2014年11月24日 星期一

Hook Worms & Crohn's Disease: A Possible Treatment?

A hook worm grows in the small intestine of humans, cats, and dogs, growing and putting its host at risk for infection. Why would someone volunteer to be infected with hook worms? Patients undergo helminthic therapy to cure or control certain diseases, like Crohn’s.

Hook Worms

Helminthic Therapy

Helminthic therapy involves infecting a patient with worms from the helminth family, including hook worms and whipworms. Most of the time, the patient will receive an injection of the worm’s eggs via inoculation. This therapy is not only used to treat Crohn’s disease, but also multiple sclerosisasthma, and inflammatory bowel disease (IBD), among others.
Hook Worms & Crohn'sHook worms can sometimes cause itching and blistering in the patient, but this side effect is mostly just discomfort. Cutaneous larva migrans is a more concerning side effect, causing a “creeping eruption” that both reddens the skin and causes it to rise. The good news about hook worms is they generally don’t go much deeper than the skin, which helps prevent them from doing further damage.
In patients with diseases like Crohn’s, hook worms are thought to lessen the body’s autoimmune response to antigens, which in turn reduces infection in the gastrointestinal tract. Some researchers believe that because today’s children aren’t as exposed to infectious diseases as children were in past generations, the incidence of conditions such as Crohn’s in adults has increased. Treatments such as hook worm therapy are now necessary to restore the body’s natural autoimmune balance.
One major problem for Crohn’s patients looking for treatment is that often they will have to travel far to be infected with hook worms. Currently, only one clinic in Tijuana, Mexico, is providing hook worm treatment for Crohn’s. However, as more research is done, there may be an increase in the availability of hook worm therapy.

Helminthic Therapy in the U.S.

Currently, a company called Ovamed is working on getting the necessary approvals for helminthic therapy. In recent years, a San Diego company, Asphelia Pharmaceuticals, began working with Ovamed on researching various forms of helminthictherapy. Asphelia noted that patients infected with hook worms and other helminths tended to be less likely to get diseases such as multiple sclerosis and Crohn’s. The key, Asphelia says, is to find a helminth that has minimal side effects with multiple advantages. Hook worms may be the very helminth researchers are searching for. Aside from the skin issues mentioned above, hook worms can also cause diarrhea, anemia, and weight loss. However, these side effects are generally present in more severe infestations.

Hook Worm Therapy Research

Hook worms are also being researched by a University of Nottingham researcher in England. While hook worms are dangerous in the tropics where infestations are common, scientist David Pritchard had no problems among his patients in controlled experiments, he says. Because the hook worms are instituted in such small numbers, the risks of anemia and infection are smaller, so patients are able to reap benefits without concern of major side effects.
In his tests, Dr. Pritchard found that his subjects showed lower amounts of inflammation in the intestines, which was measured by testing the T-cells of study participants. Those participating in the study also noticed that their allergy symptoms began disappearing. As word spread of the work Dr. Pritchard was doing, he was able to extend his research to other allergy sufferers and he soon became known as the first helminthic therapy researcher to actually infect his subjects with hook worms.
The long-term goal of Dr. Pritchard and other researchers is to track down the reason hook worms and other helminths are so effective, to possibly develop less invasive ways of treating patients suffering from immune system disorders. While many patients may cringe at the thought of being infected with hook worms, the fact that they work in treating patients with asthma, allergies, and other issues should not be minimized.

Side Effects of Hook Worm Therapy

Over time, hook worms can cause side effects that can be more dangerous, including increased risk for anemia. Protein deficiency can also develop, leading to an impairment of mental functioning  and stunting physical growth in some patients. Medications are available to offset these side effects and patients undergoing hook worm therapy may be prescribed iron supplements if anemia is present.

2014年11月11日 星期二

港人攝入鹽糖份量過高

星島日報 – 2014年11月11日

食物安全中心表示,港人對鹽與糖的攝入量高,平均每人每日攝入約9克鹽,是世界衛生組織建議的2倍。
食安中心顧問醫生何玉賢表示,根據世衛建議的標準,每人每日可攝取不超過5克的鹽及50克的糖,攝取過量會增加患高血壓、心臟病及中風的風險。
降低香港食物中的納和糖國際諮詢委員會提議,抽樣調查港人對鹽與糖的攝取量,再制訂具體政策,又建議當局與食物業界商討,研究在製作食物過程中要少鹽少糖。

Sugar vs Fat on BBC: Which is Worse?

Sugar or fat, which is worse? That’s the question in the BBC documentary “Sugar vs. Fat” that aired the other night. And it’s been a long time since I got so many e-mails asking me for comments!
It’s an interesting setup. Two identical twin brothers – both of them doctors – go on a diet for a month. One on an extreme low fat diet, one on an extreme low carb diet (not even vegetables are allowed!). Here’s some background information:
You can watch the show online here if you’re in the UK or watch a lower-quality copy on YouTube if you’re not.
Unfortunately they end up mostly “confirming” their preconceived ideas. Ready? Here comes the spoilers:

Result

Obviously when there is only one person on each diet, chance plays a big role. But I think the findings were more or less what could be expected, it’s mostly the ignorant (or TV-drama) explanations I have objections to.
Weight
First thing first. Even though both brothers were at a fairly decent weight to start with, the low-carb brother lost the most weight: 4 kg (9 pounds) vs only 1 kg (2 pounds) for the low-fat brother.
As study after study show more effective weight loss on a low-carb diet, this should be no surprise. The loss of fat was 1,5 kg on low-carb (a good result in a month) and 0,5 kg on low-fat. Most of the rest was probably fluid. On a very strict low-carb diet you quickly lose a kilo or two of glycogen and water weight.
How much – if any – muscle mass the participants lost is impossible to know as the BodPod test only measures fat mass vs. non-fat mass (including water).
Brain function
For testing the brain function of the brothers the producers chose to make them do stock trading with fake money.
This shows that the producer is ignorant or just interested in a dramatic show. Why? Because short-term stock trading – without insider info or other illegal tricks – is a game of pure chance. It’s been convincingly shown that a trained monkey has a 50% chance of beating a well-educated stock broker. Why? Because it’s all chance.
In other words this test is rubbish, but the low-fat brother wins.
More interesting and relevant is that the low-carb brother complains of feeling “thick-headed”. I’m sure he’s honest. Going on an extreme low-carb diet – without even vegetables – can absolutely result in problems concentrating etc. for a week or even more, before the body and brain adapts to burning fat and ketones.
This problem can often be partially avoided by increasing the intake of fluid and salt. And after a week or two it’s normally gone.
Exercise
For testing their exercise capacity the brothers do “long sessions of uphill cycling”. The low-carb brother predictably loses badly.
Why? Two things: the body needs weeks or sometimes even months to adapt to high-intensity exercise, using mostly fat and ketones. And even then you might need a little bit of carbs for explosive and anaerobic sports like this.
I’ve interviewed Dr Peter Attia who successfully races his bicycle for hours on a very low-carb diet. Even he uses a little bit of slow-release starch for maximum performance on his long training sessions:
Diabetes
Finally the icing on the (diabetes) cake. The doctor claims that the low-carb brother has become “almost” pre-diabetic by eating low-carb! The word “almost” should actually be interpreted as “not”. I wonder if the doctor knows the first thing about low-carb and diabetes. In fact I wonder how much he knows about diabetes at all.
The low-carb brother has a fasting glucose of 5,1 before the diet (normal) and a fasting glucose of 5,9 after the diet (normal). Did you catch the word “normal” twice? Yes, thats right, a fasting glucose of up to 6,0 mmol/L is considered normal, at least in Sweden. It also varies significantly from day to day. If we tested the doctors’s own fasting blood glucose it might be 5,9 today and 5,1 tomorrow.
The result could be due to chance but sometimes the fasting glucose level actually gets slightly higher on an LCHF diet, while the glucose levels during the day (after meals) is way lower. This is probably because the body is adapted to burning fat and so the need for burning glucose when fasting is lower. Thus you don’t get the same fasting “dip” in sugar levels.
They also did glucose tolerance tests – a much more relevant test. But the result of the low-carb brother is never mentioned. I guess it was normal.
The fact that diabetes is effectively treated with a low-carb diet should tell us everything we need to know. You don’t get type 2 diabetes by eating a diet that can cure diabetes. And you certainly don’t get type 2 diabetes (strongly correlated to obesity) by losing 4 kilos of excess weight in a month.

Summary

The documentary concludes that it’s not about fat or sugar, it’s about avoiding processed food with both fat and sugar in it. I’m sure that strategy would work fine for these two fairly fit brothers. It’s an excellent start. But it’s not enough for everybody.
Finally, while a super-strict low-carb diet is not necessary for everyone and has possible side-effects (especially during the first week or two) it certainly do not result in diabetes. That’s just ignorant.

2014年11月5日 星期三

研究:輪班工作逾10年很傷腦

法新社 – 2014年11月4日
(法新社巴黎3日電) 研究今天指出,從事輪班工作10年以上的人,可能會出現腦力與記憶喪失的情況,這份研究同時警告這類高風險工作的安全隱憂。 根據這篇發表在「職業與環境醫學」(Occupational & Environmental Medicine)期刊的研究,大腦功能的影響可以回復,但可能得要至少5年時間。 這是凸顯輪班工作危險性的最新研究。由於輪班工作會打亂生理時鐘,先前研究認為和潰瘍、心血管疾病與某些癌症有關,但學界對於大腦功能的影響則少有探討。 研究人員分別在1996年、2001年與2006年,測驗法國南部各類部門3000多名現任或退休員工的長期與短期記憶、大腦處理速度與整體認知功能。 研究對象約有半數從事輪班工作,研究人員比較兩組幾次的測驗結果後發現,輪班工作和「慢性的認知功能損害」有關。 研究說,從事10年以上輪班工作和認知損害的關聯性更為強烈,相當於早了6.5年和年齡有關的腦部退化。 數據也顯示,「在離開輪班工作後,認知功能需要至少5年才能恢復」。(譯者:中央社陳怡君)

2014年11月4日 星期二

教出最快樂孩子 有秘訣

教出最快樂孩子 有秘訣經濟日報專訊】教出快樂的孩子,哪有父母不想?全球最快樂兒童,得分最高是荷蘭,秘訣在大人願放手,讓孩子在生活中有得揀。說得容易,但對子女由細管到大的直升機父母,要做到便有難度。
大人願放手 孩子生活有得揀
孩子應該快快樂樂的成長,沒有人會對此有異議,但近年看着香港的孩子變成「大忙人」,與父母長輩當年同年齡相比,他們懂得更多、享受更多,但快樂的時間呢?今年嶺南大學的兒童快樂指數調查顯示,兒童的快樂指數隨年齡增長而下降,學習壓力大、空閒時間少等都是影響其快樂的重要因素。
教出樣樣要叻的孩子,是不少父母的人生目標,有沒有想過,不如教出一個最快樂的孩子?
聯合國兒童基金會去年發表報告,以兒童貧窮率、肥胖率、教育普及率等數據,評比29個先進國家的兒童快樂排名,首五名全部來自歐洲,其中荷蘭的小朋友,被譽為全球最快樂。
當評估全球學生學習能力權威的指標PISA,公布名列前茅的是芬蘭,全球專家一窩鋒研究當地成功的秘訣,但同樣是全球第一,則大家又有否興趣知道教出最快樂小孩,關鍵是甚麼?
台灣《遠見雜誌》本月號的報道,便綜合荷蘭孩子的快樂模式,文章指,曾經在當地一所中學,問全班近30名孩子是否快樂,結果只得兩人沒有舉手,其他都爭着說有趣的事。
其實,孩子的世界很簡單,不是在家,就是在學校,快樂不快樂,亦離不開這兩個地方。
不公布成績排名 學習壓力小
該報道指荷蘭的孩子在學校快樂,因為學習壓力小,初入小學幾乎都是玩,中、高年班才開始有些功課,學校不公布學生成績排名,以免比較。相對於中國傳統望子成龍心態,西方少來這一套,當地的父母也不着重孩子一定要上最好的學校,少見有虎爸或虎媽。一名中文老師分享,荷蘭父母認為,催谷孩子太急,摔下來可能更傷。
教育是為了讓孩子成為快樂的人,所以當年無論是在學校或家庭,也認為教養的手段和方法也應以快樂為重,孩子會爭著說自己快樂,這些笑臉,可不是鬥高分數或再多興趣班可換得來的。
固然,各地的教育制度及文化不同,硬要比較或許也不公道,但期望孩子快樂成長,應該人同此心。但若換了在香港,也問問孩子快樂嗎?答案如何,不用多說吧?本港孩子是如何成長的?愈來愈令人看得心痛,學習壓力愈來愈大、空閒玩樂的時間減少,快樂愈來愈少,又有何出奇?
讓孩子快樂的方法,沒有全球通用的方程式,教育制度,也不是人人有很多選擇。不過,《遠見雜誌》引述荷蘭一位專門研究快樂的學者Rutt Veehoven,提出其中一點父母可以做到的,就是讓孩子有更多選擇的自由。
參加甚麼課外活動、與甚麼同學玩,升學讀甚麼學校,荷蘭的父母,很少強迫孩子做不鍾意的事,鼓勵他們做喜歡的事、看書也可看自己喜歡的書。
所謂讓孩子快樂的秘訣,聽來也不是甚麼特別事情,但這正正可能對於香港的孩子,愈來愈陌生。
港孩日常生活 多由父母決定
香港的父母都是緊張大師,對於孩子的日常生活幾乎包辦所有話事權,事無大小,由細到大,甚至到大學升學,也是父母的決定。怪獸家長,又或直升機家長也好,心態上是為孩子好,惟恐不自小催谷,就會輸掉人生,但最終卻只落得成為虎媽虎爸,也苦了孩子。
美國學者Jim Taylor便曾撰文指,讓孩子自主決定重要,不止學習下決定的技巧,且作出好的決定後,也讓他們得到滿足感與成功感。
本港今年亦有調查訪問逾千名小四至中三學童的調查,有逾四成對父母擅自為其做決定感到反感。
父母望子成龍,誰不想自己的孩子跑贏?在香港,面對教育競賽的氛圍下,父母愈來愈難當,如何教出快樂的孩子,或許確實是大難題。