Author Archives: Bix

First Autopsy Study Of An Okinawan Centenarian: Absence of Many Age-Related Diseases (Repost)

OkinawanDiet4

This photo of a centenarian from Okinawa (she’s not the woman in this study) is a still image from National Geographic’s video Secrets of Living Longer. It a great little video, very uplifting!

This is a fascinating discussion about the physical state of a 100-year-old woman from Okinawa at her death:

First Autopsy Study Of An Okinawan Centenarian: Absence of Many Age-Related Diseases, J Gerontol A Biol Sci Med Sci, 2004

Consistent with the compression-of-morbidity hypothesis, several studies have reported that a significant proportion of centenarians delay or escape age-related diseases. Of those who live with such diseases for a long time, many appear to do so with better functional status than do younger persons who do not achieve extreme old age. The authors describe the first autopsy in an Okinawan-Japanese centenarian who escaped many age-related illnesses and delayed frailty toward the end of her very long life.

CompressionOfMorbidityCurve“Compression of morbidity” refers to the compressing or shortening of time between illness and death. If there is a lot of compression, someone remains relatively healthy until a brief time before they die (green line in graph). If there is not much compression, someone becomes more sick and frail as they age (blue lines in graph). If you want a long healthy life, you need to postpone the onset of chronic disease (like diabetes, heart disease, cancer), as this woman did.

Here’s some background on this woman:

A 100-year-old woman came to Chubu Hospital in Okinawa, Japan because of shortness of breath. The patient had been healthy until very late in life, when, in short succession, she suffered a T7 compression fracture at age 92 years, two hip fractures at ages 97 and 98 years that were treated with prosthetic replacements, and bronchitis requiring 6 weeks’ hospitalization at age 99 years. She had no history of congestive heart failure, myocardial infarction, angina, stroke, hypertension, diabetes, tuberculosis, other pulmonary disease, or cancer. Cognitive impairment was first noted by her daughter and her physician at age 98 years. She did not take any medications. She lived her entire life in Okinawa, where she worked for many years as a farmer. As a young woman, she smoked 2 to 3 cigarettes per day, and she had no history of alcohol use. She used a wheelchair after the second hip fracture and depended on her family for assistance with all activities of daily living.

Note that the cognitive impairment did not occur until after her two major hip replacement surgeries. Surgery and exposure to anesthesia is known to disrupt brain function, especially in the elderly. I’m curious about that “2 to 3 cigarettes per day.” I wonder if they meant 2 to 3 packs, because you can be exposed to more background or second-hand smoke than just a couple cigarettes would give.

It looks like the cause of death, in the end, was pneumonia:

The patient was admitted to the hospital and received intravenous fluids and oxygen. … After 3 weeks in the hospital on antibiotic therapy, the patient became depressed, expressed thoughts of dying, and refused to eat. …The patient’s family requested that no aggressive measures be taken to prolong the patient’s life and that all phlebotomy stop. … Nearly 6 weeks after admission, the patient suddenly experienced loose bloody stools, her oxygen saturation rate quickly decreased to 60%, and she died.

And here’s a bit about her health at death:

That the patient’s coronary vessels were free of atherosclerotic narrowing and calcification is remarkable given autopsy reports on white centenarians (those aged 100 to 103 years) and other exceptional survivors (those aged 90 to 103 years), which show coronary vessel narrowing in 66% of patients and coronary calcification in 84% to 97% of patients (5,6). This finding is consistent with the low incidence of and mortality from cardiovascular disease in Okinawa compared with Japan overall and the United States (1,2,8).

The patient’s kidneys, like the heart and stomach, appeared remarkably healthy. The usual age-associated changes in kidney structure include loss of 30%–50% of cortical glomeruli by the seventh decade and sclerosis of up to 30% of the remaining glomeruli (13). In this case, 90% of the glomeruli had no sclerosis and there appeared to be no loss in total number.

Her heart, digestion, and kidneys were all healthy and could have provided additional years of high-quality life. Her weaknesses were her bones and her lungs. The authors suggest that her lung ailments developed through exposure to various environmental pollutants, e.g cigarette smoke and farming chemicals. They didn’t mention the extraordinary levels of toxic waste strewn around the island from US military bases. Indeed, Okinawa is nicknamed “the junk heap of the Pacific.” Three of its rivers rank among the five most polluted rivers in Japan.

With all that pollution, it’s notable she never had any cancer. In fact, Okinawans as a population have cancer rates orders of magnitude lower than ours, especially cancers of the breast and prostate. Although those rates have been creeping up as their diet becomes more Westernized. The more I read, the more I am convinced that diet plays a key role in cancer, both development and progression, as well as other chronic diseases.

What did this woman eat? This table provides some clues (from Traditional Okinawan Diet: Sweet Potatoes):

OkinawanDiet1

She would have been in her mid 40s at the time of this data, so during mid-life at least, she probably got most of her calories from carbohydrates (carbs supplied 85% of calories here) especially sweet potatoes with some rice, beans, and vegetables. Hers was likely a very low-fat (6% of calories), low-protein, high-carbohydrate diet, the kind of starch-based diet that Dr. McDougall might rubber-stamp.

By the way, Willcox’s data also reveal that Okinawans consumed a mere 2% of the RDA for vitamin D (compared to 31% on Japan mainland), and just 27% of the RDA for vitamin B12 or 0.6 micrograms a day. They also failed to meet the RDA for calcium and zinc. Still, many lived long and healthful lives.

The authors of this autopsy study said there are three variables that predict longevity, “genetic predisposition, lifestyle choices, and chance.” Two of those, genes and chance, are out of our control. Lifestyle isn’t. And what we eat is a big chunk of “lifestyle.”

It is not inevitable that we will become increasingly sick and frail as we age.

Originally posted 20 January 2015.

New Study: Short-Term Exposure To NO2 In Air Pollution Linked To Depression

Short-term Exposure To Ambient Nitrogen Dioxide And Increased Hospitalization Burden For Depression In China: A Multicity Analysis, International Journal of Environmental Health Research, 25 September 2022

Abstract
Evidence for the increased hospitalization burden, including admissions, expenditures and length of hospital stay (LOS) for depression attributable to ambient nitrogen dioxide (NO2) is lacking. We investigated the associations between short-term exposure to ambient NO2 and attributable admissions, hospitalization expenditures and LOS for depression in 57 Chinese cities during 2013-2017 using a well-established two-stage time-series study approach. Short-term exposure to ambient NO2 was associated with significantly increased admissions, hospitalization expenditures and LOS for depression, and the attributable fractions were 6.87% (95% CI: 2.90%, 10.65%), 7.12% (3.01%, 11.04%) and 6.12% (2.59%, 9.50%) at lag02, respectively. The projected total attributable admissions, hospitalization expenditures and LOS for depression related to ambient NO2 at the national level were 23,335 (9,863, 36,181) admissions, 318.70 (134.43, 492.21) million CNY and 539.55 (227.99, 836.99) thousand days during the study period, respectively. Short-term exposure to ambient NO2 is associated with increased hospitalization burden for depression.

NO2 is nitrogen dioxide, one component of air pollution. From the EPA:

NO2 primarily gets in the air from the burning of fuel. NO2 forms from emissions from cars, trucks and buses, power plants, and off-road equipment.

NO2 is already known to increase susceptibility to respiratory infections, contributive to the development of asthma, and damage the airways of anyone who breathes it (coughing, wheezing, difficulty breathing). It contributes to the development of diabetes and heart disease. Now we have evidence that it affects the brain. It’s a strong oxidant.

This map shows concentrations of NO2 across the US at 5:00 am this morning. Los Angeles and the Northeast Corridor have particularly polluted air today, as they do often. Their levels are “greater than the maximum established for one year by the World Health Organization.”

You can check you own air by visiting Windy.com, selecting “Air quality” on the right sidebar, then NO2 or other pollutant. Move around or zoom in to where you live.

#PublicHealth

A Photographer Built A Waterhole And The Animals Came

This photographer built a waterhole about 3 miles from the nearest water source in a very dry part of Kenya’s Southern Rift Valley. He then designed a hide from which to take photos.

We Built a Waterhole, Will Burrard-Lucas Photography Blog, 24 October 2022

You wouldn’t think that so much wildlife could exist in such a dry and seemingly inhospitable place.

I like his night shots:

He said:

Of course, my dream was for the lions to turn up and eventually they did. Thinking back to that experience still gets my pulse racing… I was alone with nothing but air between me and the lions. The cats were just a few meters away and seemed impossibly large from my vantage point. The lions knew I was there and held my gaze as they approached the water. Nothing compares to that connection, the feeling of vulnerability and the exhilaration.

The one below was from another nearby water source away from his built one. It was this set of photos that inspired him to build his own hole.

I guess owls are more afraid of humans than of zebra.

These are just a few of his photos. You can visit Will Burrard-Lucas’ site for more and to read about how he constructed his waterhole and hide. What a great idea!

“Our Data Strongly Support The Claim That Exercise Is An Evidence-Based Treatment For Depression”

Exercise As A Treatment For Depression: A Meta-Analysis Adjusting For Publication Bias, Journal of Psychiatric Research, June 2016

From the abstract:

The effects of exercise on depression have been a source of contentious debate.

I did not know that. I thought the evidence for benefits of exercise vis-a-vis depression was relatively strong. Although, if I was a big pharmaceutical company for which antidepressants brought in a fair share of revenue, I’d make sure there were studies published that countered benefits.

We included randomized controlled trials (RCTs) of exercise interventions in people with depression (including those with a diagnosis of major depressive disorder (MDD) or ratings on depressive symptoms), comparing exercise versus control conditions. … Twenty-five RCTs were included.

Overall, exercise had a large and significant effect on depression.

Previous meta-analyses may have underestimated the benefits of exercise due to publication bias.

Our data strongly support the claim that exercise is an evidence-based treatment for depression.

Publication bias. I wonder how that happened. You know who benefits from publication bias here? BigPharma.

I liked this graphic:

Source: How to Exercise to Help Treat Depression, Healthy Place, 29 March 2018

The Mouse In The Maze Experiment (How Creativity Dies In Caution)

Girl painting mosquito. Photo source: OpenIDEO

The Mouse In The Maze experiment:

Some years ago, psychologists used a maze puzzle in an intriguing experiment with college students.* A cartoon mouse was shown trapped inside a picture of a maze, and the task was to help the mouse find the way out. There were two different versions of the task. One was positive, approach-oriented; the other was negative or avoidance-oriented. In the positive condition, there was a piece of Swiss cheese lying outside the maze, in front of a mouse hole. In the negative condition, the maze was exactly the same, but instead of the Swiss cheese feast at the finish, an owl hovered above the maze, ready to swoop down and capture the mouse in its talons at any moment.

The maze takes less than two minutes to complete, and all the students who took part in the experiment solved their maze. But the contrast in the aftereffects of working on different versions of the maze was striking. When the participants later took a test of creativity, those who had helped their mouse avoid the owl turned in scores that were fifty percent lower than the scores of students who had helped their mouse find the cheese. The state of mind elicited by attending to the owl had resulted in a lingering sense of caution, avoidance, and vigilance for things going wrong. This mind-state in turn weakened creativity, closed down options, and reduced the students’ flexibility in responding to the next task.

This experiment tells us something very important: the same action (even something as slight as solving a simple maze puzzle) has different consequences depending on whether it is done to move toward something we welcome (activating the brain’s approach system) or to avoid something negative (activating the brain’s avoidance system). In the maze experiment, aversion was triggered by something as minor as the sight of a cartoon owl. It led to reductions in exploratory, creative behaviors. This is dramatic evidence that the avoidance system can narrow the focus of our lives, even when triggered by a purely symbolic threat.
The Mindful Way Through Depression, Mark Williams, John Teasdale, Zindel Segal, Jon Kabat-Zinn, 2007

* The Effects Of Promotion And Prevention Cues On Creativity, Journal of Personal and Social Psychology, December 2001

This was just a puzzle. It wasn’t even real. Yet it had real-life effects on the students.

Originally posted 2 June 2019.

A 5-Month Old Bird Just Flew 8,400 Miles Nonstop, Breaking World Record

The five-month-old bar-tailed godwit smashed the record for long-distance migration following a non-stop, 11-day flight from Alaska to Tasmania.

Birdlife Tasmania convenor Eric Woehler said the bird probably lost “half or more of its body weight” during “continuous day and night flight”.

“If a godwit lands on water, it’s dead. It doesn’t have the webbing in its feet, it has no way of getting off the water.”

“So if it falls into the water from exhaustion, if bad weather forces it onto the ocean surface, that’s it.”

11 days. No rest. No food. Flying, flying flying. Tell me birds don’t have it all over humans.

Source: Massimo, Neatorama, ABC News Australia