Otzi's Diet
Otzi's digestive tract contains the remains of three meals. They were composed of cooked grains (wheat bread and wheat grains), meat, roots, fruit and seeds (1, 2). The meat came from three different animals-- chamois, red deer and ibex. The "wheat" was actually not what we would think of as modern wheat, but an ancestral variety called einkorn.
Isotope analysis indicates that Otzi's habitual diet was primarily centered around plant foods, likely heavily dependent on grains but also incorporating a variety of other plants (3). He died in the spring with a belly full of einkorn wheat. Since wheat is harvested in the fall, this suggests that his culture stored grain and was dependent on it for most if not all of the year. However, he also clearly ate meat and used leather made from his prey. Researchers are still debating the quantity of meat in his diet, but it was probably secondary to grains and other plant foods. It isn't known whether or not he consumed dairy.
Read more »
Selasa, 17 April 2012
Will the UC-Davis Chancellor be Held Accountable for "Systemic and Repeated Failures?"
During the brief Occupy Wall Street etc campaign last year, the pepper spraying of unarmed protesters on the University of California - Davis campus became a symbol for some of what the powers that be thought of those who challenge the political economic status quo. We discussed this incident (here and here) on Health Care Renewal as an example of how the privileged hired leaders of big organizations, including health care organizations, may put their own interests ahead of the organizations' missions. Note that this case is relevant to Health Care Renewal since UC- Davis has a medical school and academic medical center.
The Task Force Report
Now, five months later, an internal investigation of the case has been made public, and it seems to support our concerns about the leadership of large organizations. The AP described the resulting report (via the Seattle Post-Intelligencer). In summary,
The report concluded that the Chancellor (functionally, the CEO) of UC-Davis, Linda Katehi had substantial responsibility for the incident:
Furthermore,
An editorial in the Merced Sun-Star focused more vividly on Katehi's poor leadership.
Furthermore, an article in the Atlantic suggested that Katehi was not truthful in her dealing with the investigation:
Will Leadership be Held Accountable?
So, in summary, the report on the pepper-spraying incident portrays the Chancellor of UC-Davis as presiding over a dysfunctional police department, hastily responding to rumors rather than evidence, making decisions without considering alternatives, poorly communicating decisions and their rationale, and not always being honest. This is not the portrait of a capable leader. This a a portrait of someone totally out of her depth.
So why is she paid the big bucks? As we have discussed endlessly, the top hired leaders of big health care (and other related) organizations seem to be almost universally lauded by their boards of trustees, not to mention fawning public relations departments, as brilliant. That brilliance is used as a rationale for the leaders' compensation and benefits, and for deflecting their accountability.
Yet often on close examination top hired leaders prove to be bumblers at best. Again and again their leadership has been shown to subvert the mission of their own organizations. Yet the structure that has been erected to protect them, to put them into a "CEO bubble," keeps them unaccountable.
Even after this report, will Chancellor Katehi be held accountable? Once again, I am not holding my breath. The strength of her protective bubble was demonstrated in an article in the Sacramento Bee,
What an example of cognitive dissonance this was. "Systematic and repeated failures," and "drastic poor judgment," which resulted in injuries to students and clear violation of the university mission is not reason enough to fire a CEO (as long as she writes a contrite letter promising to uphold the mission in the future)? There is no way to understand this other than as a manifestation of belief in the "divine right of CEOs" (look here and here).
So my response is that we will not solve the problem of health care dysfunction, and our society's larger political economic problems until we resolve to hold our leaders accountable for the missions they are supposed to uphold.
The Task Force Report
Now, five months later, an internal investigation of the case has been made public, and it seems to support our concerns about the leadership of large organizations. The AP described the resulting report (via the Seattle Post-Intelligencer). In summary,
a UC Davis task force said the decision to douse seated Occupy protesters with the eye-stinging chemical was 'objectively unreasonable' and not authorized by campus policy.
'The pepper-spraying incident that took place on Nov. 18, 2011, should and could have been prevented,' concluded the task force created to investigate the confrontation.
The report concluded that the Chancellor (functionally, the CEO) of UC-Davis, Linda Katehi had substantial responsibility for the incident:
The task force blamed the the incident on poor planning, communication and decision-making at all levels of the school administration, from Katehi to Police Chief Annette Spicuzza to Lt. John Pike, the main officer seen in the online videos.
Furthermore,
The task force blamed the chancellor for not clearly communicating to her subordinates that police should avoid physical force on the protesters. It also said she was responsible for the decision to deploy police on a Friday afternoon, rather than wait until early morning as Spicuzza recommended.
An editorial in the Merced Sun-Star focused more vividly on Katehi's poor leadership.
The independent assessment of events leading up to the infamous Nov. 18 pepper-spraying incident at the University of California at Davis provides a devastating indictment of the leadership of Chancellor Linda P.B. Katehi and key vice chancellors -- and of the operations of the campus Police Department.
Katehi showed either extreme naivete or incompetence in weighing a response to protesters camping in the Quad. The report of the task force, led by former California Supreme Court Associate Justice Cruz Reynoso, revealed a deeply flawed structure for decision-making. Little or no consideration of alternatives. Failing to record and adequately communicate key decisions, so that ambiguity and uncertainty ruled.
The command and leadership structure of the campus Police Department, the report concluded, is 'very dysfunctional.' Lieutenants, the report stated, don't 'follow directives of the Chief.' This department needs a top-to-bottom review to bring it into line with best practices in policing for a university campus.
Campus leaders had been dealing with protests since 2009 and were well aware of events that November in Oakland and at UC Berkeley.
But instead of deliberate preparations, those events, according to the report, sparked alarmist fears among Katehi and other administrators that if any encampment was not removed immediately, older non-students might assault young female students.
Katehi said she was worried about 'the use of drugs and sex and other things, and you know here we have very young students ... we were worried especially about having very young girls and other students with older people who come from the outside without any knowledge of their record ... .'
But the report suggests Katehi and her leadership team did little or nothing to verify whether these fears were well-founded, ignoring evidence from student affairs staff that protesters were students and faculty. The report concludes that Katehi's fears were 'not supported by any evidence' obtained by the Kroll Inc. investigators.
Worse, even if the concerns were real, Katehi and her leadership team did not consider alternatives to immediate removal of the encampment -- or learn anything from the experience of other places. This rush to action resulted in ad hoc decision-making, apparently with no one having a clear understanding of what was supposed to happen.
Katehi did make one thing clear: She wanted the tents removed at 3 p.m. -- though it was never certain what legal authority police had to remove tents during the day in order to implement a policy against overnight camping. Subordinates, the report says, took her statement as an executive order and tactical decision.
The report also notes that Katehi 'failed to express in any meaningful way her expectation' that campus police would use no force. There is no indication what Katehi thought police should do if protesters refused a request to take down tents.
Furthermore, an article in the Atlantic suggested that Katehi was not truthful in her dealing with the investigation:
at face value ... [the report's] findings are also very damaging to the still-serving Chancellor of UC Davis, Linda Katehi. For instance, the Kroll report says about a letter asking the demonstrators to disperse:Chancellor Katehi told Kroll investigators that Student Affairs wrote the letter and that she did not review it before it went out. The record contradicts both of these statements, as detailed below. Katehi did review the letter, provided an editorial change and approved it. Student Affairs did not write the letter...
Will Leadership be Held Accountable?
So, in summary, the report on the pepper-spraying incident portrays the Chancellor of UC-Davis as presiding over a dysfunctional police department, hastily responding to rumors rather than evidence, making decisions without considering alternatives, poorly communicating decisions and their rationale, and not always being honest. This is not the portrait of a capable leader. This a a portrait of someone totally out of her depth.
So why is she paid the big bucks? As we have discussed endlessly, the top hired leaders of big health care (and other related) organizations seem to be almost universally lauded by their boards of trustees, not to mention fawning public relations departments, as brilliant. That brilliance is used as a rationale for the leaders' compensation and benefits, and for deflecting their accountability.
Yet often on close examination top hired leaders prove to be bumblers at best. Again and again their leadership has been shown to subvert the mission of their own organizations. Yet the structure that has been erected to protect them, to put them into a "CEO bubble," keeps them unaccountable.
Even after this report, will Chancellor Katehi be held accountable? Once again, I am not holding my breath. The strength of her protective bubble was demonstrated in an article in the Sacramento Bee,
Cruz Reynoso, the former state Supreme Court justice whose task force blamed 'systemic and repeated failures' of UC Davis' leadership for the pepper-spraying of students last fall, said Thursday that Chancellor Linda P.B. Katehi should stay on the job and enact reforms to prevent a recurrence.
'She should not resign. The balance is that she has done a lot of good despite this drastic poor judgment,' Reynoso said, a day after releasing an investigative report that faulted the chancellor for failing to make clear to campus police she wanted no force used in dispersing protesters and taking down an Occupy encampment on Nov. 18.
Reynoso said he was impressed by the chancellor's response: a written statement Wednesday vowing to protect students' 'safety and free speech' as the university learns 'from the difficult events.'
What an example of cognitive dissonance this was. "Systematic and repeated failures," and "drastic poor judgment," which resulted in injuries to students and clear violation of the university mission is not reason enough to fire a CEO (as long as she writes a contrite letter promising to uphold the mission in the future)? There is no way to understand this other than as a manifestation of belief in the "divine right of CEOs" (look here and here).
So my response is that we will not solve the problem of health care dysfunction, and our society's larger political economic problems until we resolve to hold our leaders accountable for the missions they are supposed to uphold.
Senin, 16 April 2012
Exercise and Food Intake
The New York Times just published an article reviewing some of the recent research on exercise, food intake and food reward, titled "Does Exercise Make You Overeat?". I was planning to write about this at some point, but I don't know when I'd be able to get around to it, and the NYT article is a fair treatment of the subject, so I'll just point you to the article.
Basically, burning calories through exercise causes some people to eat more, but not everyone does, and a few people actually eat less. Alex Hutchinson discussed this point recently on his blog (1). Part of it depends on how much fat you carry-- if you're already lean, the body is more likely to increase hunger because it very much dislikes going too low in body fat. Most overweight/obese people do not totally make up for the calories they burn through exercise by eating more, so they lose fat. There is a lot of individual variability here. The average obese person won't lose a substantial amount of fat through exercise alone. However, everyone knows someone who lost 50+ pounds through exercise alone, and the controlled trials support that it happens in a minority of people. On the other side of the spectrum, I have a friend who gained fat while training for a marathon, and lost it afterward.
Read more »
Basically, burning calories through exercise causes some people to eat more, but not everyone does, and a few people actually eat less. Alex Hutchinson discussed this point recently on his blog (1). Part of it depends on how much fat you carry-- if you're already lean, the body is more likely to increase hunger because it very much dislikes going too low in body fat. Most overweight/obese people do not totally make up for the calories they burn through exercise by eating more, so they lose fat. There is a lot of individual variability here. The average obese person won't lose a substantial amount of fat through exercise alone. However, everyone knows someone who lost 50+ pounds through exercise alone, and the controlled trials support that it happens in a minority of people. On the other side of the spectrum, I have a friend who gained fat while training for a marathon, and lost it afterward.
Read more »
Beet Juice, Beet Smoothie: Blood Pressure & Stamina
Don't sleep on beet juice. Studies performed over the past several years suggest that drinking beetroot juice may lower blood pressure and thus have implications for the treatment of cardiovascular disease. What is the underlying cause of this lowering of blood pressure? It is the nitrate content of beetroot. Additionally, other studies suggest that this juice boosts stamina, which can prolong exercising.
So how does one incorporate this vegetable into one's diet? Well below is a recipe for a delicious, beet smoothie. As always, please consult with your doctor before adjusting your diet or lifestyle.
BEET SMOOTHIE -
Ingredients:
1/2 cup freshly squeezed orange juice
1 cup mixed frozen berries or blueberries
2 tablespoons granola
1/3 cup diced beet, raw (50 grams)
1/4 cup plain low-fat yogurt or low-fat coconut milk
1 teaspoon honey or agave syrup
2 or 3 ice cubes
sliced orange for garnish (optional)
Instructions:
Place all of the ingredients in a blender and blend for 1 full minute. Pour into a glass, garnish with an orange slice and enjoy.
Yield: 1 generous serving.
{Recipe Source}
SOURCES:
STUDY: NITRATE IN BEETROOT & BLOOD PRESSURE
STUDY: BEETROOT & BLOOD PRESSURE
STUDY: BEETROOT & STAMINA
STUDY: STAMINA CONTINUED
So how does one incorporate this vegetable into one's diet? Well below is a recipe for a delicious, beet smoothie. As always, please consult with your doctor before adjusting your diet or lifestyle.
 |
| {Source} |
Ingredients:
1/2 cup freshly squeezed orange juice
1 cup mixed frozen berries or blueberries
2 tablespoons granola
1/3 cup diced beet, raw (50 grams)
1/4 cup plain low-fat yogurt or low-fat coconut milk
1 teaspoon honey or agave syrup
2 or 3 ice cubes
sliced orange for garnish (optional)
Instructions:
Place all of the ingredients in a blender and blend for 1 full minute. Pour into a glass, garnish with an orange slice and enjoy.
Yield: 1 generous serving.
{Recipe Source}
SOURCES:
STUDY: NITRATE IN BEETROOT & BLOOD PRESSURE
STUDY: BEETROOT & BLOOD PRESSURE
STUDY: BEETROOT & STAMINA
STUDY: STAMINA CONTINUED
You can now find HHB on Facebook. Share with your friends:
Minggu, 15 April 2012
Next Primal Chef Event Sunday 5/20
Gil Butler has been working on a television show called Primal Chef, where he invites local chefs to make creative dishes from a list of Paleo ingredients, in a designated amount of time. The format is reminiscent of Iron Chef. The food is judged afterward by figures in the Paleo community. Robb Wolf was a judge on the first episode.
Gil has invited me to be a judge on the next show, along with Sara Fragoso and Dr. Tim Gerstmar. The next day, Sunday April 20th, Gil is organizing a catered Primal Chef event in Seattle, with Paleo dinner, speakers, entertainment, prizes, and a screening of part of Paleo Chef episode 1. You can read the details and sign up here. I won't be speaking because I don't have time to put together another talk right now, but I will be attending the event.
Gil has invited me to be a judge on the next show, along with Sara Fragoso and Dr. Tim Gerstmar. The next day, Sunday April 20th, Gil is organizing a catered Primal Chef event in Seattle, with Paleo dinner, speakers, entertainment, prizes, and a screening of part of Paleo Chef episode 1. You can read the details and sign up here. I won't be speaking because I don't have time to put together another talk right now, but I will be attending the event.
Jumat, 13 April 2012
Once More with Feeling - Johnson and Johnson Found Guilty, Fined $1.1 Billion
The latest legal black eye for giant pharmaceutical and device company Johnson and Johnson appeared in an Arkansas court room. As documented by Bloomberg, via NJ.com,
The prosecutors had alleged a variety of kinds of deceptions about Risperdal,
In summary,
Bloomberg noted that
In fact, this is just the latest in a remarkable string of legal cases suggesting an ongoing pattern of unethical and illegal behavior by this very large health care corporation. As we wrote recently, this included
- Convictions in two different states in 2010 for misleading marketing of Risperdal, as noted above
- A guilty plea for misbranding Topamax in 2010
- Guilty pleas to bribery in Europe in 2011 by J+J's DePuy subsidiary
- A guilty plea for marketing Risperdal for unapproved uses in 2011 (see this link for all of the above)
- Accusations that the company, which makes smoking cessation products, participated along with tobacco companies in efforts to lobby state legislators (see post here)
- A guilty plea to misbranding Natrecor by J+J subsidiary Scios (see post here)
- More recently, in 2012, testimony in a trial of allegations of unethical marketing of the drug Risperdal (risperidone) by the Janssen subsidiary revealed a systemic, deceptive stealth marketing campaign that fostered suppression of research whose results were unfavorable to the company, ghostwriting, the use of key opinion leaders as marketers in the guise of academics and professionals, and intimidation of whistleblowers. After these revelations, the company abruptly settled the case (see post here).
- Most recently, there are reports that the company is in negotiation with the US Department of Justice to settle other lawsuits about the marketing of Risperdal, perhaps for as much as $1.8 billion (see this BusinessWeek story.)
Meanwhile, as we also discussed recently, Johnson and Johnson seems to have lost the ability to manufacture high quality products. It has had to make 30 separate product recalls since 2009. The latest was Liquid Infant Tylenol. (The current WSJ Health Blog list of recalls can be found here.)
So the real question here is how many instances of manufacturing of defective, mislabeled, contaminated, or harmful products, and how many court cases showing unethical or illegal behavior will it take until the leadership and governance of this company improves (and by extension, the leadership and governance of other large health care corporations with similar bad records improves).
As we posted not long ago, the CEO who presided over most of these messes will be allowed to retire with a huge golden parachute. His devotion to "making the numbers," that is, hitting short-term revenue targets ahead of all other goals, probably had something to do with a company once thought of as a paragon of corporate behavior turning so bad. Yet he became extremely rich doing this, and neither his riches nor his legal status have ever been challenged. His successor apparently will be another former sales representative who may be just as devoted to "making the numbers,." Thus has the business school dogma that short-term financial results, prettied up as "shareholder value," is the only thing that should matter to corporate leadership (look here) poisoned health care.
How many more doctors and patients have to be deceived, how many products have to be contaminated or defectively made before we demand better leadership of health care organizations?
Johnson & Johnson was ordered to pay $1.1 billion by a state judge after an Arkansas jury found the company’s officials misled doctors and patients about the risks of the antipsychotic drug Risperdal.
Jurors in Little Rock yesterday said the company’s marketing campaign also violated consumer-protection laws. The panel deliberated about three hours before finding J&J and its Janssen unit engaged in 'false or deceptive acts' by sending a 2003 letter touting Risperdal as safer than competing drugs to more than 6,000 doctors across the state.
The prosecutors had alleged a variety of kinds of deceptions about Risperdal,
Along with contending that J&J and Janssen defrauded the Medicaid program by failing to properly outline the antipsychotic medicine’s risks, Arkansas officials alleged J&J officials deceptively marketed the drug as safer and better than competing medicines.
The state also argued the companies marketed the drug for 'unapproved uses, including various symptoms in children and the elderly' after being warned by federal authorities to halt such sales.
In summary,
Arkansas Attorney General Dustin McDaniel said in an e- mailed statement that he sued because residents in the state deserved to be protected from 'fraud and deceptive practices.'
He said that jurors found 'Johnson & Johnson and Janssen Pharmaceuticals lied to patients and doctors because they cared more about profits than people.'
Bloomberg noted that
It’s the third jury verdict against J&J, the second-biggest maker of health products, in cases where states alleged it hid Risperdal’s risks and tricked Medicaid regulators into paying more than they should have for the medicine. Louisiana and South Carolina juries also found the company’s Risperdal marketing violated consumer-protection laws.
In fact, this is just the latest in a remarkable string of legal cases suggesting an ongoing pattern of unethical and illegal behavior by this very large health care corporation. As we wrote recently, this included
- Convictions in two different states in 2010 for misleading marketing of Risperdal, as noted above
- A guilty plea for misbranding Topamax in 2010
- Guilty pleas to bribery in Europe in 2011 by J+J's DePuy subsidiary
- A guilty plea for marketing Risperdal for unapproved uses in 2011 (see this link for all of the above)
- Accusations that the company, which makes smoking cessation products, participated along with tobacco companies in efforts to lobby state legislators (see post here)
- A guilty plea to misbranding Natrecor by J+J subsidiary Scios (see post here)
- More recently, in 2012, testimony in a trial of allegations of unethical marketing of the drug Risperdal (risperidone) by the Janssen subsidiary revealed a systemic, deceptive stealth marketing campaign that fostered suppression of research whose results were unfavorable to the company, ghostwriting, the use of key opinion leaders as marketers in the guise of academics and professionals, and intimidation of whistleblowers. After these revelations, the company abruptly settled the case (see post here).
- Most recently, there are reports that the company is in negotiation with the US Department of Justice to settle other lawsuits about the marketing of Risperdal, perhaps for as much as $1.8 billion (see this BusinessWeek story.)
Meanwhile, as we also discussed recently, Johnson and Johnson seems to have lost the ability to manufacture high quality products. It has had to make 30 separate product recalls since 2009. The latest was Liquid Infant Tylenol. (The current WSJ Health Blog list of recalls can be found here.)
So the real question here is how many instances of manufacturing of defective, mislabeled, contaminated, or harmful products, and how many court cases showing unethical or illegal behavior will it take until the leadership and governance of this company improves (and by extension, the leadership and governance of other large health care corporations with similar bad records improves).
As we posted not long ago, the CEO who presided over most of these messes will be allowed to retire with a huge golden parachute. His devotion to "making the numbers," that is, hitting short-term revenue targets ahead of all other goals, probably had something to do with a company once thought of as a paragon of corporate behavior turning so bad. Yet he became extremely rich doing this, and neither his riches nor his legal status have ever been challenged. His successor apparently will be another former sales representative who may be just as devoted to "making the numbers,." Thus has the business school dogma that short-term financial results, prettied up as "shareholder value," is the only thing that should matter to corporate leadership (look here) poisoned health care.
How many more doctors and patients have to be deceived, how many products have to be contaminated or defectively made before we demand better leadership of health care organizations?
Langganan:
Postingan (Atom)