV show, House MD. on the surface this is a show about a misanthropic doctor and his associates. Every episode follows a similar formula: first a patient collapses, then they try treatment that repeatedly do not work. Towards the end of the show, House will get a brilliant idea and treat the patient. There is also a little bit of the personal life storyline for the characters in every episode as well. But the show is actually much much deeper than it would initially appear.

House MD is really a show about two different styles of practicing medicine. In the 60s and 70s the style of medicine known as paternalism was taught and widely practiced. Paternalism is roughly defined as a style where the doctor knows all and the patients except his wisdom without question. Believers in this practice saw patients as weak and saw science is all-powerful to solve diseases. The competing philosophy of that is humanism, in which the physicians sympathize with their patients and work with them to find a common solution to their problems. Physicians who practice in the style try to use a holistic approach and appreciate patient's feelings and moral values.

As a doctor, House represents the alpha paternalist doctor. He is absolutely brilliant as a scientist and always right, but disdains patient interaction. He is thrust in to a modern hospital however, and forced to confront several of the changing aspects of medicine. His boss is a woman, as as one of his fellows. He also has a minority fellow, to go along with a fellow who is a rich white legacy. While he is an angry paternalist, his fellows all believe strongly in humanism. The overriding premise of the show is that his paternalist style can solve all of his patients problems but ironically enough, he cannot solve his own. For his personal struggles, he needs but resists the humanism of his colleagues.

It should also be noted that House with his fellows must confront all of the major problems facing modern medicine. There are episodes about, pharmaceutical companies trying to buy influence, fetal rights, patient rights, rights to treatment of prisoners and poor people, and personal struggles with drug addiction and dishonest relationships. Some episodes tend to confront the philosophical topics, such as how to spend the last moments of one's life, were facing up to mistakes. Further episodes comment on politics or current events. The topics on the show read like a list of topics from an actual medical bioethics class and are deeper than almost any other show on television..

While the cases that appear on the show are unusual and unlikely to occur in the number that they do, the actual medical dialogue on the show is surprisingly accurate. The treatments and symptoms are generally right from the textbook. While the show rarely betrays the long and often tedious work involved in being a physician, it does accurately portray the roles that students and attending physicians have in a modern hospital. Of all the medical shows on television, House easily is the most interesting to someone who understands or works in medicine.

Opinion : A plan to get rid of undue Pharmaceutical influence

In the last two years or so, there has been a lot of progress and publicity on the issue of pharmaceutical companies influencing medical trials. This article in Slate adds some useful information to the debate by uncovering new insidious ways that pharmaceutical companies are wielding influence on science. While the author's solution of making journals follow the same disclosure that scientists do is a good start, I think that there is a much better way to solve the whole situation. The best way to promote full disclosure in the pharmaceutical industry is simply to require each pharmaceutical company to submit a detailed and itemized list of all the parties that they have spent promotional or development money on for each budget year.

I would imagine that this is neither a difficult solution to legislate, or to comply with. It could be a simple form that is attached to the company's regular SEC filings for each fiscal year. This would create a government mandate for public disclosure that could be reviewed by accountants and for which executives could be held accountable. I am sure that some place in each company there exists a detailed lists of expenditures so that each company can track how effective these are. I cannot think of any objections to the public interest for mandating that each company make these itemized reports available to the public. While I realize that few people would bother to look their doctor up, it would give activists and investigators an important tool to demand accountability of healthcare professionals. This tool would also enable stronger peer review as conflicts of interest would be readily apparent to other scientists and scientific editors.

Opinion : Anti- Cancer Plan

For the election this year, Lance Armstrong called on candidates to have a plan to fight cancer. Despite the fact that cancer deaths are generally decreasing across the board, it is still a major problem, and I applaud him for bringing attention to it. However the only candidate to immediately come up with a plan was John Edwards, and this makes me sad. On the continuing theme that I could run this country better than John Edwards, here is the Chris Gange plan to fight cancer:

Prevention: the first step has to be prevention, as most cancer deaths are still from preventable causes.

- I would dramatically increase the amount of anti-smoking advertising and also raise taxes on cigarettes to help offset increasing health care costs.

- I would create a program to provide financial incentives for people to get cancer screenings, especially breast cancer, colon cancer, and prostate cancer. I believe that providing a small amount of payment would be very effective as it would save money in the long run, and also it would provide more incentive to lower income people who are more susceptible to not catching cancer in time.

- I would direct research money to practical applications, such as finding out why people are not getting annual screenings and attempting to remedy those problems with creative solutions. For instance if women find mammograms uncomfortable, I would have engineers determine ways to make the machines more user friendly. This type of research is likely to be far more cost effective in lives saved then the very basic cancer research that gets the vast majority of money now.

- I would also direct research money to finding more chemicals that are partial carcinogens, so that they can be regulated. While large companies lobby against this type of research, I believe that there are several target compounds worth researching, such as phthalates, and aromatic compounds. An independent advisory board would need to be set up to insure that lobbyists do not have influence overthe funding or reporting of this type of research.

- I would increase funding for HPV and hepatitis vaccines.


Education: the public needs to be better educated about the causes and ways to prevent cancer. This goes a long way with prevention.

- I would create a program to provide free counseling to people who are concerned that they may be at risk. There should also be computer models and public health interventions that find and target people with high risk and notify them of this.

- I would create a website and a hotline that would act as a clearinghouse of information on what causes cancer and the treatment and prevention options. This website needs to be user friendly and understandable by average people, however it must speak with the authority of government scientists and physicians and can't be influenced by independent, for-profit parties.

- I would create advertising campaign to educate people about common symptoms that may be associated with cancer so that they know to not ignore symptoms and go to a doctor before the problem gets out of control.


Treatment:

- Organize cancer treatment centers into local centers of excellence and centralize all cancer care at these centers. This would mimic the way that cystic fibrosis and some other more rare diseases are treated. While this would be a near impossible task with our current fragmented and competing healthcare system, this would yield significantly better outcomes, as repeated studies show that higher case volume improves individual patient outcomes. This would also allow for more specialization in the field of oncology and would make it much easier to compare outcomes across different geographic regions. Quality control stats would be made public and hold the centers accountable.

- Develop a protocol to provide palliative care for terminal patients, and fund research into this area.

- Create a database to track all types of cancer with respect to socioeconnomic, geographical and clinical stats. This data would then be made publicly available to facilitate researchers who look for trends. This would greatly improve our ability to spot clusters and identify new risk factors

- Fund research that follows survivors long term and provide follow up care to survivors. they are a growing but largely undefined segment as far as health care is concerned.

Dateline 9/20/2007

I know it's been awhile, but I've been very busy. I am going to try to make more regular entries however, as I have gotten a new voice dictation system which makes reading these entries much quicker. To recap my current situation:

I am two months into my second year of graduate school and it has been a completely new experience for me. It has been driving me crazy because there is no set schedule and both classes and work are very irregular. The only class I am taking this year is pathology. I find this class very fascinating but it is difficult to take this class in a vacuum. We only had four hours of class this week, and it has been difficult to keep myself interested. I have been on campus a lot however, because I am also still working at the office and doing research for my masters degree.

As far as work goes, it seems like I am doing a lot when in reality I am barely making enough to pay the bills. I began this year excited about being a tutor for the first-year classes, however this is not worked out very well. Scheduling appointments has been rough because they tend to come in large groups and almost half of my appointments have canceled. Tutoring at Drexel is irregular and unpredictable so I have been supplementing that work by working in the office that I worked in over the summer. Now that the admissions work is over, I have been spending my time doing filing and other menial office jobs. This works out because the people in the office like me, however those feelings are not always mutual. I did have a stroke of luck a few weeks ago when I was in the Jiffy Lube reading a magazine. I read that private SAT tutors can make almost $50 an hour and I decided that I should go into that business. After two weeks of filling out applications and other things, I believe that I have gotten a job at Excel tutoring and hopefully we'll get started with a few students next week. I have not gotten a feel for this however, and I have no idea how this is going to turn out, as I've never done anything like this before.

As far as my research, I ended up in the radiology department which is something that fascinates me, however this project so far has not been very engaging. The doctor I am working with is a really cool guy, but he is very busy and has little time to meet. The main project that I wanted to work on still needs to be submitted to the IRB, and while I am finishing the paperwork, this process depends on residents who have better things to do. In the meantime my advisor has given me the job of digitizing some old slide sets into power points. This is an interesting job because I get to learn about different radiology diagnoses, however it is not really research like I was used to in engineering. As long as it gets me my masters degree I guess...

The other work that I've been doing has involved being a TA for the bioethics group discussions for first-year students. This has turned out to be a thankless job, although I do enjoy debating bioethics. The students frequently put me in a bad position however, by doing a very poor job or not bothering to show up. I feel that they are good at the class and I know it's because they have better things to do, but I have to mark them down anyways. I guess TAs probably felt the same way about me when I was an undergraduate.

On the social life front, I have been spending a lot of time with my girlfriend Lindsay since she has started class at Temple and moved to North Philadelphia. I will admit however that almost none of my other friends have been around and I rarely hang out with the people that I talk to in class, so that is pretty much my whole social life at the moment. On a side note, my best friend from high school's best friend from college has moved to Philadelphia area recently and is trying to make connections, so I have made an indirect friend.

The biggest thing in my life continues to be getting admitted to medical school. I have completed my AMCAS and all the secondaries for 13 allopathic schools, however my academic advisor from Drexel is holding up the process as he is still not written my letter of recommendation. I did hear from the first school however. My alma mater, Boston University, rejected me already. It took them only about two weeks from the application completion date and they sent the rejection by e-mail on Labor Day. I also have decided to apply to two osteopathic schools, although for some reason my AACOMAS application is taking forever to clear. As much as I hate BU for rejecting me, I do appreciate the timeliness. I am likely going to be waiting for all the others for months, and it is very nerve-racking.