Being Bould

One fine winter's afternoon in 1997 I came across Bould's garage in King's Cliffe in Northamptonshire. It had been closed for some time, and is now, of course, replaced by a bijou selection of stone-faced houses in this 'sought after village'. I'm so glad I recorded its final few months. It became the reference for a Christmas card I did where I stuck enamel signs all over that blank front wall, but I love the freeze-frame of the past it gives, just as it was when it closed. The National sign with the stylised Mercury head, together with the optimistic 'petrol 24 hours', a Smurf poster (oh no), the faded Castrol dispenser in the doorway and an equally non-confidence building M.O.T sign in the window. Commentator Diplomat has given me a sworn affidavit that he turned up for petrol here and bought a road atlas that had been in the window for about ten years. He was somewhat taken aback to be charged full price for an object whose cover details had faded to almost nothing. Next door was a collection of wrecked cars and vans that I also photographed, but you will all have to eat up your greens if I'm to show it off. Anyway, what exactly was the Smurf thing all about?

The Glooston Terror

It is late afternoon, the brassy sun starting to dip down towards the field edge. But against the lane something stirs under the bark of an ash tree already being strangled by ivy. Billowing out from the trunk it rapidly multiplies itself, silent dark orange bubbles manifesting themselves in the dying light.

The only trouble is, I haven't a clue as to what it's called. The girls have worked overtime in the library again, and we did think we'd hit the jackpot with Fistulina hepatica or Ganderma resinaceum, but were ultimately disappointed. But maybe the alien-like appearance is because it's still an infant. After all, don't these things usually pop-out in the autumn? So it's over to you dear readers. I expect that there will be a fair amount of cod latin suggestions of a doubtful nature, but I do hope that there will be some more scholarly work put in. Of course it may be that this is an entirely new species, brought here from another galaxy. There were rumours of bright lights emanating from near the Glooston pub the other night, but that may have been one of the clientele going home with his car headlights on for once.

A Maine Giant in Medicine and Public Health

A pioneer in medicine, genetics, and public health from Maine died earlier last week. Victor McKusick, MD was born in 1921 in Parkman, Maine, a farming community south of Greenville of 500 inhabitants. He attended a one-room schoolhouse for eight years, with the same teacher for seven of those years, and with his identical twin, Vincent. Graduating the top of his high school class of 28 students, Victor attended Tufts University, then earned a medical degree at Johns Hopkins University Medical School (never earning a college degree, since medical schools at that time, especially during WWII, allowed some students to enter medical school before finishing college).

After becoming a cardiologist at Hopkins, he was particularly intrigued by patients he treated with Marfan Syndrome, a hereditary disease that is characterized by malfunctions of the aorta, dislocated eye lenses, and unusually tall stature. These experiences spurred his interests in public health and genetics. As a Professor of Epidemiology at the Hopkins School of Hygiene and Public Health and eventually as a Professor of Medical Genetics, some of his best known accomplishments were his pedigree study of Amish communities and his development of the Mendelian Inheritance of Man (MIM), the listing of known genetic disease markers. These and other studies led to his becoming known as the father of medical genetics.

Victor earned numerous honorary degrees and awards for his work, including the National Medal of Science and the Lasker Award. Although Victor spent his career at Johns Hopkins, he maintained strong ties to his home state. He founded the Short Course in Human Genetics in 1959, held at Jackson Laboratory at Mount Desert Island every summer and that continues to attract international leaders in biomedical research. He also served on the Board of Trustees of University of New England.

Although many speculated if having an identical twin spurred his interest in genetics, he once pointed out that an important event in his life was probably more likely the cause. At age 15 he was hospitalized for 10 weeks with a severe streptococcal infection at Massachusetts General Hospitals. He always felt fortunate that sulfanilamide came out as an antibiotic in 1936. In 1937, he was 15, and witnessed the miraculous melting away of his infection with the infusion of this drug.

He is survived by his twin, Vincent, who graduated from Bates College and law school, and eventually became the Chief Justice of the Maine Supreme Court for 15 years. He is also survived by his wife, Dr. Anne Bishop McKusick, who is a rheumatologist, and his three children.
Dr. McKusick reminisced about his proposing in the 1960s that the human genome should be mapped:

"It took a little nerve," he said later, because nobody then had the tools to do the job. "I'm a congenital encyclopedist. I enjoy keeping on top of all the information. Also, I feel I have a tiger by the tail. I don't dare let go: It'll eat me up."

We are very fortunate to claim such a gem as Dr. McKusick to be from Maine and to have made such a mark in public health and medicine. On a personal note, I was very fortunate to have spent an evening with him at a Foundation for Blood Research dinner several years ago. Despite all his accomplishments and honors, he was incredibly humble and fun. I’m sure his life’s story will continue to be an inspiration to many of us in Maine.

Dora Anne Mills, MD, MPH

Johns Hopkins Press Release:

Oral History of Human Genetics Project Interview with Dr. McKusick:

Birthday Blog

This blog celebrates its first birthday today. What a time I've had. A Dorset Rhubarb Kiosk, a Gloucestershire Fire Extinguisher. An Essex Cinema, a Kent Moon Rocket. Bedford Vans, Riley Cars. Tattered Penguins and more Golden Syrup than I've got pudding bowls for. And the people. Scarecrows in a Suffolk pea field and a spooky allotment, and, where it all started, a Pink Panther worshipping in a medieval abbey. But probably best of all has been the happy band of commentators that give me as much pleasure as the posts themselves, and through their own blogs take me to worlds that I could never have dreamt existed. Thankyou everybody. (Takes out big onion and red spotted handkerchief.) As Toby Savage said very early on in this enterprise "We used to do this round a pub table". He's right, but it's now a very big table and all are welcome.

I've been saving the LNER book for today, the covers of which are a superb example of the art of Frank Newbould, who gave us some of the very best flat colour graphic posters of the 1930s. Designed for American tourists, the book simply gives a commentary of what can be seen from LNER trains or reached from their destinations. Including, oddly enough, much in Scotland.

The Inuit: Lessons from the Arctic

The Inuit (also called Eskimo) are a group of hunter-gatherer cultures who inhabit the arctic regions of Alaska, Canada and Greenland. They are a true testament to the toughness, adaptability and ingenuity of the human species. Their unique lifestyle has a lot of information to offer us about the boundaries of the human ecological niche. Weston Price was fascinated by their excellent teeth, good nature and overall robust health. Here's an excerpt from Nutrition and Physical Degeneration:
"In his primitive state he has provided an example of physical excellence and dental perfection such as has seldom been excelled by any race in the past or present...we are also deeply concerned to know the formula of his nutrition in order that we may learn from it the secrets that will not only aid in the unfortunate modern or so-called civilized races, but will also, if possible, provide means for assisting in their preservation."
The Inuit are cold-hardy hunters whose traditional diet consists of a variety of sea mammals, fish, land mammals and birds. They invented some very sophisticated tools, including the kayak, whose basic design has remained essentially unchanged to this day. Most groups ate virtually no plant food. Their calories came primarily from fat, up to 75%, with almost no calories coming from carbohydrate. Children were breast-fed for about three years, and had solid food in their diet almost from birth. As with most hunter-gatherer groups, they were free from chronic disease while living a traditional lifestyle, even in old age. Here's a quote from Observations on the Western Eskimo and the Country they Inhabit; from Notes taken During two Years [1852-54] at Point Barrow, by Dr. John Simpson:
These people [the Inuit] are robust, muscular and active, inclining rather to spareness [leanness] than corpulence [overweight], presenting a markedly healthy appearance. The expression of the countenance is one of habitual good humor. The physical constitution of both sexes is strong. Extreme longevity is probably not unknown among them; but as they take no heed to number the years as they pass they can form no guess of their own ages.
One of the common counterpoints I hear to the idea that high-fat hunter-gatherer diets are healthy, is that exercise protects them from the ravages of fat. The Inuit can help us get to the bottom of this debate. Here's a quote from Cancer, Disease of Civilization (1960, Vilhjalmur Stefansson):
"They are large eaters, some of them, especially the women, eating all the time..." ...during the winter the Barrow women stirred around very little, did little heavy work, and yet "inclined more to be sparse than corpulent" [quotes are the anthropologist Dr. John Murdoch, reproduced by Stefansson].
Another argument I sometimes hear is that the Inuit are genetically adapted to their high-fat diet, and the same food would kill a European. This appears not to be the case. The anthropologist and arctic explorer Vilhjalmur Stefansson spent several years living with the Inuit in the early 20th century. He and his fellow Europeans and Americans thrived on the Inuit diet. American doctors were so incredulous that they defied him and a fellow explorer to live on a diet of fatty meat only for one year, under the supervision of the American Medical Association. To the doctors' dismay, they remained healthy, showing no signs of scurvy or any other deficiency (JAMA 1929;93:20–2).

Yet another amazing thing about the Inuit was their social structure. Here's Dr. John Murdoch again (quoted from Cancer, Disease of Civilization):
The women appear to stand on a footing of perfect equality with the men, both in the family and the community. The wife is the constant and trusted companion of the man in everything except the hunt, and her opinion is sought in every bargain or other important undertaking... The affection of parents for their children is extreme, and the children seem to be thoroughly worthy of it. They show hardly a trace of fretfulness or petulance so common among civilized children, and though indulged to an extreme extent are remarkably obedient. Corporal punishment appears to be absolutely unknown, and children are rarely chided or punished in any way.
Unfortunately, those days are long gone. Since adopting a modern processed-food diet, the health and social structure of the Inuit has deteriorated dramatically. This had already happened to most groups by Weston Price's time, and is virtually complete today. Here's Price:
In the various groups in the lower Kuskokwim seventy-two individuals who were living exclusively on native foods had in their 2,138 teeth only two teeth or 0.09 per cent that had ever been attacked by tooth decay. In this district eighty-one individuals were studied who had been living in part or in considerable part on modern foods, and of their 2, 254 teeth 394 or 13 per cent had been attacked by dental caries. This represents an increase in dental caries of 144 fold.... When these adult Eskimos exchange their foods for our modern foods..., they often have very extensive tooth decay and suffer severely.... Their plight often becomes tragic since there are no dentists in these districts.
Modern Inuit also suffer from very high rates of diabetes and overweight. This has been linked to changes in diet, particularly the use of white flour, sugar and processed oils.

Overall, the unique lifestyle and diet of the Inuit have a lot to teach us. First, that some humans are capable of being healthy eating mostly animal foods. Second, that some humans are able to thrive on a high-fat diet. Third, that humans are capable of living well in extremely harsh and diverse environments. Fourth, that the shift from natural foods to processed foods, rather than changes in macronutrient composition, is the true cause of the diseases of civilization.

Hurricane season is here: Do you have a plan?

Hello, Dolly! Hurricane season is here.

It's a long way from Broadway to the Gulf Coast, but Dolly knows how to perform for a crowd, no matter the location. Taking honors as the fourth named Atlantic storm of the 2008 season, Hurricane Dolly -- recently downgraded to a tropical depression -- made landfall this week in south Texas. Despite fame as a musical delight, Dolly reminded people this week that hurricanes are no laughing matter.

The U.S. hurricane season lasts from June 1 to Nov. 30, a full six months of havoc-wreaking potential. Most tropical storms develop during the peak of the season, August through October. In 2008, experts predict that there will be about 15 named storms and eight hurricanes, four of which have the potential of being major hurricanes — category 3 or greater.

With so many potential storms brewing, it's up to each of us to be ready and to protect ourselves, our families and friends. The top tip? Make a family disaster plan. As anyone who lives in a hurricane-prone area knows, residents are often required to evacuate on short notice. Know the local evacuation routes as well as area shelters and carry a list of emergency phone contacts. If you have seniors living near by, check on them and make sure they have a way to leave town, if necessary.

It's also key to create a disaster supply kit. You'll need a radio, first-aid kit, non-perishable food items, water, flashlights, batteries, clothing and a waterproof container with important documents. Put the kit in an easy-to-access area where you can grab it and go during an evacuation.

Hurricanes can be scary for kids, so help them get informed and prepared with these games. It's also a good idea to toss some toys or books for the kids in your disaster kit to help while the time away in a shelter or during a power outage.

More tips, including preparedness for pets and securing your home, are just a mouse click away.

Remember: While the curtain has closed on Dolly, the peak of the season is just around the corner- an ominous reminder to get ready and be prepared.

Photo courtesy Federal Emergency Management Agency. A Brownsville, Texas, resident pushes his stalled car through floodwaters on July 24 following Hurricane Dolly's landfall.

Changing Down

Trawling through the Archive this afternoon, looking for a picture of an Ulster linen-weaving machine with a teapot balanced on it, I came across this. It will particularly appeal, I hope, to those who have ever ascended Wardley Hill in Rutland before it was obliterated by a three-lane blacktop that carved a new and utterly boring route up to Uppingham through the limestone escarpment. The road sign indicates the turn into a little lane that led into Wardley village itself. Why I was lurking in a ditch on a late summer afternoon has escaped me, but I think it was something to do with trying out a new telephoto lens on my Pentax. Always a slow gear-grinding haul for lorries, every year they would get stuck in the heavy falls of snow we once had, drivers having to sleep in their cabs with just a tartan-patterned Thermos for company. "Wardley Hill is still blocked", Radio Leicester told us, and we thought of all those Leyland Comets, Guy Warriors, Seddons and Albions disappearing under blankets of piled-up snow. In this photograph it's a much kinder day in 1978 as a Foden tanker (fleet number 147 for truck pedants) transports Heygates Flour eastwards. Or it might have been empty, we shall probably never know. All I do know is that I went "Yes!" when someone lit that bonfire at the bottom of the hill.

Book Review: "The Human Diet: Its Origins and Evolution"

I recently read this book after discovering it on another health site. It's a compilation of chapters written by several researchers in the fields of comparative biology, paleontology, archaeology and zoology. It's sometimes used as a textbook.

I've learned some interesting things, but overall it was pretty disappointing. The format is disjointed, with no logical flow between chapters. I also would not call it comprehensive, which is one of the things I look for in a textbook.
Here are some of the interesting points:
  • Humans in industrial societies are the only mammals to commonly develop hypertension, and are the only free-living primates to become overweight.
  • The adoption of grains as a primary source of calories correlated with a major decrease in stature, decrease in oral health, decrease in bone density, and other problems. This is true for wheat, rice, corn and other grains.
  • Cranial capacity has also declined 11% since the late paleolithic, correlating with a decrease in the consumption of animal foods and an increase in grains.
  • According to carbon isotope ratios of teeth, corn did not play a major role in the diet of native Americans until 800 AD. Over 15% of the teeth of post-corn South American cultures showed tooth decay, compared with less than 5% for pre-corn cultures (many of which were already agricultural, just not eating corn).
  • Childhood mortality seems to be similar among hunter-gatherers and non-industrial agriculturists and pastoralists.
  • Women may have played a key role in food procurement through foraging. This is illustrated by a group of modern hunter-gatherers called the Hadza. While men most often hunt, which supplies important nutrients intermittently, women provide a steady stream of calories by foraging for tubers.
  • We have probably been eating starchy tubers for between 1.5 and 2 million years, which precedes our species. Around that time, digging tools, (controversial) evidence of controlled fire and changes in digestive anatomy all point to use of tubers and cooked food in general. Tubers make sense because they are a source of calories that is much more easily exploited than wild grains in most places.
  • Our trajectory as a species has been to consume a diet with more calories per unit fiber. As compared to chimps, who eat leaves and fruit all day and thus eat a lot of fiber to get enough calories, our species and its recent ancestors ate a diet much lower in fiber.
  • Homo sapiens has always eaten meat.
The downside is that some chapters have a distinct low-fat slant. One chapter attempted to determine the optimal diet for humans by comparing ours to the diets of wild chimps and other primates. Of course, we eat more fat than a chimp, but I don't think that gets us anywhere. Especially since one of our closest relatives, the neanderthal, was practically a carnivore.
They consider the diet composition of modern hunter-gatherers that eat low-fat diets, but don't include data on others with high-fat diets like the Inuit.

There's some good information in the book, if you're willing to dig through a lot of esoteric data on the isotope ratios of extinct hominids and that sort of thing.

Trees & Mr.Badmin

It must seem slightly odd, posting a poster about March trees in July. Mind you, the weather round here recently has had me out gathering wood for the stove, I can tell you. No, this one's because I've been fortunate enough to land some Shell Posters. In the 1950s these were essential educative wall decorations, and a set of Nature Studies adorned my school hall. No.6 June was a favourite, with the same scene of a country house divided into day and night, but they could equally be illustrations of the salient features of counties or the twelve months of a year in trees. Artist S.R.Badmin (1906-88) produced this series, brilliant evocations of the natural history on our doorsteps with each illustration showing pertinent trees with their leaves and fruit in the foreground. Badmin will be remembered for the Ladybird Book of Trees (still one of the best) but his watercolour skills produced hundreds of atmospheric paintings and his fine eye many meticulous line drawings. I was very privileged to be invited to Mr.Badmin's West Sussex home in 1987, and my girlfriend commented that it must be wonderful for him to have the South Downs just outside his big picture window. He poured out some more tea and said "Too close for me my dear".

Clean your home, protect your health

Ever heard the old saying "cleanliness is next to saintliness?" As it turns out, cleanliness is also key to healthiness, especially when it comes to infectious diseases.

By following good hygiene practices, disinfecting our homes and safely disposing of waste, we can all help fight the spread of infectious disease, according to a new fact sheet from the U.S. Department of Health and Human Services.

The fact sheet, "Control of Pandemic Flu Virus on Environmental Surfaces in Homes and Public Places," highlights everyday things you can do to prevent the spread of disease, such as using your sleeve to cover your sneeze instead of your hands. The suggestions focus on stopping the spread of germs early, which is when it counts the most. Some of the tips are obvious -- such as washing your hands before eating or disinfecting kitchen counters -- while others are less well-known.

Among the tips:
• Wash your hands before removing clothes from the washer or dryer, especially if you've sneezed or coughed.
• Take care not to fluff or shake sheets or linens when removing them from beds for cleaning.
• Wash common surfaces, such as doorknobs, door handles, remote controls, phones and microwave buttons.
• Don’t forget to sanitize surfaces in your car, such as the steering wheel, stick shift, radio or window controls.
• Carry alcohol-based hand wipes or sanitizing gels when you’re away from home in case you can’t find a place to wash your hands.
• Teach your kids to follow good hygiene while away from home, especially at school -- where diseases often spread.
• Wash your hands after emptying waste baskets.

Remember: Even though these tips are aimed at pandemic flu, many of them can also work against other infectious diseases. Our recommendation? Take a look at the fact sheet and find ways to build these practices into your everyday life now, as they are bound to pay off sooner rather than later.

Sunscreen and Melanoma

Melanoma is the most deadly type of skin cancer, accounting for most skin cancer deaths in the US. As Ross pointed out in the comments section of the last post, there is an association between severe sunburn at a young age and later development of melanoma. Darker-skinned people are also more resistant to melanoma. The association isn't complete, however, since melanoma sometimes occurs on the soles of the feet and even in the intestine. This may be due to the fact that there are several types of melanoma, potentially with different causes.

Another thing that associates with melanoma is the use of sunscreen above a latitude of 40 degrees from the equator. In the Northern hemisphere, 40 degrees draws a line between New York city and Beijing. A recent
meta-analysis found consistently that sunscreen users above 40 degrees are at a higher risk of melanoma than people who don't use sunscreen, even when differences in skin color are taken into account. Wearing sunscreen decreased melanoma risk in studies closer to the equator. It sounds confusing, but it makes sense once you know a little bit more about UV rays, sunscreen and the biology of melanoma.

The UV light that reaches the Earth's surface is composed of UVA (longer) and UVB (shorter) wavelengths. UVB causes sunburn, while they both cause tanning. Sunscreen blocks UVB, preventing burns, but most brands only weakly block UVA. Sunscreen allows a person to spend more time in the sun than they would otherwise, and attenuates tanning. Tanning is a protective response (among several) by the skin that protects it against both UVA and UVB. Burning is a protective response that tells you to get out of the sun. The result of diminishing both is that sunblock tends to increase a person's exposure to UVA rays.

It turns out that UVA rays are more
closely associated with melanoma than UVB rays, and typical sunscreen fails to prevent melanoma in laboratory animals. It's also worth mentioning that sunscreen does prevent more common (and less lethal) types of skin cancer.

Modern tanning beds produce a lot of UVA and not much UVB, in an attempt to deliver the maximum tan without causing a burn. Putting on sunscreen essentially does the same thing: gives you a large dose of UVA without much UVB.

The authors of the meta-analysis suggest an explanation for the fact that the association changes at 40 degrees of latitude: populations further from the equator tend to have lighter skin. Melanin blocks UVA very effectively, and the pre-tan melanin of someone with olive skin is enough to block most of the UVA that sunscreen lets through. The fair-skinned among us don't have that luxury, so our melanocytes get bombarded by UVA, leading to melanoma. This may explain the incredible rise in melanoma incidence in the US in the last 35 years, as people have also increased the use of sunscreen. It may also have to do with tanning beds, since melanoma incidence has risen particularly in women.

In my opinion, the best way to treat your skin is to tan gradually, without burning. Use clothing and a wide-brimmed hat if you think you'll be in the sun past your burn threshold. If you want to use sunscreen, make sure it blocks UVA effectively. Don't rely on the manufacturer's word; look at the ingredients list. It should contain at least one of the following: titanium dioxide, zinc oxide, avobenzone (Parsol 1789), Mexoryl SX (Tinosorb). It's best if it's also paraben-free.

Fortunately, as an external cancer, melanoma is easy to diagnose. If caught early, it can be removed without any trouble. If caught a bit later, surgeons may have to remove lymph nodes, which makes your face look like John McCain's. Later than that and you're probably a goner. If you have any questions about a growth, especially one with irregular borders that's getting larger, ask your doctor about it immediately!

A Sticky End

The search is over. No more will I be seen on my hands and knees rummaging at the back of shelves in Sainsburys. No more will supermarket assistants quicken their steps to the rest room when they see me approaching with my notebook in my hand. It's all Tate & Lyle's fault, deciding to taunt me with seven different designs of a gold can to celebrate their anniversary. Why couldn't I just be content with one or two? Why did I have to collect big tins as well as small? Oh no, I was seen everywhere from Tesco's in Devizes to Asda in Wisbech, reaching into dim recesses to turn cans round to see if there was a small tin with 'Fantastic in Flapjacks' on it, or a big tin with 'Happy Birthday Lyle's'. But one tin avoided my obsessive searches. Nowhere (and I do mean nowhere) could I find 'Pour it on Porridge' in the big 907g can. It became the Holy Grail, the tin that I became convinced would be found in a shaft of sunlight on a pedestal of rock at the back of a cave in Borneo. In desperation I started a dialogue with bewildered customer care girls at Tate & Lyle's, more used to dealing with housewives whose treacle tarts hadn't turned-out treacly enough. Eventually my badgering resulted in a very kind note from 'technical'. Apparently they could only fit six separate designs for the big can on one printing sheet. So a large 'Pour it on Porridge' doesn't exist. (I bet they made just one though. I would have.) I pass all this on in case it helps some other poor deluded soul who is still out there getting his hands sticky in Somerfields in Salford or Waitrose in Warminster. Right. Anyone got a recipe for an acre of flapjack?

Preparing for college means more than studying for the SATs

Congratulations, high school graduates! Your tassels have been turned and caps thrown in the air. For those going on to college, a new journey awaits. But before heading to campus with your laptop and books, consider packing a few more things in your bag.

University life can present many challenges, not the least of which are final exams. Outbreaks of infectious disease, natural disasters and other emergencies can force schools, including the dining hall, to shut down for a period of time. Surveys have indicated that most people have not created emergency preparedness plans and are unprepared for an emergency. Being at school and away from home and family presents additional challenges. Knowing what to do and having a plan can make all the difference in the time of an emergency.

To help plan ahead, talk with your resident advisor or student life office about your school's emergency preparedness plan. Check out your school's Web site for information concerning evacuation plans and drills. Familiarize yourself with the plans and keep important phone numbers in a safe place such as your emergency preparedness kit.

If you don't have a kit, make one. As you buy your twin sheet sets and shower shoes, pick up items for an emergency preparedness kit too. You'll need things like a flashlight, bottled water, batteries and canned food.

Supplies for the kit should last about three days, but if you're able and have room, pack in a little more in case of an extended emergency. If your dorm room is small and storage space is limited, check to see if your dorm has a central storage area.

You've worked hard to get here. A little more preparing can help keep you safe and healthy on "College Hill" no matter what threats you face.

Grains and Human Evolution

[Update 8/2011: as I've learned more about human genetics and evolution, I've come to appreciate that many Europeans actually descend from early adopters of agriculture more than they descend from the hunter-gatherers that previously occupied Europe.  Also, 10,000 years has been long enough for significant genetic adaptation.  Read The 10,000 Year Explosion for more information].

You've heard me say that I believe grains aren't an ideal food for humans. Part of the reason rests on the assertion that we have not been eating grains for long enough to have adapted to them. In this post, I'll go over what I know about the human diet before and after agriculture, and the timeline of our shift to a grain-based diet. I'm not an archaeologist so I won't claim that all these numbers are exact, but I think they are close enough to make my point.

As hunter-gatherers, we ate some combination of the following: land mammals (including organs, fat and marrow), cooked tubers, seafood (fish, mammals, shellfish, seaweed), eggs, nuts, fruit, honey, "vegetables" (stems, leaves, etc.), mushrooms, assorted land animals, birds and insects. The proportion of each food varied widely between groups and even seasons. This is pretty much what we've been living on since we evolved as a species, and even before, for a total of 1.5 million years or so (this number is controversial but is supported by multiple lines of evidence). There are minor exceptions, including the use of wild grains in a few areas, but for the most part, that's it.

The first evidence of a calorically important domesticated crop I'm aware of was about 11,500 years ago in the fertile crescent. They were cultivating an early ancestor of wheat called emmer. Other grains popped up independently in what is now China (rice; ~10,000 years ago), and central America (corn; ~9,000 years ago). That's why people say humans have been eating grains for about 10,000 years.

The story is more complicated than the dates suggest, however. Although wheat had its origin 11,500 years ago, it didn't become widespread in Western Europe for another 4,500 years. So if you're of European descent, your ancestors have been eating grains for roughly 7,000 years. Corn was domesticated 9,000 years ago, but according to the carbon ratios of human teeth, it didn't become a major source of calories until about 1,200 years ago! Many American groups did not adopt a grain-based diet until 100-300 years ago, and in a few cases they still have not. If you are of African descent, your ancestors have been eating grains for 9,000 to 0 years, depending on your heritage. The change to grains was accompanied by a marked decrease in dental health that shows up clearly in the archaeological record.

Practically every plant food contains some kind of toxin, but grains produce a number of nasty ones that humans are not well adapted to. Grains contain a large amount of phytic acid for example, which strongly inhibits the absorption of a number of important minerals. Tubers, which were our main carbohydrate source for about 1.5 million years before agriculture, contain less of it. This may have been a major reason why stature decreased when humans adopted grain-based agriculture. There are a number of toxins that occur in grains but not in tubers, such as certain heat-resistant lectins.

Non-industrial cultures often treated their seeds, including grains, differently than we do today. They used soaking, sprouting and long fermentation to decrease the amount of toxins found in grains, making them more nutritious and digestible. Most grain staples are not treated in this way today, and so we bear the brunt of their toxins even more than our ancestors did.

From an evolutionary standpoint, even 11,500 years is the blink of an eye. Add to that the fact that many people descend from groups that have been eating grains for far less time than that, and you begin to see the problem. There is no doubt that we have begun adapting genetically to grains. All you have to do to understand this is look back at the archaeological record, to see the severe selective pressure (read: disease) that grains placed on its early adopters. But the question is, have we had time to adapt sufficiently to make it a healthy food? I would argue the answer is no.

There are a few genetic adaptations I'm aware of that might pertain to grains: the duplication of the salivary amylase gene, and polymorphisms in the angiotensin-converting enzyme (ACE) and apolipoprotein B genes. Some groups duplicated a gene that secretes the enzyme amylase into the saliva, increasing its production. Amylase breaks down starch, indicating a possible increase in its consumption. The problem is that we were getting starch from tubers before we got it from grains, so it doesn't really argue for either side in my opinion. The ACE and apolipoprotein B genes may be more pertinent, because they relate to blood pressure and LDL cholesterol. Blood pressure and blood cholesterol are both factors that respond well to low-carbohydrate (and thus low-grain) diets, suggesting that the polymorphisms may be a protective adaptation against the cardiovascular effects of grains.

The fact that up to 1% of people of European descent may have full-blown celiac disease attests to the fact that 7,000 years have not been enough time to fully adapt to wheat on a population level. Add to that the fact that nearly half of genetic Europeans carry genes that are associated with celiac, and you can see that we haven't been weeded out thoroughly enough to tolerate wheat, the oldest grain!

Based on my reading, discussions and observations, I believe that rice is the least problematic grain, wheat is the worst, and everything else is somewhere in between. If you want to eat grains, it's best to soak, sprout or ferment them. This activates enzymes that break down most of the toxins. You can soak rice, barley and other grains overnight before cooking them. Sourdough bread is better than normal white bread. Unfermented, unsprouted whole wheat bread may actually be the worst of all. 

Any Excuse

Last night I watched John Schlesinger's 1995 film of Cold Comfort Farm. A thoroughly enjoyable experience, and even if you're a big fan of Stella Gibbons' book I don't think you'll be disappointed in Malcolm Bradbury's adaptation. One of the more obscure high points for me is when Flora Poste persuades Amos Starkadder to buy a Ford van and leave the farm in order to preach his gospel according to The Quivering Brethren. So taken with the idea, he is seen waving the latest Ford van brochure about, a pristine prop if ever I saw one. I got very excited, wincing when Amos appeared to fold it in two to shove it in his pocket, but started to think 'I've got that in the Archive somewhere'. As you will have guessed by now, I haven't. It's for 1938 Bedford Light Vans and I thought I'd just post it anyway. But if any film prop managers need one for an excitable pre-war proto tradesman to flourish on camera, you know where to find it. (No creasing.) For commercial vehicle cognescenti the van pictured is the 5/6 cwt 10hp 4 cylinder version, costing £140 plus £15 tax (in primer). For a 'fine quality cellulose' finish you added another fiver.

Another China Tidbit

A final note about the Chinese study in the previous post: the overweight vegetable-eaters (read: wheat eaters) exercised more than their non-vegetable-eating, thin neighbors. So although their average calorie intake was a bit higher, their expenditure was as well. 

Although I speculated in the last post that affluent people might be eating more wheat and fresh vegetables, the data don't support that. Participants with the highest income level actually adhered to the wheat and vegetable-rich pattern the least, while low-income participants were most likely to eat this way.

Interestingly, education showed a (weaker) trend in the opposite direction. More educated participants were more likely to eat the wheat-vegetable pattern, while the opposite was true of less educated participants. Thus, it looks like wheat makes people more educated. Just kidding, that's exactly the logic we have to avoid when interpreting this type of study!

Unexpected Alphabets No 3

Mr.Wilkinson was recently very gracious in acknowledging, in his absorbing English Buildings blog, the introduction I gave him to the Welland Valley Viaduct and its attendant church kneelers. So I return the compliment by finally photographing this sign he spotted on the same day behind a straggling hawthorn hedge in Rutland. Goodness knows how long it is since the Leicester Water Department commandeered a field just outside Uppingham, some nineteen miles from the city; it's been either Anglian Water or Severn Trent around here ever since I've had to cough-up to pay their exorbitant bills. But I love the cast iron 'pleasing decay' and the fact that for all its neglect it still manages to shout a stentorian command like an old sergeant major leaning into the wind on a parade ground. A straight forward well-lettered sign that wouldn't have dreamt of displaying a logo or a catch-phrase like 'On Tap For U'.

Wheat in China

Dr. Michael Eades linked to an interesting study yesterday on his Health and Nutrition blog. It's entitled "Vegetable-Rich Food Pattern is Related to Obesity in China."

It's one of these epidemiological studies where they try to divide subjects into different categories of eating patterns and see how health problems associate with each one. They identified four patterns: the 'macho' diet high in meat and alcohol; the 'traditional' diet high in rice and vegetables; the 'sweet tooth' pattern high in cake, dairy and various drinks; and the 'vegetable rich' diet high in wheat, vegetables, fruit and tofu. The only pattern that associated with obesity was the vegetable-rich diet. The 25% of people eating closest to the vegetable-rich pattern were more than twice as likely to be obese as the 25% adhering the least.

The authors of the paper try to blame the increased obesity on a higher intake of vegetable oil from stir-frying the vegetables, but that explanation is misleading. A cursory glance at table 3 reveals that the vegetable-eaters weren't eating any more fat than their thinner neighbors. Dr. Eades suggests that their higher carbohydrate intake (+10%) was partially responsible for the weight gain, but I wasn't satisfied with that explanation so I took a closer look.  Dr. Eades also pointed to their higher calorie intake (+120 kcal/day), which makes sense to me.

One of the most striking elements of the 'vegetable-rich' food pattern is its replacement of rice with wheat flour. The 25% of the study population that adhered the least to the vegetable-rich food pattern ate 7.3 times more rice than wheat, whereas the 25% sticking most closely to the vegetable-rich pattern ate 1.2 times more wheat than rice! In other words, wheat flour rather than rice was their single largest source of calories. This association was much stronger than the increase in vegetable consumption itself!

All of a sudden, the data make more sense. Wheat seems to associate with health problems in many contexts. Perhaps the reason we don't see the same type of association in American epidemiological studies is that everyone eats wheat. Only in a culture that has a true diversity of diet can you find a robust association like this. The replacement of rice with wheat may have caused the increase in calorie intake as well. Clinical trials of low-carbohydrate diets as well as 'paleolithic diets' have shown good metabolic outcomes from wheat avoidance, although one can't be sure what role wheat plays from those data.

I don't think the vegetables had anything to do with the weight gain, they were just incidentally associated with wheat consumption. But I do think these data are difficult to reconcile with the idea that vegetables protect against overweight.

Cancer in Other Non-Industrialized Cultures

In Cancer, Disease of Civilization (1960), Wilhjalmur Stefansson mentions a few cultures besides the Inuit in which large-scale searches never turned up cancer. Dr. Albert Schweitzer examined over 10,000 traditionally-living natives in Gabon (West Africa) in 1913 and did not find cancer. Later, it became common in the same population as they began "living more and more after the manner of the whites."

In Cancer, its Nature, Cause and Cure (1957), Dr. Alexander Berglas describes the search for cancer among natives in Brazil and Ecuador by Dr. Eugene Payne. He examined approximately 60,000 people over 25 years and found no evidence of cancer.

Sir Robert McCarrison conducted a seven year medical survey among the Hunza, in what is now Northern Pakistan. Among 11,000 people, he did not find a single case of cancer. Their diet consisted of soaked and sprouted grains and beans, fruit, vegetables, grass-fed dairy and a small amount of meat (including organs of course).

Mortality and Lifespan of the Inuit

One of the classic counter-arguments that's used to discredit accounts of healthy hunter-gatherers is the fallacy that they were short-lived, and thus did not have time to develop diseases of old age like cancer. While the life expectancy of hunter-gatherers was not as high as ours today, most groups had a significant number of elderly individuals, who sometimes lived to 80 years and beyond. Mortality came mostly from accidents, warfare and infectious disease rather than chronic disease.

I found a a mortality table from the records of a Russian mission in Alaska (compiled by Veniaminov, taken from Cancer, Disease of Civilization), which recorded the ages of death of a traditionally-living Inuit population during the years 1822 to 1836. Here's a plot of the raw data:

Here's the data re-plotted in another way. I changed the "bin size" of the bars to 10 year spans each (rather than the bins above, which vary from 3 to 20 years). This allows us to get a better picture of the number of deaths over time. I took some liberties with the data to do this, breaking up a large bin equally into two smaller bins. I also left out the infant mortality data, which are interesting but not relevant to this post:

Excluding infant mortality, about 25% of their population lived past 60. Based on these data, the approximate life expectancy (excluding infant mortality) of this Inuit population was 43.5 years. It's possible that life expectancy would have been higher before contact with the Russians, since they introduced a number of nasty diseases to which the Inuit were not resistant. Keep in mind that the Westerners who were developing cancer alongside them probably had a similar life expectancy at the time. Here's the data plotted in yet another way, showing the number of individuals surviving at each age, out of the total deaths recorded:

It's remarkably linear. Here's the percent chance of death at each age:

In the next post, I'll briefly summarize cancer data from several traditionally-living cultures other than the Inuit.

Cancer Among the Inuit

I remember coming across a table in the book Eat, Drink and Be Healthy (by Dr. Walter Willett) a few years back. Included were data taken from Dr. Ancel Keys' "Seven Countries Study". It showed the cancer rates for three industrialized nations: the US, Greece and Japan. Although specific cancers differed, the overall rate was remarkably similar for all three: about 90 cancers per 100,000 people per year. Life expectancy was also similar, with Greece leading the pack by 4 years (the data are from the 60s).

The conclusion I drew at the time was that lifestyle did not affect the likelihood of developing cancer. It was easy to see from the same table that heart disease was largely preventable, since the US had a rate of 189 per 100,000 per year, compared to Japan's 34. Especially since I also knew that Japanese-Americans who eat an American diet get heart disease just like European-Americans.

I fell prey to the same logic that is so pervasive today: the idea that you will eventually die of cancer if no other disease gets you first. It's easy to believe, since the epidemiology seems to tell us that lifestyle doesn't affect overall cancer rates very much. There's only one little glitch... those epidemiological studies compare the sick to the sicker.

Here's the critical fact that modern medicine seems to have forgotten: hunter-gatherers and numerous non-industrial populations throughout the world have unusually low cancer rates. This idea was widely accepted in the 19th century and the early 20th, but has somehow managed to fade into obscurity.  Allow me to explain.

I recently read Cancer, Disease of Civilization by Vilhjalmur Stefansson (thanks Peter). Stefansson was an anthropologist and arctic explorer who participated in the search for cancer among the Canadian and Alaskan Inuit. Traditionally, most Inuit groups were mostly carnivorous, eating a diet of raw and cooked meat and fish almost exclusively. Their calories came primarily from fat. They alternated between seasons of low and high physical activity, typically enjoyed an abundant food supply yet also periodically faced famines.

Field physicians in the arctic noted that the Inuit were a remarkably healthy people. While they suffered from a tragic susceptibility to European communicable diseases, they did not develop the chronic diseases we now view as part of being human: tooth decay, overweight, heart attacks, appendicitis, constipation, diabetes and cancer. When word reached American and European physicians that the Inuit did not develop cancer, a number of them decided to mount an active search for it. This search began in the 1850s and tapered off in the 1920s, as traditionally-living Inuit became difficult to find.

One of these physicians was captain George B. Leavitt. He actively searched for cancer among the traditionally-living Inuit from 1885 to 1907. Along with his staff, he claims to have performed tens of thousands of examinations. He did not find a single case of cancer. At the same time, he was regularly diagnosing cancers among the crews of whaling ships and other Westernized populations. It's important to note two relevant facts about Inuit culture: first, their habit of going shirtless indoors. This would make visual inspection for external cancers very easy. Second, the Inuit generally had great faith in Western doctors and would consult them even for minor problems. Therefore, doctors in the arctic had ample opportunity to inspect them for cancer.

A study was published in 1934 by F.S. Fellows in the US Treasury's Public Health Reports entitled "Mortality in the Native Races of the Territory of Alaska, With Special Reference to Tuberculosis". It contained a table of cancer mortality deaths for several Alaskan regions, all of them Westernized to some degree. However, some were more Westernized than others. In descending order of Westernization, the percent of deaths from cancer were as follows:

Keep in mind that all four of the Inuit populations in this table were somewhat Westernized. It's clear that cancer incidence tracks well with Westernization, although other factors could be involved in producing this result (such as poorer diagnosis in less Westernized regions). By "Westernization", what I mean mostly is the adoption of European food habits, including wheat flour, sugar, canned goods and vegetable oil. Later, most groups also adopted Western-style houses, which incidentally were not at all suited to their harsh climate.

In the next post, I'll address the classic counter-argument that hunter-gatherers were free of cancer because they didn't live long enough to develop it.

Sweetie Time

When I had a proper job in an agency, it was the custom on Friday afternoons to get shed loads of sweets in, usually a precursor to one of the juniors being sent out to the local off licence, itself a limbering-up period before hitting the pub in St.John's Wood. So I thought I'd revive the sweets end of things by sharing these jars of goodies with you, shot through the glass of Britcher & Rivers' Rye sweetshop. They remind me that Fox's Glacier Mints were made in Leicester and had a neon polar bear on the gable end of their factory (or did I imagine it?); that one of my favourite Liquorice Allsorts is available on its own as a Pascal Spog; and that I never did see the point of trying to eat a plastic space ship with a tiny spot of sherbet in it. Have the Anglican brethren amongst us noted how much communion wafers have the same pointless flavour? Minus a holy shot of sherbet, of course. However much we're reduced to picking up Revels and Maltesers when we're queuing-up to mortgage ourselves for a gallon of petrol, or slinging catering-size bags of Jelly Babies into supermarket trollies, isn't it encouraging that there are still shops like Britcher & Rivers that unscrew jars of sweets and dish the contents into metal weighing scoops? I'd say more, but it is Friday and at least one local round here opens at five. Have a good weekend.

Cancer and the Immune System

My understanding of cancer has changed radically over the past few months. I used to think of it as an inevitable consequence of aging, a stochastic certainty. The human body is made of about 50 trillion cells, many of which replicate their DNA and divide regularly. It's only a matter of time until one of those cells randomly accumulates the wrong set of mutations, and loses the molecular brakes that restrict uncontrolled growth.

Strictly speaking, the idea is correct. That is how cancer begins. However, there's another check in place that operates outside the cancer cell itself: the immune system. A properly functioning immune system can recognize and destroy cancerous cells before they become dangerous to the organism. In fact, your immune system has probably already controlled or destroyed a number of them in your lifetime.

I recently read a fascinating account of some preliminary findings from the lab of Dr. Zheng Cui at Wake Forest university. His group took blood samples from 100 people and purified a type of immune cell called the granulocyte. They then evaluated the granulocytes' ability to kill cervical cancer cells in a cell culture dish. They found that it varied dramatically from one individual to another. One person's granulocytes killed 97% of the cancer cells in 24 hours, while another person's killed 2%.

They found some important trends. Granulocytes from people over 50 years old had a reduced ability to kill cancer cells, as did granulocytes from people with cancer. This raises the possibility that cancer is not simply the result of getting too old, but a very specific weakening of the immune system.

The most important finding, however, was that the granulocytes' kung-fu grip declined dramatically during the winter months. Here's Dr. Cui:

Nobody seems to have any cancer-killing ability during the
winter months from November to April.

Hmm, I wonder why that could be?? Vitamin D anyone??

Zoonotic diseases: Or why it’s best that your dog doesn’t lick your face

Ever wonder if it’s okay to let your best friend — the furry one who pads around your house on four legs — lick your face or share your spoon?

Probably not, says Lonnie King, DVM, senior veterinarian at the Centers for Disease Control and Prevention, who spoke with APHA’s Get Ready campaign about zoonotic diseases recently. Which brings up another question: What in the world is a zoonotic disease? The word “zoo” sort of makes you think of the zoo — the place you go to see elephants and giraffes without having to go on a safari in South Africa. The word “zoonotic” has its roots in Greek and means animal diseases. Zoonotic diseases are naturally occurring diseases that can be transmitted from or through animals to people.

About 75 percent of recent emerging infectious diseases affecting humans are diseases of animal origin, says King, who is director of CDC’s director of CDC’s National Center for Zoonotic, Vector-Borne and Enteric Diseases.

So when it comes to deciding whether or not it’s okay to let Fluffy or Fido get close, it’s best to use common sense, King says.

“We love our pets, and the benefits that we get from the human-animal bond…helps our psychological well being,” King says in an exclusive online Q&A with the Get Ready campaign.

But dogs, cats, birds and turtles, among other cute critters, can transmit diseases like toxoplasmosis, salmonella, roundworms and hookworms, to name a few.

“Don’t be so overly concerned that you miss out on the wonderful benefits of your pets as companions and the richness they add to your life,” King advises. “Just understand that they are a potential source of threats — not a high risk — but you need to use precautions.”

By the way, there are also some diseases that Fluffy and Fido can catch from you.

The full Q&A with King on zoonotic diseases is online now on the Get Ready Web site.