Do we really need broccoli pills?

Whenever scientists find evidence that some new plant molecule (or phytochemical) is healthy, a ‘superfood’, that it prevents cancer, or helps you lose weight, what’s the first thing we do? We make a pill out of it.

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Red wine might prevent heart disease? Resveratrol pills! Fatty fish prevents cancer? Fish oil pills! Green tea? Catechin pills! Turmeric? Curcumin pills! And on, and on, and on.

Broccoli is one of the most recent foods to receive this treatment. Researchers found that a sulfur compound in broccoli, sulforaphane, has anti-microbial properties and kills cancer stem cells. It also increases liver enzymes that are known to be helpful against cancer.

So, what happens? A pharmaceutical company makes a pill, called Sulforadex, chalk full of sulforaphane. Perhaps unsurprisingly, it’s not even the first ‘broccoli pill’ on the market.

Now you might say, so what? My grandma told me to eat my broccoli when I was five years old. She knew this, why do we even need this research? Well, as people of science, we know that data are better than anecdotes. We also know that although our ancestors’ oral traditions often contain a great deal of wisdom, other times they are nonsense. So, I think it’s great that this research is being done.

The part that bugs me is that compounds that appear curative from research that is often funded by taxpayers must immediately be broken down into pill form and monetized. Many times in the past such pills have failed to fulfill the incredible promises made by their creators. Whether this was because the compound easily oxidized outside the plant (for example, catechins in green tea) or because it required a combination of other micronutrients present in the actual plant is interesting, but not super relevant. So, why does this keep happening? The answer is basically this: broccoli does not have lobbyists, red wine cannot be patented, whole blueberries can’t be crammed into a massively overpriced pill that everyone will buy and nobody will take.

I’m not saying the pills are bad for you. Some of them are smoke and mirrors, but some are likely effective supplements. But I know people taking a number of different supplements made from plant compounds like catechins, anthocyanins, curcumin, fiber, and many others. So, if you find yourself taking more than one pill that cost you a lot of money at GNC, and cost the company almost nothing to make, why aren’t you just eating vegetables? I get it, it’s hard, it’s expensive. But is it really harder than driving to a totally different store? Is it really more expensive than supplements at a specialized health food store, MANY of which are over 50 dollars for a month’s supply for one pill? And are you even considering the fact that there are likely thousands of other phytochemicals in the vegetables that might be healthy too?

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In other words, if there are enough healthy compounds in broccoli to make multiple different supplement pills, maybe even hundreds, why not just listen to your grandmother? Or if your grandmother didn’t tell you to eat your vegetables you can listen to mine.

Remember to eat your broccoli!

 

References

  1. Kim, BG, Fujita, T, Stankovic, KM, et al. 2016. Sulforaphane, a natural component of broccoli, inhibits vestibular schwannoma growth in vitroand in vivo. Scientific Reports doi:10.1038/srep36215
  2. Mahn, A., Reyes, A. 2012. An overview of health-promoting compounds of broccoli (Brassica oleracea) and the effects of processing. Food Science and Technology International 18 (6).
  3. Doss, JF, Jonassaint, JC, Garrett, ME, et al. 2016. Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease. PLoS ONE 11(4): e0152895. https://doi.org/10.1371/journal.pone.0152895.

 

 

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Got chronic pain? Maybe try a placebo

If you have chronic pain and want to avoid pain meds, or even popping too many ibuprofen, maybe you should try a placebo!

The placebo effect is what we call improvement from a treatment when that treatment doesn’t do anything that should help the condition, usually in the context of clinical research. The placebo effect can actually be pretty powerful, and is one of the reasons why doing controlled experiments is so important. In an age where scientists often fail to replicate research, placebos are seen by some scientists and doctors as a promising treatment for some conditions. Leaving aside a number of technical discussions about what the ‘placebo effect’ really is, placebos are cheap, don’t have negative side effects, and the beneficial effects are well documented for some conditions.

‘But doctors can’t prescribe placebos!’ you say. ‘That would be unethical!’ Well, it turns out that placebos can help people even when they KNOW it’s a placebo. Check this out.

Lower back pain is a huge problem all over the world (seriously, it leads to tons of disability cases everywhere). So, in this study Carvalho and colleagues (2016) took adults with persistent lower back pain who were fine taking pills and didn’t take opioid drugs. They also didn’t include people who had pain from a bunch of different causes, like cancer, broken bones, surgeries, and trauma. Instead they were just trying to look at people with lower back pain without any obvious cause. They split everyone up into two groups of people: what they called ‘treatment-as-usual’ or TAU, and an ‘open-label placebo’ group (OLP). So, they actually TOLD the people getting the placebo that they were getting a placebo. All participants had the placebo effect explained to them in a ‘positive’ way. ‘Positive way’ just means they were told that placebos can help people if they are taken consistently, even if there’s nothing in them. 83 people were included in this study.

So what happened? Well, not only did the placebo (OLP) group see improvement in their pain symptoms, but their degree of disability from their lower back problems was actually substantially reduced! Kind of crazy.

How does this work? The idea is basically that the patient’s belief the placebos might help are actually leading to the improvements. Maybe they are just helping patients not notice the pain, or not care as much about the pain. An alternative hypothesis is that simply by seizing some agency, or in other words, by ‘doing something’ about their pain and feeling in control of their situation, the pain can be reduced.

Is this a real effect? Well, yeah. I mean, pain was a problem for the people in this study, and the placebo reduced their pain. A placebo can’t make a limb regrow, won’t kill parasites, won’t cure cancer or mental health problems, and you should probably run away from people saying otherwise. If you have a condition that could be dangerous, placebo treatment instead of conventional treatment is a BAD idea. But for issues like chronic pain, it could provide cheap and easy relief with no negative side effects for many people.

There are certainly some ethical considerations with doctors prescribing placebos (although it’s apparently commonly done in Europe with patients who are drug seeking or who doctors think are hypochondriacs). Most of these considerations are vastly reduced however when patients are TOLD they are being given a placebo, and simply told the truth that the placebo effect is real, and can be powerful. Pretty cool!

 

References:

  1. Rutherford BR, Mori S, Sneed JR, Pimontel MA, Roose SP. (2012) Contribution of spontaneous improvement to placebo response in depression: a meta-analytic review. J Psychatric Res 2012; 46: 697-702
  2. Chaparro LE, Furlan AD, Deshpande A, Mailis-Gagnon A, Atlas S, Turk DC. Opioids compared with placebo or other treatments for chronic low back pain: an update of the Cochrane Review. Spine 2014;39:556–63
  3. Open Science Collaboration (2015). Estimating the reproducibility of psychological science. Science, 349
  4. Carvalho C, Caetano JM, Cunha, L, Rebouta, P, Kaptchuk TJ, Kirsch I (2016) Open-label placebo treatment in chronic low back pain: a randomized controlled trial. Pain doi: http://dx.doi.org/10.1097/j.pain.0000000000000700

 

Any weight will make you bigger, but only the big ones make you stronger?

Since the 1950’s, researchers have thought that lifting weights mostly just makes you stronger, then once you are strong enough to lift really heavy weights, your muscles get bigger too.

Buckner and colleagues (2016) discuss a bunch of research that has come out since then. They say it shows that when lifting big weights, some people get big muscles, some people get stronger, some people get both, and some people get the shaft. So, not everyone gets the same response from lifting. And also, bigger is not necessarily equal to stronger.

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The authors say that people get bigger muscles from lifting light weights lots of times OR from lifting heavy weights a couple times, but only lifting heavy weights makes you stronger. This means strength and muscle size might be sort-of related, but they aren’t the same thing. How does that work?

Basically, the authors suggest that you can get BETTER at lifting heavy weights. Meaning, your central nervous system (brain and spinal cord) and other neural (nerve) parts get better at making your muscles exert force.

Also, people stay strong for a long time after stopping lifting (like half a year even if you are young), but that your muscles get smaller pretty fast (you go back to normal in just a few months if you haven’t been lifting long).

Of course, then they sum it up all sciencey at the end by saying that we aren’t totally certain about all this, and we have to do more research (said every scientist ever).

Reference:

Buckner SL, Dankel SJ, Mattocks, KT, Jessee, MB, Mouser, JG, Counts, BR, Loenneke, JP. (2016) The problem of muscle hypertrophy: revisited. Muscle and Nerve (published online) DOI: 10.1002/mus.25420

Why does science so often seem to disagree with itself?? Thoughts for new scientists or non-scientists.

An undergraduate student of mine recently showed me a scientific journal article he had been reading that confused him. Specifically, one result of the paper was that people who ate a vegetarian diet had higher cancer rates than those who ate meat [1]. He was confused by this because he said he had read other papers that suggested the exact opposite [for example 2, 3]. The point of this post is not to get into any discussions about the health effects of meat, but rather to briefly discuss the implications of contradictory results from the scientific literature. There are three issues that are immediately relevant and fairly straightforward for a growing scientist or a non-scientist: variation in how studies are carried out, the ‘random sample’-based idea of science, and reproduction of research.

Perhaps the simplest of these is the idea that if you ask the same question in different ways, you might find different results. I would personally explain this by pointing out that how you ask the question actually changes the question itself, just a little bit. To illustrate this, start with the question, “Does eating meat increase your risk of cancer?” To test this, one might start with a group of people who eat the average omnivorous American diet, remove all meat from their diets, and compare their cancer rates to the control (meat-eating) group five years later. This study has in fact modified the question slightly and asked, “How does removing meat from an omnivorous diet affect cancer risk?” Alternatively, if you compare cancer rates in the general population between vegetarians and omnivores, you are asking, “How do cancer rates compare among people who eat vegetarian diets compared to those who eat omnivorous?” At first glance, this may seem a pedantic distinction, but in practice this difference can be major. Can you think of any reasons people might not eat meat that could affect their health in other ways? What about people who have a major family history of cancer? They might be very careful about what they eat, but might also have an elevated risk of cancer even if they take special care.

The second issue here is the ‘random sample’-based idea of science. In essence, scientists are trying to make general conclusions that are generalizable to all people, not just those in their current study. In order to do that, they often try to collect a sample of people that is representative of the entire population. If they fail to do that, it’s not strictly a flaw in study, but it becomes important to be clear about which populations the results can be generalized to. For example, imagine the only vegetarians I can find for a research study are part of specific religions such as Buddhists or Seventh-day Adventists, along with a smattering of upper-middle class white Lutherans, pretty common in my part of the country. Well, in the end, that’s a pretty limited sample of people. What else might those populations do differently than the general population?

Finally, science is based upon the idea of repeating the same study many times. Both due to the random sample idea, but also the way we do statistics to come to conclusions, there is a certain possibility of error to every study. A well-designed and well-conducted study with a fairly large sample size, carried out by objective researchers who have no financial stake in the outcome, should have a low possibility of simply being ‘wrong.’ Unfortunately, every individual study does have this possibility. Studies in which the researchers have a heavily vested interest, or that are carried out by people who are not careful and objective, may have a higher likelihood of making errors. Now, this may seem depressing: “Why should we even believe science?” Nevertheless, the true power of science arises in reproducibility. If ten different researchers have conducted the exact same research, and nine reach the same conclusions, you can be pretty confident in the results of the nine. To, be clear, the contradictory study may be of very high quality as well, and may simply have found a different result due to random chance.

So, when you read a study, and you find the results confusing, or contradictory to your prior beliefs, here is my suggestion. First, keep an open mind. Maybe your prior beliefs were wrong! Approach every new idea considering the possibility that it might be right. Second, think critically about the study. The authors have probably stated a research question or hypothesis. But ask yourself, is their stated question really the question they asked with their research? What population do they say they studied? Did they really? Finally, look for more. Do they cite other related research? What did that prior research conclude? Has any new research cited the paper in question? Try using Google Scholar, or any number of other search tools to find other research on the same topic. Look for a review! Some articles are actually just summaries of many other research articles, and can be enormously helpful in this situation. Maybe yours is the only relevant research, but maybe there is a large body of science either supporting it, or failing to. Happy sciencing!

 

References

  1. Burkert, N.T., et al., Nutrition and Health – The Association between Eating Behavior and Various Health Parameters: A Matched Sample Study. PLoS ONE, 2014. 9(2): p. e88278.
  2. Tantamango-Bartley, Y., et al., Vegetarian Diets and the Incidence of Cancer in a Low-risk Population. Cancer Epidemiology Biomarkers & Prevention, 2013. 22(2): p. 286-294.
  3. Key, T.J., et al., Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford). The American Journal of Clinical Nutrition, 2009. 89(5): p. 1620S-1626S.

 

The problem with needing to keep my brain entertained at all times

In Zen and the Art of Motorcycle Maintenance, by Robert Pirsig, one thing the narrator talks about is that many people don’t pay attention to their work, but instead want to be entertained, even while working. His mechanic continually fails to fix his motorcycle, apparently due simply to sloppy work. He blames this sloppiness at least in part on the fact that the mechanics are constantly rocking out to music when he shows up, and suggests that they will be unable to focus on his bike while they are listening to music.

I read this book recently, and the idea seemed kind of laughable. In the era of texting while driving, blasting Zep while cranking on some lug nuts doesn’t really seem like a big deal. I know people who  watch TV while cleaning the house, listen to books on tape while writing, watch TV while eating dinner, and can’t go for a run without good music. Heck, I AM some of those people. In fact, I’m one of the worst offenders I know, which may be why this topic resonates with me.

Is this a problem? I’m not sure. I get to listen to some awesome music, expand my brain with The Great Courses on audio book, and half-way enjoy myself at all times. My work may or may not suffer, so I’ll put that in the ‘maybe’ category. One downside that I never truly enjoy the things I’m using to distract myself – it’s hard to focus on the newest episode of Sherlock if I’m constantly running out of the room to organize something. The other, possibly more important issue, is that it turns everything else in my life into a drag.

Going for a run, lifting weights, cleaning the house, washing dishes, analyzing data, writing a book, biking to work, even eating dinner, etc. All of these things become chores, even when they don’t have to be, because I’m distracting myself from them by doing something ‘more entertaining’ at the same time. But many of these tasks when I focus on them, aren’t tasks at all, but rather something I can enjoy, or even get passionate about.

Maybe it’s a good idea to stop trying to distract myself from my life and just live it. I can’t believe I just wrote that; it sounds like a motivational poster. I guess I probably shouldn’t have been watching Netflix while writing this…

 

BJCP style #2: Belgian blonde (18A)

For the second beer in our series, I decided to brew a Belgian blonde, mostly because it’s become one of my favorite styles of beer, but also because it’s pretty difficult to find more than a few good examples.

11 - 23- 15 031My assistant brewer that day was my friend Trevor, who still hasn’t managed to come drink any since we brewed.

For those of you who are unfamiliar, Belgian blondes are about 6% to 7.5% ABV, light and fruity with maybe little spicy character, a mildly sweet grain front, and a dry finish. There are other style expectations too, but that’s about all I can keep in my head. In my mind a Belgian blonde is kind like a fluffy, fruity, lower ABV, less hoppy version of a SONY DSCtripel. I only have to make that comparison though because I’ve drank a lot more tripels than blondes. If you’ve never had one, Leffe blonde is probably the easiest to find, and is a great example of the style.

So many Belgian beers I have had from breweries and home brewers in the United States are just undrinkable to me. They tend not to have a lot of real Belgian yeast character, and they finish far too sweet. So, my main goals here were to capture at least a decent amount of the fruity, slightly spicy flavor a Belgian blonde should have, and get a nice dry finish.

Recipe:

Grain:

  • 10.33 lbs. Belgian pilsner (The extra .33 lbs. was just because I spilled a bit of grain)
  • 1 lb. German wheat
  • 4 oz. light dry extract (I actually forget why I put this in, I don’t have notes on it…)
  • 1.25 lbs. table sugar (Try to kick up the dry finish)

Hops: (the slightly odd hop weights were because I was finishing off quantities of certain hops I had lying around that I thought appropriate for the style).

  • 0.6 oz. Mt. Hood (First wort hop, boiled 60 minutes)
  • 0.4 oz. Hersbrucker at 60 min.
  • 0.2 oz. Mt. Hood at 7 min.
  • 1 oz. Saaz at 2 min.

Misc:

  • 1 tsp gypsum in the mash
  • 0.25 tsp irish moss at 10 min.
  • 0.25 oz. coriander at 5 min.
  • 1 tsp yeast nutrient at 10
  • Yeast was SafBrew Fermentis T-58 with no starter

We did a full volume mash with about 8 gallons of water to account for grain absorption and boil-off, using a 70 qt. cooler with a home-made bag.

After the boil we cooled to 65F and added the yeast. After fermentation started (about 12 11 - 23- 15 032hours), I moved it to the basement where ambient was 60F for about 36 hours until high krausen dropped, then moved it to my fermentation closet with a plant mat to try to get it up to 75F until fermentation was completely done (about 6 days). I use a similar temperature profile, with some variation, with most beers I brew, but especially Belgians. The reason why this is important is that by starting out fairly cool during the most intense fermentation, one prevents high concentrations of hot fusel alcohols, as well as other problems like band-aidy flavors. But heating up the fermentation as it starts to cool ensures that your fermentation will finish strong, and you’ll get a nice dry finish to your beer, which as I talked about before, is so critical with Belgian brews.

After another seven days, I primed with 4.5 oz. of corn sugar and bottled. This is a little more priming sugar than I’d usually use, but Belgians should have a solid carbonation to them.

The end result: delicious! It ended up being a little too alcoholic (like 9%!!), so it started out a little astringent but over time it mellowed out, and after a couple months is amazing.

Next up: quadruppel!

 

 

 

8 Reasons Why Healthcare is Smashing our National Piggy-Banks

Following from my last post, I’m currently researching the state of healthcare expense in the United States. It turns out there are probably many important causes of high health-care costs, and the issue is fairly complex. Shocking. Here are eight ideas that I’ve heard thrown around that we will be investigating.

Over the next few months we will be going through some of the evidence for each of these ideas, and exploring others if it turns out that our initial ideas aren’t cutting it. If you have any ideas to add, feel free to chime in!

  1. Specialist physicians are overpaid and/or overused
  2. Pharmaceutical companies overcharge (and are probably evil)
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    Pharmaceutical CEOs = supervillains

     

  3. Insurance companies overcharge
  4. Pharmaceutical companies’ fairly new ability to advertise directly to consumers is putting a great deal of pressure on doctors
  5. The Affordable Care Act has caused a huge increase in healthcare prices
  6. Fear of malpractice lawsuits make doctors do far too many tests to cover their butts
  7. Pressure on doctors to use new, expensive drugs and procedures from patients and pharmaceutical companies
  8. Hospitals and doctors compete by adding luxuries and amenities, NOT by lowering prices

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    Guess how much this costs per night? Lots.

Remember, these are IDEAS or hypotheses, not positions I have evidence for yet. I’m fairly confident that some of these will prove to be important, but I doubt all of them will. So, if you have a strong opinion for or against some of these feel free to comment, and stay tuned, but don’t get mad (yet)! These are simply possibilities that we will be investigating, and that I could find at least one book, scientific article, or tinfoil-hat nutjob talking about.