Where's the War on Alzheimer's?

I saw this excellent article in the  Jan/Feb 2015 AARP Bulletin by T.R.Reid concerning the rapid growth of Alzheimer's in the country, and the relative lack of expenditure by the Government to try and find a prevention or cure for the disease.
See this link: AARP Bulletin - January/February 2015 - Page 14-15
The article shows projections of over 13 million patients costing over a trillion dollars per year to care for by 2045.  It also points out that there has NEVER been any patient cured of the disease.   Meanwhile, the US Government is spending around $566 Million on research into the cause and cure of Alzheimer's disease.
Spending on research can sometimes be a waste.  For example, there are some problems that we could dump immense amounts of money to solve, but there are no viable paths to study.  So spending more money would generally result in massive waste. .  In the case of Alzheimer's however, according to this article there are some potentially fruitful studies that could be done to hopefully find a cure.  The Alzheimer's association believes that there is a need for about $2 Billion in spending per year to get to a cure.
As in many cases of spending on research, it is a gamble.  By putting money into research, we would be betting that a cure would be found that would avoid the costs in dollars and lost lives that would more than pay off in the long run.  If AARPs projections are correct, expending $2 Billion per year now could help avoid some or all of the possible $1 Trillion/per year in future cost.  That sounds like a good payoff!  I really think the US should be spending more on this important problem.  It should be at least proportional to the impact of the disease on the US population.  Apparently we're spending $5.4 Billion on cancer, and $1.2 Billion on heart disease, and the cost impact of those diseases is probably lower than the cost impact of Alzheimer's disease.  Below are the costs in 2014 of the disease in the United States according to the Alzheimer's Association

Sadly, the article points out that many of the existing medications and therapies don't work all that well in slowing down the progress of the disease.  At one time it was thought that daily aspirin, daily physical exercise, and brain exercise puzzles might prevent the disease.  But none of these appeared to have any statistical significance in tests. The world needs a medical solution to the problem!

In Sep 2015, Bradley Fikes of Union Tribune reported on a new breakthrough in the understanding of how Alzheimer's works in the brain, which will hopefully lead to new techniques to prevent or cure the disease.  

I would think that the rest of the world is experiencing the same problem with the rising cost of this horrible disease.  Therefore, other countries should be more than willing to share in the cost and participating in the research.  I wonder if there are international efforts to coordinate research so we can minimize waste and share findings.  However, I would bet that "big pharma" is also working hard on this problem.  If one of the companies does discover a "magic pill" that could prevent a person from getting the disease, or cure a patient with the disease, it could be worth a lot!  However, I hope we don't get into a situation where the treatment could cost $100,000 per patient.

‘America’s Bitter Pill,’ by Steven Brill - NYTimes.com

I saw 60 minutes this evening where Leslie Stahl interviewed Steven Brill of the New York Times.  Apparently he has written a new book about how the medical "industry" is now making huge profits from Obamacare --even "non profit" hospital businesses are "profiting" by paying their executives extremely high salaries, which, in turn drives up the costs.

Here is a link to the book review.

‘America’s Bitter Pill,’ by Steven Brill - NYTimes.com


After seeing this 60 minutes piece and reading the book review, I also read the book.  On the surface, the book is simply a chronological description of the development, passing and implementation of the Affordable Care Act.  It doesn't sound too exciting?    It describes step-by-step who was involved in the development and writing of the law, how it got modified in order to pass, and then how the implementation of the law unfolded, including the development of the healthcare.gov website.  However, I did find it somewhat exciting even though I knew what happened.  Brill was able to make the story interesting by providing some personal information about each of the major players, so we understood better about the motivations behind each individuals position or role.

I think  it is a shame that all of our US Congress and Senators didn't pull together to help develop the Affordable Care Act in a cooperative spirit.  Yes, it is possible that there are flaws in the law.  It may have been better if all sides worked to make necessary corrections.  After the act was passed, and problems were identified, it would have been good to have congress pass minor changes to the act to make those necessary corrections.  As it is, hundreds of millions of dollars and tens of thousands of hours have been spent fighting against the act and wasting lawyers and judges time on somewhat trivial problems or flaws in the wording.

I don't understand who is against the act, or who is behind the vehement effort the Republicans have mounted to fight against the law.  I can't see how any businesses involved in the health care industry would be against it.  They are ALL making lots of money, as are the CEOs.  Hospitals, insurance companies, doctors, pharmaceuticals, medical device manufacturers are all making seemingly windfall profits from the law.  States are getting assistance from the Federal Government to improve the health of all of their citizens.  More of our citizens are now contributing to their own health care by paying for their insurance.  Because more people have insurance, more Americans are able to obtain preventative health care which should eventually reduce the overall cost.  What is not to like?  I have tried to read and listen to the complaints issued by the Republican Party as they have continually tried to stop or repeal the Affordable Care Act with many different parliamentary and legal procedures.  They all say it is bad --but they never have been able to explain why and even when they have presented alternative approaches, it is clear that the alternatives have not been thought through.   

Red meat cancer link explained --and additional research still needed

San Diego Union Tribune had a front page article by Bradley Fikes that explains new research concerning the link between red meat and cancer:  Red meat cancer link explained | UTSanDiego.com. I also found UCSD article.

The UC San Diego study was led by: Dr Ajit Varki, and was published in the Proceedings of the National Academy of Sciences and this link is to the abstract of the report:

http://www.pnas.org/content/early/2014/12/25/1417508112.abstract.  The incidence of cancer increases due to the presence of a compound called Neu5Gc (also called "

N-Glycolylneuraminic acid" that is present in red meat.  The research appears to have been performed very carefully with the necessary proper discipline, however after publishing, there still could be peer review findings that could indicate errors in the research tests or reported results.

It seems that this research might be a major breakthrough, and it can help dispel the many dietary myths and recommendations that have built up concerning the eating of red meat.  For example, the concern that has been reported for many years about eating grilled meats as worse than "stewed" meats. It also seems to explain why vegetarians who avoid dairy products can reduce the probability of getting cancer.  Certain dairy products and cheeses  (goat cheeses?) have the Neu5Gc compound.  Fish are OK, except for fish eggs!  Who knew?

The report also says that possibly eating red meat while we are young is OK, but as we get older, the bad effects of eating it has a higher probability of leading to cancer.  I can see how this might make sense from a biological and an anthropological standpoint.

The good news is that now that we are gaining an understanding of the cause, we may be able to develop types of animals who produce little or no Neu5Gc in their bodies, or develop "antidote" foods or food supplements which could neutralize the Neu5Gc compound in the meat, or in our digestive tract.

I think there are other studies that will probably be performed to help us design good diets.   If a person has an ounce or so per week, is that just as bad as eating a couple of pounds per week?  Are those of us who have eaten red meat all of our lives "doomed?"  --or is there "salvation" in becoming a vegetarian now?  Below are some studies that I believe NIH and the livestock industry may want to fund and start working on ASAP:

• What is the dose sensitivity of the body to Neu5GC?  
• How much red meat would cause all cells of our body to contain Neu5Gc? 
• If we stop eating red meat, will the residual Neu5Gc in our body's cells gradually diminish?  How fast does it go away?
• How far down does the amount of Neu5Gc in our body have to go before the cancer risk becomes negligible from this cause, of course
• The testing techniques for measuring the amount of Neu5Gc in foods and in animal cells (human cells) appears to be complex and expensive using chromatograms.  Are there possible techniques that are quicker and easier to perform that provide adequate measurement for clinical use? 
• The research seemed to test only the amount in animal's liver. The research indicated it may be higher in liver, prostate, and several other locations. What is the typical distribution of Neu5Gc in human organs? Is it evenly distributed in all organs? Or does it concentrate in certain ones?
• Can the amount in a person's body be estimated by taking a biopsy, a blood sample, urine sample, or saliva?
• Are there chemicals, drugs, food supplements, cooking methods, or other techniques that reduce the amount of Neu5GC in the food, or that is absorbed into our body?
• Are there chemicals, drugs, food supplements that will help our body eliminate Neu5Gc from our body?
• Are there parts of red meat animals that have more, or less amounts of the Neu5Gc? For example is there more in fat, organ meat, broth?
• Is there some way of reducing the amount of Neu5GC in red meat animals (feed, exercise, breeding, or other types of care?  
• How long after stopping eating of red meat does it take for our body to be free of  Neu5GC?
• If we eat small amounts of red meat or red meat byproducts, (gelatin, broth, flavoring in french fries for example) will we be exposed to Neu5GC?  Will our body then have as much as if we ate a lot of red meat? Or do we have to go completely "vegan" to avoid even accidental ingestion of residual amounts.
• What is the "age curve" vs probability of getting cancer from having Neu5GC in our bodies? The research was done using mice and autopsy at 85 weeks near end of life. If they had eaten red meat while young but none after middle age, would that reduce the probability of cancer a lot? Or only a little bit?

I think it will take many years for more definitive research to be done.  I also suspect that the red meat industry will try dis-information campaigns similar to what the tobacco and anti-global warming group did.  That type of modest campaign will spread doubt about the research, and slow down spending on research about this process,   It will also take a long time to see the effect of this research on the recommendations of nutrionists.  There are some, however,who are already expressing concern about red meat -- but generally they are already vegetarians who are in the "told you so" mode.  See this Dr. Mirkin website as example.

It is also interesting to learn the archeological history of Neu5Gc in humans and other animals.  See this article on phys.org website.  Human ancestors used to make their own Neu5Gc, but between 2 and 3 million years ago, they lost that capability.

STUDY: RED WINE CHEMICAL ACTIVATES RESPONSE | UTSanDiego.com

I've been following the studies on the benefits of  red wine and resveratrol for several years.  There were several well designed studies done that demonstrated that taking resveratrol, a compound found in red wine, blueberries, raspberries and chocolate, mice and rats would have longer lifespans.  Recent research was done by Paul Schimmel and Matthew Sajish at The Scripps Research Institute (TSRI).  This article in today's San Diego Union Tribune by Bradley Fikes summarizes the research and explains that we now have a better understanding of the actual mechanism behind how resveratrol works in the body--and the mechanisms of the cell's DNA.

STUDY: RED WINE CHEMICAL ACTIVATES RESPONSE | UTSanDiego.com

From the studies done several years ago with mice, it appeared that if humans wanted to get health benefits from resveratrol, they would need to take huge amounts of the stuff to be comparable to the amounts that were fed to mice.  However, according to these latest studies, apparently only a very small amount of the resveratrol is needed to trigger the good effects of the chemical.

So maybe a glass of red wine with dinner each night is the key to the success of the  "Mediterranean diet." and the answer to the "French Paradox" too!

Police in This City Have Shot More than 90 Dogs Since 2011

It is interesting to see that police departments also have an "unequal" performance when it comes to shooting dogs.  See this article in "The Blaze" written by Elizabeth Kreft:  Police in This City Have Shot More than 90 Dogs Since 2011 | Video | TheBlaze.com.  In some cities, the rate of dog shootings is very low, in other cities, the rates are very high.  That could be due to differences in police training, or could be differences in the area's pet preferences.  For example, are there more pit bulls in buffalo as a percentage of population than New York, where more people have little yorkies, or miniature poodles?  It is very difficult to determine the source of the problem from the few statistics that are maintained and provided.

It is not surprising that so many of the dog-shooting situations seem to involve police actions for drug-enforcement.  If police departments didn't have to enforce the bans on "recreational" drugs, they would have very little to do.  Much of their activity, even during routine traffic stops, involves searching for illegal drugs or use of alcohol (DUI). The war on drugs has forced illegal drug dealers to handle large amounts of money, and caused them to carry weapons and keep attack dogs for protection.  That, in turn, requires the police to also be more heavily armed, and forces them to be more alert and aggressive when approaching suspects.  A fierce, barking dog increases the confusion level during the confrontation and actually increases the chances of making a more serious mistake (like shooting a human suspect).

It is also interesting that apparently it is easier to get statistics from the police departments concerning the number of dogs shot than it is to get similar numbers for how many HUMANS that the police have shot.  I think that every time any police, FBI, Homeland Security, Coast Guard employee fires a weapon in the line of duty (other than training), the purpose of the shooting should be recorded and reported in a Federal, public-accessible database.  That information is essential for proper management of our law-enforcement resources.  Do we need better training?  Better or different types of weapons?  Changes in procedures?

We really do need to call a "truce" on the war on drugs that has gone on for far too long.  When prohibition ended, it allows a reduction in the costs for FBI and police, and eliminated a huge amount of graft and corruption in those departments.  Yes, the effect was that we had more alcoholics on the road, and more families destroyed by alcoholism.  It was not a simple decision.  De-escalating the drug war is a good first step.  By decriminalizing marijuana in some states, we might be able to see if that reduces the amount of drug-related crime in those states?  Or will it lead to more crime and will more people switch to more dangerous forms of "illegal" recreational drugs?  For 50 years, the police and right-wingers have said that marijuana was a "gateway" drug that leads people to harder drugs -- this will be an opportunity for the country to see if that was true.

 

New therapies give hope to Alzheimer’s patients | UTSanDiego.com

Article in today's Union Tribune about Alzheimer's disease, and some promising drug trials to cure or slow the progress of early Alzheimer's disease.



New therapies give hope to Alzheimer’s patients | UTSanDiego.com

I just saw this article on Scientific American.
I think we are starting to realize more and more the complexity of the organisms that live in our gut.  This article is almost counterintuitive concerning the artificial sweetteners.

Here is a link to it:  http://www.scientificamerican.com/article/sugar-substitutes-linked-to-obesity/

Here is the text of the article:

Sugar Substitutes Linked to Obesity

Artificial sweeteners seem to change the microbiomes of our guts

Sep 17, 2014 |By Alison Abbott and Nature magazine

This is the first work to suggest that sweeteners might be exacerbating metabolic disease. 
Credit: Joel Penner via flickr

The artificial sweeteners that are widely seen as a way to combat obesity and diabetes could, in part, be contributing to the global epidemic of these conditions.

Sugar substitutes such as saccharin might aggravate these metabolic disorders by acting on bacteria in the human gut, according to a study published by Nature this week (J. Suez et al. Naturehttp://dx.doi.org/10.1038/nature13793; 2014). Smaller studies have previously purported to show an association between the use of artificial sweeteners and the occurrence of metabolic disorders. This is the first work to suggest that sweeteners might be exacerbating metabolic disease, and that this might happen through the gut microbiome, the diverse community of bacteria in the human intestines. “It’s counter-intuitive — no one expected it because it never occurred to them to look,” says Martin Blaser, a microbiologist at New York University.

The findings could cause a headache for the food industry. According to BCC Research, a market-research company in Wellesley, Massachusetts, the market for artificial sweeteners is booming. And regulatory agencies, which track the safety of food additives, including artificial sweeteners, have not flagged such a link to metabolic disorders. In response to the latest findings, Stephen Pagani, a spokesman for the European Food Safety Authority (EFSA) in Parma, Italy, says that, as with all new data, the agency “will decide in due course whether they should be brought to the attention of panel experts for review”.

A team led by Eran Elinav of the Weizmann Institute of Science in Rehovot, Israel, fed mice various sweeteners — saccharin, sucralose and aspartame — and found that after 11 weeks, the animals displayed glucose intolerance, a marker of propensity for metabolic disorders.

To simulate the real-world situation of people with varying risks of these diseases, the team fed some mice a normal diet, and some a high-fat diet, and spiked their water either with glucose alone, or with glucose and one of the sweeteners, saccharin. The mice fed saccharin developed a marked glucose intolerance compared to those fed only glucose. But when the animals were given antibiotics to kill their gut bacteria, glucose intolerance was prevented. And when the researchers transplanted faeces from the glucose-intolerant saccharin-fed mice into the guts of mice bred to have sterile intestines, those mice also became glucose intolerant, indicating that saccharin was causing the microbiome to become unhealthy.

Elinav’s team also used data from an on­going clinical nutrition study that has recruited nearly 400 people in Israel. The researchers noted a correlation between clinical signs of metabolic disorder — such as increasing weight or decreasing efficiency of glucose metabolism — and consumption of artificial sweeteners.

But “this is a bit chicken-and-egg”, says Elinav. “If you are putting on weight, you are more likely to turn to diet food. It doesn’t necessarily mean the diet food caused you to put on weight.”

So his team recruited seven lean and healthy volunteers, who did not normally use artificial sweeteners, for a small prospective study. The recruits consumed the maximum acceptable daily dose of artificial sweeteners for a week. Four became glucose intolerant, and their gut microbiomes shifted towards a balance already known to be associated with susceptibility to metabolic diseases, but the other three seemed to be resistant to saccharin’s effects. “This underlines the importance of personalized nutrition — not everyone is the same,” says Elinav.

He does not yet propose a mechanism for the effect of artificial sweeteners on the micro­biome. But, says Blaser, understanding how these compounds work on some species in the gut might “inspire us in developing new therapeutic approaches to metabolic disease”.

Yolanda Sanz, a nutritionist and vice-chair of the EFSA’s panel on dietetic products, nutrition and allergies, says that it is too soon to draw firm conclusions. Metabolic disorders have many causes, she points out, and the study is very small.

This article is reproduced with permission and was first published on September 17, 2014.