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Do statins prolong life? Not if you don’t already have heart disease

February 14, 2008 by bobleckridge

Prescribing statins (lipid lowering drugs) prophylactically to try to reduce heart attacks has become big, big business. Just one drug, Lipitor, made by Pfizer, made $12.7 BILLION of sales last year alone. Health Insurance companies in the US, and the national GP contract in the UK reward doctors for putting patients with “high” cholesterol onto statins to produce lower blood levels in those patients. But does this do any good?

Many studies have shown that if you prescribe statins to people who have had a heart attack, then you are likely to reduce the rate of death from strokes and further heart attacks. For every 28 patients over 65 with heart disease who take statins, one life will be saved. The population based West of Scotland study showed you needed to treat 715 men to save one life.

However, studies of those without heart disease, and those aged over 70, have failed to show any significant lowering of mortality from the consumption of statins.

There are two other problems with statins – firstly, if they do what they say they do, they will reduce deaths from heart disease. What they don’t do is improve the quality of life of those who take them. Secondly, many experts believe the incidence and severity of side-effects from taking statins for many years is unknown, and probably underestimated.

We are right to be sceptical of drug company sponsored “evidence” when considering mass treatment of healthy individuals whose cholesterol level happens to fall outside the promoted “norms”. This is a problem which is widespread in medicine. A finding from one group of patients is turned into “evidence” and is then applied widely to groups of the population who are significantly different from the experimental group.

Posted in from the consulting room, health | 4 Comments »

Creativity the Medici Effect way

February 13, 2008 by bobleckridge

The Medici Effect by Frans Johansson (ISBN 978-1-4221-0282-4) says on the front “If you can’t read it and come up with at least a minor Mona Lisa or two, you’re not trying”. Pretty enticing, huh? Well, so far, it hasn’t done that for me. Am I not trying? Well, actually, as Johansson shows, just reading about something isn’t enough. You have to turn your reading into actions.

The front cover quote is kind of misleading – this is an inspiring book but it certainly isn’t a “how to do it” kind of book.

The Medici Effect is an exploration of a single, simple concept – the intersection. The author’s claim is that innovation and creativity flourishes in the intersections. What intersections? Where different disciplines come together in the same team or project; where cultures meet; where languages meet. This concept reminds me strongly of the network science ideas which I read about in the fabulously inspiring “Linked“.

I think it’s very true. Some of my most creative times come around my visits to France and Japan. I spend most of my holiday leave in France and I love to go to the bookshops and the newsagents. The French publish utterly different magazines and books from the kind I find anywhere else in the world, and there is something about their perspective which I find so different from the one I find in the UK. In fact, for me, there’s something about reading French which is stimulating and exciting. I also visit Japan a couple of times a year and there the culture, the architecture, the contrasts of the spiritually ancient and the gaudy new sitting side by side, the design ethos focussed on transience and the constant dynamism of change, I find totally inspiring. When I go to Japan, I teach, with the aid of an interpreter which slows down my presentation style and gives me much more time to reflect. I come up with a new way to communicate something every time I go there.

The Medici Effect is what happens when you bring together diverse influences, and Johansson makes the claim that creativity and innovation is, in the final analysis, something that happens randomly. He gives the example of Edgar Allen Poe, who used to randomly choose three words from the dictionary and try to tie them together to make a new story.

As well as the valuing of difference and diversity which challenges and shifts our perspectives and stimulates our creative flow, Frans Johansson recommends abundance. He gives the example of Joyce Carol Oates, who published 45 novels, 39 collections of stories, 8 poetry collections, 5 dramas and 9 essay collections in four decades.

I especially liked his point that to be an innovative person you can’t just come up with ideas, you have to come up with ideas which are valuable and which are taken up by society or by other people. That seems so true to me. The truly creative people produce. They don’t just think. They do.

Posted in books, creativity, from the reading room | 6 Comments »

Flower bed in Ikebukuro

February 12, 2008 by bobleckridge

brassica

Isn’t this an interestingly different flower bed in the middle of the busy Ikebukuro district of Tokyo?

flower bed ikebukuro

Posted in from the dark room, photography | 8 Comments »

The use of music to understand scientific experiments

February 12, 2008 by bobleckridge

Sometimes scientific experiments and findings can be really beautiful. When this happens we see a real cross-over from science to art. I recently came across a rather technical study from the field of quantum mechanics. Researchers have used a laser to study the wave patterns of movement of nuclei inside hydrogen molecules. As well as producing amazing colourful images which clearly show exactly the phenomena revealed in the experiment, the scientists produced an acoustic version relating the frequencies at the subatomic level to frequencies which we can hear, so letting us understand what’s going on using the musical analogy of notes and chords. The whole experiment is reported here. Do scroll down to reference 2 which gives a clickable link to a short movie file where you can see and hear what happens.

Posted in from the reading room, science | 2 Comments »

A view of the hills

February 11, 2008 by bobleckridge

I like to look out onto the hills every morning. You’ve maybe seen some of my photos that I’ve taken from my living room windows. In Tokyo, it’s not so easy to see the hills but when I looked really to the side out of my hotel room window, I could see them. Oh, yes, there they are!

hills beyond tokyo

Posted in from the dark room, photography | 4 Comments »

An Eater’s Manifesto

February 10, 2008 by bobleckridge

Michael Pollan has written a Change This Manifesto about his new book “In Defence of Food”. I love the opening line –

Eat food. Not too much. Mostly plants. That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy.

In a three part book, he attacks the dominance of “experts” who promote a reductionist idea of nutrition based on components which are not foods; the Western diet with its imbalances and overload of processed foods; and sums up with 12 commandments to escape from the effects of the Western diet.

Essentially, he is arguing for us to eat whole foods, not industriously produced so-called foods which are manufactured from components; to enjoy our eating as a social experience; and for us to eat more fruit and veg, and less meat. The conclusions then are not ground-breaking but I like the simplicity of the message and the call to treat food as food, not as some utility, and to enjoy the sharing of meals.

Posted in from the reading room, health | Tagged | 5 Comments »

The home of electronics?

February 9, 2008 by bobleckridge

As the sun set over Tokyo I snapped this photo of the coppery-reddish sunlight illuminating this office block. It looked like a massive silicon chip or computer motherboard and, somehow, I thought that was really apt.

office ikebukuro

Posted in from the dark room, photography | 2 Comments »

Sky high window cleaning

February 8, 2008 by bobleckridge

I looked out of the window of my 18th floor hotel room in Tokyo and saw these guys cleaning the windows.

I loved the glass, the reflections and the sight of the two men perched up there…..I wonder how long it takes them to clean ALL those windows?

windowcleaning

Posted in from the dark room, photography | 2 Comments »

The Randy Pausch “Last Lecture”

February 8, 2008 by bobleckridge

Wow! This could be one of the best talks I’ve ever heard. Randy Pausch is a computer science professor at Carnegie Mellon. They run a lecture series entitled “The Last Lecture” where a professor imagines what he’d say if he only had one lecture left to give before he died. Randy Pausch was diagnosed with terminal pancreatic cancer not long before giving this lecture.

He called the lecture “Really Achieving your Childhood Dreams”. It’s funny, it’s inspiring and it’s deeply moving. Here is the video of the lecture. It runs for just over an hour, so I urge you to sit down, relax and watch it through. The hour will fly past, I promise you. And you’ll be SO glad you took the time to watch it.

If you’ve been as impressed by this as I was, you can find out a lot more here.

Here’s a man who knows what it is to be a hero, not a zombie……..

Posted in from the viewing room, life, personal growth, video | 4 Comments »

The Surprising Diabetes Study – lower blood sugar doesn’t equal lower risks

February 8, 2008 by bobleckridge

There has been an accepted wisdom in the management of diabetes. Diabetes, as you probably know is a disease which presents with abnormally high levels of sugar in the blood. It’s actually a complex disease and involves much more than sugar levels but doctors, dietiticians and other experts have always worked on the premise that if you can “normalise” the patient’s blood sugar level, then you’ll reduce the risks they have of the serious harms that come with this disease. One of the most serious potential harms is death from heart disease. Now a study which has run for four years has come up with a totally surprising result.

Researchers took people who have “Type 2” diabetes (by far the commonest form of diabetes, and not the kind that usually required insulin treatment – that’s the kind that affects younger people mainly) and they randomly assigned them to different groups. The study is looking at management of sugar, cholesterol and blood pressure. The groups studied for sugar control were divided into an “intensive” control group and a “less intense” control group. The former group has had diet and drugs to try to maintain a blood sugar level the same as that found in people who don’t have diabetes. Everyone expected that the less well controlled group would suffer more heart disease but the study has just been stopped because so many more people in the “intensive” control group have died from heart disease than in the less well controlled group. This is totally contrary to expectations, and, so far, nobody has come up with an explanation.

The researchers are at pains to say that diabetics shouldn’t give up their drugs because we don’t yet understand what’s going on here and there is still clear evidence that blood sugar levels which go sky high pose a serious immediate risk to health.

Here’s the statement which really struck me though –

Clearly, people without diabetes are different from people who have diabetes and get their blood sugar low.

I suspect the answer to this puzzle will be found when that conclusion is taken on board. Human beings are just not like machines, and the idea that health can be achieved by managing to control the level of a single particular component of the body within an artificially set of “norms” is misguided. You don’t cure diabetes by assuming the only difference between a diabetic and a person without diabetes is the level of the blood sugar.

This is an excellent example of why we need to understand health and disease from a complexity perspective rather than a simplistic, reductionist one.

Posted in from the consulting room, health | 3 Comments »

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