Blue/Black Or White/Gold, And Why Care? A Neuropsychiatrist Examines ‘The Dress’

Sometimes it just seems like the whole world has gone crazy. Like when your colleagues, all serious people, cluster for precious minutes around a computer screen debating the color of a dress. And you see that, online, many other serious people are doing the same thing — say, at On Point or The New York Times.

So though I was curious about the science behind the recent viral phenomenon known as “The Dress,” my first question for Boston-area neuropsychiatrist Dr. Jon Lieff was a more mundane “Why?” To quote one top Slate commenter, “How is this a thing?”

Not that it’s a bad thing. The dress phenomenon “informs people that perception is not what it seems,” Dr. Lieff says. “We think we see reality when in reality, what we see is what the brain wants us to see. And that leads us into philosophy…”

But let’s not go into philosophy just yet. (And you can read Dr. Lieff’s thoughts at more depth on his Website, Searching for the Mind.) Let’s talk instead about why this of all optical illusions swept the Internet.

His bottom line: “Our brain is correcting for an imagined light source. That’s the problem.”

And what’s unusual about it: “This doesn’t usually happen with an illusion: In any crowd, you have half the people saying one thing and the other half saying another thing. And because of the type of illusion it is, once it’s fixed, your brain is going to keep you on the blue side or the white side. I’m sure you’ve seen other kinds of illusions where it flips back and forth.  This is different. Once people choose their sides, they’re saying, ‘This is it, and I’m the right one and you’re the wrong one.’ So it’s captured the imagination, but in truth there are hundreds of these occurring all day long, that people don’t realize.”

“An example: if you’re watching a waterfall on the TV and your hand is on the desk, your hand thinks the desk is rising up. Continue reading

Study: Well-Water Can Raise Arsenic Levels In Formula-Fed Babies

Parents already concerned by recent revelations about arsenic in rice, grains and juices, brace yourselves: a new study found higher levels of arsenic excreted by infants exclusively fed formula, compared to breast-fed babies. A likely culprit: well-water.

In the small study of private well-water users in New Hampshire, overall arsenic exposure was relatively low for most 6-week-old infants regardless of how they were fed. “So that’s good news,” says Kathryn Cottingham, a professor of biological sciences at Dartmouth and the study’s co-lead author. “That said, infants fed exclusively with breast milk were less exposed to arsenic than infants fed with formula, and some infants fed with formula may have been exposed to very high levels of arsenic due to high concentrations in their home tap water.”

In the study, published in the journal Environmental Health Perspectives, researchers measured arsenic in the home tap water of 874 families, urine from 72 infants and breast milk from nine mothers.

Donald Clark/flick

Donald Clark/flick

Arsenic levels in the tap water tended to be well below the EPA’s recommended upper limit, researchers report. Still, they found that: “measured urinary arsenic concentrations were 7.5 times higher in exclusively formula-fed infants compared to breast-fed infants,” says Cottingham.

The bottom line, she says, is get your well-water tested.

“In terms of fear mongering, that’s the fear I’d like to instill: if you have well-water, get your water tested,” she says.”I don’t want to freak people out about feeding their babies formula.”

Arsenic is a naturally occurring element found in groundwater around the world — and in some places, in very high concentrations.

Exposure to high levels of arsenic, a human carcinogen, has a number of potential health consequences, the study authors note, including cancer, cardiovascular disease, diabetes, obesity, adverse birth outcomes, and altered immune systems. Continue reading

What New Peanut Study Means For Kids With Food Allergies — And What It Doesn’t

In this undated photo provided by Cambridge University Hospitals NHS Foundation Trust, Dr. Andrew Clark of Cambridge University, right, performs a skin prick test, which is used to diagnose food allergies, on Lena Barden, 12, during clinical trials at Addenbrooke's Hospital Clinical Research Facility, Cambridge, England. An experimental therapy in Britain that fed children with peanut allergies small amounts of peanut flour has helped more than 80 percent of them eat a handful of the previously worrisome nuts safely. (Cambridge University Hospitals NHS Foundation Trust/AP)

In this photo provided by Cambridge University Hospitals NHS Foundation Trust, Dr. Andrew Clark of Cambridge University, right, performs a skin prick test, which is used to diagnose food allergies, on Lena Barden, 12, during clinical trials at Addenbrooke’s Hospital Clinical Research Facility, Cambridge, England. (Cambridge University Hospitals NHS Foundation Trust/AP)

By Richard Knox

Erin Brazil is frustrated. She’d hardly had time to digest the peanut allergy study that got heavy media coverage this week when, she says, she got “inundated by calls and emails and Facebook posts saying ‘There’s a cure, there’s a cure!’ ”

Brazil is a Boston food-allergy activist whose 4-year-old son Gabriel is severely allergic to peanuts and other foods. So she knows better than anyone that the new study, while a landmark in the field, represents no cure. “It doesn’t do anything for Gabriel,” she says.

What it does mean is that many future children will be able to avoid a life of worry about whether the merest trace of peanut protein — even an invisible smear from a candy bar left by another child on playground equipment — could send them to the emergency room gasping for breath.

I can finally look a mother in the eye and give her some advice that I feel confident in.

– Dr. Hugh Sampson

And the new study means that the recommendations parents have been given over the past 15 years — to withhold peanuts until the age of 3 in children deemed at risk — “were exactly wrong,” says Dr. Wayne Shreffler, director of the Food Allergy Center at Massachusetts General Hospital.

“I strongly suspect they made things worse,” Streffler adds, because at-risk children who were deprived of peanut exposure in food during infancy were more likely to suffer a lifelong allergy from later exposure to, say, house dust. It’s almost impossible to avoid it.

In 2008, the American Academy of Pediatrics withdrew its recommendation to withhold peanuts until age 3, but until now there’s been no solid evidence in favor of deliberately feeding peanuts to at-risk kids. That’s what the new study strongly suggests parents should do — strictly under the supervision of their pediatricians. That flip-flop is widely expected to be enshrined in the next set of official guidelines.

It’s a big change, but not only does it offer nothing to children like Gabriel who already have peanut allergy, it provides no answer to the really big question: Just why have food allergies soared lately, more than quadrupling among the current generation of American children?

Even though the study doesn’t solve that mystery, allergy experts say it’s certain to accelerate research already under way to unravel the causes and devise treatments, if not outright cures.

Six million U.S. children currently have food allergies, one out of every 13 kids, according to the largest recent study. Peanut allergy is the most common, and the most troublesome — not only because it’s so hard to avoid exposure, but because peanut allergy is usually permanent, unlike those involving other foods. And peanut allergies are more likely to be fatal.

That explains why allergists are so enthusiastic about the new study. Continue reading

Personalized Cancer Test Pinpoints Best Drug For Patients

By Alison Bruzek

Cancer, whether in the pancreas, the ovaries or the liver, can take on different characteristics and spread in different ways. That’s why, unfortunately, there’s no one-size-fits-all drug to help patients fight back.

But a new, quick test can personalize treatment and help oncologists choose which chemotherapy route to take.

The test, called Dynamic BH3 Profiling, quickly predicts whether or not a drug will work for a patient by first trying that drug on a tumor sample in the lab. A paper describing the method, which researchers say could become more widespread within a couple of years, was published in the journal Cell this week.

The idea echoes how we choose the most effective antibiotics, says study author Dr. Anthony Letai, a cancer researcher with the Dana-Farber Cancer Institute.

A new tool for predicting relapse in acute myelogenous leukemia (AML) was developed by Dr. Anthony Letai (Courtesy of Dana-Farber Cancer Institute)

A new tool for predicting relapse in acute myelogenous leukemia (AML) was developed by Dr. Anthony Letai (Courtesy of Dana-Farber Cancer Institute)

“When we’re trying to choose antibiotics for people … we simply isolate the bacteria that’s causing the problem and expose it to all the drugs that are available,” he says. Then researchers choose the drugs that best put a lid on the multiplying bacteria.

“That has operated for many, many decades,” Letai says, “so we thought, why not do that for cancer cells?”

Letai’s team isn’t the first to think of this strategy. “People have tried to do this kind of thing in years past but there have been a variety of advances in technology … that make it more feasible this time around,” says Levi Garraway, a cancer researcher at Dana-Farber who was not involved with the study.

What’s different about Letai’s work is its speed: It can quickly determine whether a drug, or combination of drugs, is working. The test looks not at when the tumor cells are dead, but rather when they’re beginning to die.

The ‘Death Switch’

The researchers found that there is a point of no return, a threshold of doom, when cells begin to die that is indicative of their actual death. The team looked at varying types of cancer cells (breast, lung, melanoma) and saw that there was essentially a death switch that when flipped on, ensured the cell’s destruction.

Examining if a cancer drug flipped this switch, instead of waiting to see if the cells would eventually die, allowed the researchers to know, in about 16 to 24 hours, which drugs were working. Continue reading

Medical Marijuana 101: What It’s Like Inside A Colorado Dispensary

COLORADO SPRINGS, Colo. — Jars labeled butterscotch, chocolate mint and caramel macchiato tea glisten inside the lit refrigerator. The shelf above is stacked with pizza, flatbreads and butter. The one below has lemon bars, brownies and cookies.

The fridge could be in any higher-end grab-and-go lunch stop. But to shop here, you must present a medical marijuana patient card. And the ingredient list includes the type of pot, along with flour, sugar, milk, etc.

This is Trichome Health Consultants, a medical marijuana dispensary tucked into a line of glass storefronts on a semi-commercial strip in Colorado Springs, Colorado. As Massachusetts prepares to open its first dispensary, possibly in April, this is a glimpse into the future. Continue reading

Gov. Baker Forces Resignation Of 4 Health Connector Board Members

Gov. Charlie Baker sought and received the resignations of four member of the state’s Health Connector board, including MIT economist Jonathan Gruber, who came under fire for saying it was “the stupidity of the American voter” that led to the passage of President Obama’s 2010 heath care law.

The move helps Baker consolidate his authority over the agency responsible for helping Massachusetts residents find affordable health care plans.

Gruber became a political lightening rod following his comments and was chastised by opponents of the law. He was called to testify before Congress in December, when he told lawmakers he was “inexcusably arrogant” when he made the statement.

Besides Gruber, Baker also asked for the resignations of board members George Gonser, John Bertko and Rick Jakious — all appointees of former Gov. Deval Patrick. Continue reading

Why To Exercise Today: Protection (In Mice) From Diabetes Effect On Heart

Screen shot 2015-02-25 at 10.33.10 AM

You’ve probably seen those scary maps showing a wave of obesity engulfing the country over the last generation, as state after state converts to more-overweight-than-not. The map above comes from a similar animation, only the wave is diabetes. Watch the states turn alarming colors over time here.

For many of us as we age, Type 2 diabetes is not so much a question of “if” as “when.” So even if you don’t have diabetes now, here’s a bit more inspiration to help fend it off with exercise: Researchers report that — in mice, at least — exercise appears to protect powerfully against a potentially fatal heart complication of diabetes.

The complication is called diabetic cardiomyopathy, and it can lead to heart failure. It may not be first on your list of fears (especially if you’ve never heard of it before, as I hadn’t), but these new findings serve as yet another demonstration of the countless ways that exercise may defend you against health harms.  From the University of Virginia Health System’s press release:

“This is a proof of concept. It shows that an antioxidant coming from skeletal muscle that can be induced by exercise training can provide profound protection against an important detrimental disease condition,” said UVA researcher Zhen Yan, PhD. “The implication is if we can come up with a strategy to promote [this effect] in people who are vulnerable to, or already developing, diabetes, that could prevent the development of diabetic cardiomyopathy.”

Yan and his team used genetically modified mice to show that enhancing the production of a molecule called EcSOD – which is produced in skeletal muscle and promoted by regular exercise – would prevent the damaging effects of diabetic cardiomyopathy. These effects include stiffening and enlargement of the heart, which can lead to heart failure.

While the work amplified the expression of the molecule to levels beyond what normal exercise would produce, Yan said it’s an important demonstration of the concrete benefits of regular exercise in people. “Our studies show that even as little as two weeks of exercise could significantly elevate the level in the blood and the heart,” he said.

Yan says he’s also hoping to develop a pill that could help patients who can’t exercise, or boost the effect in people who can. Ah, yes, the eternal search for the exercise pill. Don’t hold your breath — better to huff and puff instead.

The Buffet Phenomenon: Researchers Find More Food Choices Linked To Fatter Mice

(Alpha/Flickr)

(Alpha/Flickr)

This is why I hate buffets: Too many food choices make my head spin. For weight control, I prefer the out-of-sight, out-of-mind approach — keep the oversized muffins and pepperoni pizzas out of the house altogether. Call me rigid, but it seems to work.

Apparently, mice have similar issues, according to a study published in the journal Endocrinology.

The study tried to tease out the relative importance of genetics vs. environment when it comes to obesity risk. So, baby mice born to mothers with a defined high-fat or low-fat diet were randomly assigned to one of three diet groups: either a high-fat diet, a low-fat diet or to an “eat what you want” diet in which they got to pick and choose among the various options.

Researchers from Virginia Tech College of Agriculture and Life Sciences and the Edward Via College of Osteopathic Medicine report that:  “Offspring displayed negative outcomes of increased body weight, body fat, serum leptin, and blood glucose levels when given the choice diet compared with offspring on the [low-fat diet].”

This begs the question whether a child’s environment can indeed trump genetics when it comes to obesity.

The Virginia Tech news release quotes one of the study authors who wraps up the findings simply:

“We like variety,” said Deborah Good, an associate professor of human nutrition, foods, and exercise at Virginia Tech. “But when there is a choice, we eat more than when there is not any variety.”

Though the study was done using mice, it can help inform researchers of how human’s natural environment can affect food choices and ultimately a person’s weight. In a country where one-third of adults and 17 percent of children are obese, understanding the root causes of the problem is imperative.

One apparent upside found among mice in the choice group, according to the report: they had “improved energy expenditure” compared to the low-or high-fat diet groups. “Essentially,” the news release says, “the mice burned more energy as they wandered around and evaluated which food they were going to eat.”

This recalls the food and environment research of Brian Wansink, a professor of consumer behavior at Cornell University in Ithaca, New York. A recent Psychology Today article on how we eat (and overeat) called, “Why Out of Sight is Really Out Of Mind,” discusses how we can slip into mindless eating in a world where food is everywhere. But there are ways to eat smarter, if you think about what you’re doing:

Wansink found that slim people approach an “all you can eat” buffet by “scouting out” what is available — “getting the lay of the land,” as it were — before they grab their plates and pile on food. They are also more likely to sit facing away from, and to choose a table farther away from a buffet; more likely to choose small plates; and, if eating Chinese food, eat with chopsticks.

Jean Fain, a Harvard Medical School-affiliated psychotherapist who runs “mindful eating” training sessions, has offered some tips on how to curb excessive eating, particularly during the holidays, when tables are brimming with tempting sweets and heavy dishes loaded with nostalgia. In a December post, she wrote:

If you find yourself automatically reaching for another piece of pumpkin cheesecake, step back from the dessert table and ask yourself: “How do I feel? What do I need? Do I really want another piece of cheesecake?” If you do, by all means, enjoy. But if you feel full, better to interrupt the automatic urge for more. It’ll taste better when you’re hungry. What’s more, a short interruption can give you back control.

Cartoon: A Snowballing Winter, In The Eyes Of A Medically Fragile Child

Boston Medical Center pediatrician Dr. Jack Maypole directs a program for parents of children who are “medically fragile.” Their conditions include prematurity, autism, seizure disorders and cerebral palsy. Many use wheelchairs.

This winter’s wild weather has proven a tiresome inconvenience for many of us, but for the population Dr. Maypole serves, it threatens far worse. He writes:

“In this cartoon diary, I attempt to capture whatever I can of the additional challenges and stressors experienced by parents (often single mothers) caring for a family member with complex illness or special needs. I submit this to you with hopes it will shed a little light — and perspective — on the daily struggles of these often heroic parents doing more with less than many of us.”

(Click here and zoom in to see the cartoon larger.)

(Courtesy of Boston Medical Center pediatrician Dr. Jack Maypole)

(Courtesy of Boston Medical Center pediatrician Dr. Jack Maypole)

Slashing The Pink Ribbon From Beyond The Grave

We’ve written about “Pink Fatigue,” “depinkification,” “pinkwashing,” “Taking on the Pink Juggernaut.” It’s getting to the point that every pink-tinged October also brings a backlash arguing that National Breast Cancer Awareness Month has perhaps jumped the shark.

But never have I read as powerful and furious an indictment of the current breast cancer scene as a piece by longtime Los Angeles Times reporter Laurie Becklund, As I Lay Dying. She died of metastatic breast cancer on Feb. 8, a postscript notes, but I suspect her writing will live virally on for a long time. An excerpt:

Promise me, I told my friends and family, that you’ll never say that I died after “fighting a courageous battle with breast cancer.” This tired, trite line dishonors the dead and the dying by suggesting that we, the victims, are responsible for our deaths or that the fight we were in was ever fair.

Promise me you’ll never wear a pink ribbon in my name or drop a dollar into a bucket that goes to breast cancer “awareness” for “early detection for a cure,” the mantra of fund-raising juggernaut Susan G. Komen, which has propagated a distorted message about breast cancer and how to “cure” it.

I’m proof that early detection doesn’t cure cancer. I had more than 20 mammograms, and none of them caught my disease. In fact, we now have significant studies showing that routine mammogram screening, which may result in misdiagnoses, unnecessary treatment and radiation overexposure, can harm more people than it helps.

Laurie Becklund tells her own story of unexpected cancer recurrence; she describes grappling with her new identity as someone who was surely dying, and her encounters with other women in the same situation; and she expresses her outrage at how the medical establishment and the breast cancer world have failed such patients. Part of her conclusion:

The most powerful organization in the breast cancer universe, Susan G. Komen , has raised $2.5 billion over the last 20 years, much more than many corporations will ever earn. Yet Komen channels only a fraction of those funds into research or systems to help those who are already seriously sick. Most of that money continues to go to a breast cancer “awareness” campaign that is now painfully out of date. Continue reading