I'm just back from a site visit to the Dolce Conference Center, scene-to-be of the upcoming IFHI 2009 Conference and Certification. What a facility! If you've been to the Buttes for 2005 or 2007 prepared to get gob-smacked! The premises (a former monastery) are just gorgeous this time of year. The intimacy of the lecture halls combined with the terrific AV capabilities of the facility already have my mind running in overdrive. I think it was very smart to top the attendance at 125. This will insure that everyone feels that they are a real part of the event.
Unfortunately, despite the fact that the conference is three weeks away, I'm told that all available rooms at the Dolce Conference Center have been taken. We have a few seats still available for the day sessions, and if anyone plans to register from this point on, we can book them at the nearby Double Tree Inn and the Dolce will bus these folks back and forth.
Anyway, if you want to attend IFHI, even at this late point in the process, contact IFHI Conference Services and maybe they can work something out for you.
Welcome to The Weekly Transfusion, 1.4 for the week of April 6, 2009.
Editorial: Medical journal statistics for autodidacts
You can become a better consumer of health information if you take the time to read the research source material (i.e the scientific publication in which the original claim was made). Of course if the study is technical you can see quite a bit of jargon that you may or may not understand. However many medical terms are widely understood and where you bump up against the odd phrase or name that you don't comprehend, there are usually places on the Internet where you can find simple, easy to understand explanations. Wikipedia is actually pretty good for this type of look-up, as long as the subject at hand is not controversial.
However, methodology and monikers aside, most scientific studies distill down to a simple testable premise which is easily understand by almost anyone. Did the medicine work? Was the association between this gene and that disease valid? Past asking the question, what is needed next is to look at and gauge the value of the answer. Surprisingly, even though this is usually some sort of statistical type of answer (and most laypeople are not well versed in statistics) once you know what to look for, you'd be amazed just how easy it is to evaluate most studies.
Most research studies feature a subsection entitled Results or Conclusions. It is here that the results are most often given. There are many way of calculating statistical significance, but the premise is quite simple: What is the chance that the thing we just observed/ hypothesized was random versus the odds of it being due to the relationship we are studying. This is known as probability and in statistics is usually called the P value. To find out just how significant the results of any study are, just look for the P value. The smaller this number is, the less likely the results occurred by chance. Put another way, the lower the P value the more likely you'll want to view the results as significant or important.
The great Ronald Fisher viewed P values as measures of the evidence against a hypotheses, sort of like how a prosecutor presents a case based on exceeding the jury's sense of 'reasonable doubt.'
Now for the secret (OK, not so secret) key to taking control of the medical facts in your life: The standard level of significance used to justify a claim of a statistically significant effect is when P is equal to or less than 0.05; in essence, a one-in-twenty chance that the result had nothing to do with your hypothesis.
For better or worse, the term 'statistically significant' has become synonymous with P<=0.05.
So when looking at any published results, always look for the P value and if it is greater than five cents on the dollar (0.05) you'd probably want to ignore that results (unless the premise of the article was that the researchers failed to show a relationship, which is of course just another type of observation; however, these types of studies usually don't make it out of the researcher's file cabinet) or take a look at the methodology behind the study (scientists are human; studies can be poorly designed and the conclusions derived may not have been the best test of the hypothesis).
So, P<0.05 means the results are significant, but just barely. Good enough to convict, but also likely to send a few innocent people to jail as well, since there are still strong indications that the hypothesis fails to account for the whole of the facts. Personally I like to see P values of at most 0.01-0.02 before I get excited about anything I'm reading. However I do make exceptions for studies with small numbers of participants, or if the we're dealing with an herb or vitamin where the effects studies may be slight or slow to surface.
Oftentimes you'll see P values with lots of zeros. That means they've found a more statistically reliable result. For example, the P value in the following article is P<0.001. This actually means that there 1 in a 1000 chance of the result being a random occurrence and a 999 in 1000 chance that the result was related to the premise of the study.
Just remember, look for at least a P<0.05. That means the results were statistically significant. Beyond that the more zeros you see in the P value, the better. Try your new-found statistical powers on the articles below. Look for the P values in the studies. What do they signify?
Now that you can evaluate scientific material at its source, you'll be less likely to fall for the 'man bites dog' con-jobs that are all too commonly reported in the news or as what passes for scientific discussion these days.
Resting heart rate as a low tech predictor of heart problems in women
In a large, diverse group of postmenopausal women, resting heart rate was an independent predictor of coronary events, with higher heart rate associated with greater risk. The relation between resting heart rate and risk of coronary events was stronger in younger postmenopausal women than in older ones. Resting heart rate did not independently predict stroke.
In general, age, body mass index, and saturated fat consumption were higher and cardiovascular risk factors such as hypertension, diabetes, smoking, hypercholesterolaemia, and depressive symptoms more prevalent in women with higher resting heart rate, as was self reported nervousness. Physical activity and alcohol use were inversely related to heart rate (both P<0.001), and heart rate was lower in women who used postmenopausal hormone therapy than in those who did not (P<0.001).
One can't argue that this is about as low tech a predictor of future health problems as one is likely to find. It has already been shown that resting heart rate predicts coronary events in men. For women however, the relation between heart rate and coronary events or stroke has been uncertain. The study broke the participants into groups including a 'high heart rate group' whose heart rate was greater that 76 beats per minute and 'low heart rate group' whose heart rate was greater than 61 beats per minute. The association with 'coronary events' (aka heart attacks and death). This association appears stronger in women aged 50-64 than in those aged 65 or older
Being overweight makes you age faster
Obesity and weight gain in adulthood are associated with an increased risk of several cancers. Telomeres play a critical role in maintaining genomic integrity and may be involved in carcinogenesis. Using data from 647 women ages 35 to 74 years in the United States and Puerto Rico (2003-2004), we examined the association between current and past anthropometric characteristics and telomere length in blood. These findings support the hypothesis that obesity may accelerate aging, and highlight the importance of maintaining a desirable weight in adulthood.
A telomere is a region of repetitive DNA at the end of chromosomes, which protects the end of the chromosome from destruction. When DNA needs to be read (to replicate itself, or generate RNA so as to begin coding proteins) a problem arises in that the enzymes that duplicate the chromosome and its DNA cannot continue their duplication all the way to the end of the chromosome. They need a blank area to 'park' much like the cassette tapes of days past had white 'leader tape' at their front and the back so that the tape head did not start in the song itself. Unlike cassette tape, every time DNA reproduces, a bit of the white leader tape, the 'telomere' at the end, is frittered off and has to be replaced. Telomeres and replenished by an enzyme, the telomerase reverse transcriptase. Telomeres protect a cell's chromosomes from fusing with each other or rearranging - abnormalities which can lead to cancer - and so cells are normally destroyed when their telomeres are consumed. In the women studies for this article, those having a higher body mass index (BMI) in their 30s were associated with shorter telomere length in their 40s (P < 0.01).
I suspect some of this association is epigenetic, and points again to the fact that the GT5 Warrior epigenotype may well need to get their weight profile optimized early in life and be increasingly calorie conscious as they age.
Vitamin D, adult-onset diabetes and metabolic syndrome
Vitamin D is a potent immunomodulator that also enhances the production and secretion of several hormones, including insulin. Vitamin D deficiency has been associated with increased risk of type 1 diabetes. Glycemic control and insulin resistance are improved when vitamin D deficiency is corrected and calcium supplementation is adequate.
More and more information is surfacing about vitamin D (actually more of a hormone than a vitamin) and insulin resistance. Studies consistently show that vitamin D levels in both North America and the Pacific are typically lower than optimal. In the USA , most vitamin D intake from foods is provided by fortification. Canada and New Zealand have fewer fortified choices, and intakes are correspondingly lower. The mechanism of action of vitamin D in adult onset (type 2) diabetes is thought to be to its role in the control of plasma calcium levels, which help regulate insulin synthesis, but may also be the result of vitamin D stimulating the insulin secreting (beta) cells of the pancreas directly. If you have a history of metabolic syndrome or adult onset diabetes in close family members you may want to consider adding vitamin D to your supplement regimen. However, make sure that you do it in partnership with a nutrition professional.
One from the vaults: Mom's blood type can influence child's risk of Strep (1978)
In a prospective study of maternal genital colonization with streptococci at the time of delivery, epidemiological data, including blood type (ABO group), were recorded for the 1,062 patients studied. Blood type B was found in a statistically significant (P <.005) higher proportion of patients colonized with streptococci (28%) compared with the total population (16.4%)
Evidence suggests that probiotic supplementation does change the vagina flora of women. Since it appears that the route of transmission of Streptococcus is from the birth canal, physicians should recommend probiotic supplementation for pregnant women beginning 3-4 weeks prior to expected date of delivery as a way to prevent streptococcus infection in neonates. This should be especially emphasized if the mother is either blood group B or AB.
This study again illustrates the fact that some of the best ABO correlation studies are outside the purview to today's physicians, most of whom would tell you that any research from 1978 is better suited to a history class than to any thing taught in medical school.
Since Mother's Day is fast approaching, also remember that recurring otitis media (ear infections) is strongly associated with the child's mother being blood type A. In fact the correlation here is quite startling. Children of mothers who are blood type A are twenty seven times more likely to get a second ear infection within one year of contracting the first. To give you an idea of just how strong this association is, look at the chart below to compare the RR (relative risks) of a few other disease/ lifestyle links.
Update: IfHI 2009
Just a quick word to the wise about the IfHI Conference, Norwalk Connecticut, June 5-7. We had run out of available rooms at the Dolce Center Campus. However 10 additional rooms have just been made available. Unlike previous conferences, where attendees could book almost to the day of the event, IfHI 2009 looks like it will be completely booked by the middle of May, a full month before the event. If you are planning on attending, either for certification or just personal enrichment, please make your reservations ASAP, especially if you want to stay overnight on campus.
Until next week.
Just finished the NAP Professional Services Webstore and Learning Environment. With its completion, I've realized a long standing goal: To have NAP website that is optimized for the health professional. A few of the cool new features that I've built into the site include:
- Extensive discussions of the pharmacology and biochemistry behind the indications and actions of each product. As an extra bonus, I've created a new and distinct version of the Individualist Wikipedia which directly hyperlinks entries to appropriate NAP products.
- Access to members-only monthly 'webinars' conducted by myself and the NAP Professional Technical Staff (attendance limited to 25 seats). A key feature of an NAP Webinar is its interactive elements -- the ability to give, receive and discuss information. To sign up for NAP Professional Webinars, contact Professional Services toll-free in the US at: 877-226-8973 or by email the Webinar Desk. NAP Webinars are free to all NAP Professional Clients. I'll be lecturing at the next webinar on 'Cancer Survivorship' Monday, August 11, 2008 at 8PM EST
- NAP Professional Accounts can also participate in the new Pharmashare Professional Affiliate Program.
- Early notification of upcoming limited attendance IFHI Micro Conferences.
- Physician-to-Physician Live Help via real time chat.
If you are a licensed health professional (or IfHI certified educator) and wish to open an NAP Professional Services Account click here and fill in the details. Within 24 hours you will be sent a special password to allow you full access to the site. If you are an existing professional client of NAP you can contact Professional Services toll-free in the US at: 877-226-8973 or by email at NAP Professional Services and they'll register you right away.
I'm slated to lecture at the New York Association of Naturopathic Physicians 2008 Conference. I plan to present on 'Verisimilitude and Malignancy.' Mimicry is an early step in the metastatic process and an important factor in the continued cancer-proneness of survivors. This lecture will discuss nutritional interventions physicians can employ to address these susceptibilities to enhance the survivorship of their oncology patients.
NYANP 2008: Balanced Health: Putting It All Together
8:30 am to 7:30 pm
American Conference Center
3rd Ave (between 48th and 49th) New York, NY
New York Association of Naturopathic Physicians Website
I will also be lecturing at the 2008 IFHI Certification Micro Conference held by the Plateau Eat Righters on October 25, 2008 in Crossville, Tennessee. This conference is being hosted by my friend Larry Nesbit. It is an IFHI approved certification test site and they will be administering the cetification test for IfHI Fellow.
More information about the Plateau Eat Righters 2008 IFHI Micro Conference is on the IFHI site.
Congratulations to my dear friend and colleague Dr. Paul Mittman, who received some well-deserved recognition as the American Association of Naturopathic Physicians (AANP) â€˜Physician of the Yearâ€? for 2007. Paul is just a great guy and a true asset to the profession. Without his early support The Institute for Human Individuality (IfHI) would have been impossible. Sadly, Paul also recently suffered the loss of his father.
Sometimes it's just nice to know how many people love and admire you, especially at times like these and (if you are reading this) Paul, know that Martha and I love and admire you very, very much.
Paul Mittman getting his Physician of the Year plaque at the 2007 AANP convention. I got one in 1990. Mine had a dent in it.
Speaking of IfHI, I just finished the new practitioner lookup page. If you are looking for someone who uses these types of principles in their practice this database can be a great resource. It is now searchable by name, state/province or country.
I was watching the news on TV and these two commentators were tossing the word â€˜terrorist' around. If you were to believe these guys, everyone in the Muslim world was a terrorist. However, as any decent historian will tell you, today's terrorist is often tomorrow's freedom fighter. During the American Revolution patriots often tarred and feathered neighbors who were loyal to England or who just wanted to be left alone and not have to choose sides. Many of these people were hounded out of their homes (which were often grabbed by deserving 'Sons of Liberty') and exiled.
Now these same terrorists get microbrewery beers named after them.
Calling someone a â€˜terrorist' is a lot like calling something â€˜unscientific.' It almost never adds anything to the discussion and likely tells you more about the accuser than it does about the accused.