Seth's Blog

In an amusing comment on health care, Jonathan Rauch (via Marginal Revolution) imagines an airline system as archaic and inefficient as our health care system.

“Cynthia, I have filled out my travel history half a dozen times already this year. I’ve told six different airlines that I flew to Detroit twice and Houston once. Every time I fly, I answer the same battery of questions. At least a dozen airlines have my travel history. Why don’t you get it from them?”

“We have no way we could do that. We do not have access to other companies’ records, and our personnel have our own system for collecting travel history.”

The health care system, in other words, is full of problems that have built up unsolved. Solutions exist — the problems are not impossible — but haven’t been implemented. Jane Jacobs’s great point, in The Economy of Cities, is that this is what happens when those who benefit from the status quo have too much power relative to those who benefit from change. The stagnation in American health care is profound. It isn’t solved by universal health insurance. There would remain the horrible dependence on expensive dangerous drugs that don’t work very well (e.g., antidepressants, Accutane) and the complete lack of interest in prevention. The underlying problem, the source of many visible problems, is too little innovation.

As I previously blogged, a recent study in Shanghai found that schoolchildren given milk with added bacteria had fewer colds than children given milk without added bacteria. The study was funded by Danisco, a Wisconsin company that makes bacteria-containing (“probiotic”) capsules. Obviously they want to sell more of their product. But ordinary yogurt probably produces the same result. Aaron Blaisdell told me this:

Since introducing yogurt into my daughter Maggie’s diet on a daily basis about 5 months ago, she’s gotten far fewer colds, and those she did get were milder.

I asked him for details.

Maggie is 4 years old. She eats a bowl of Traderspoint Creamery whole milk yogurt (from grassfed cows) each day. She started day care since 4-months old and now goes to a pre-school. She used to get a cold about every other month (6-8 per year), but since we introduced yogurt daily to her diet about 6 months ago, she’s only had one cold as far as I can remember and it was very mild. Even the cough which used to last a month or two after she recovered lasted only about a week or two.

How much yogurt was she eating before that?

I think she had yogurt once or twice a week for the six months prior to introducing it daily. Before that it was even rarer. We introduced it a few times between the ages of 2 and 3 years old, and after initially liking it for a day or two she would then reject it thereafter. The reason she eats it every day now is because I put Ovaltine in it (about a teaspoon).

Did he make other changes at the same time?

I also try to sneak fermented high-vitamin cod liver oil into the yogurt, but I can only do this if I make it while she isn’t looking. I also put 2-4k vitamin D3 (Carlson’s drops) into it if she isn’t looking when I make it. Also starting at the beginning of this year I switched from organic pasteurized milk to raw milk. I can’t think of any other significant changes in diet, except that I continue to try to cut down on the amount of cereal and crackers she eats and increase the amount of eggs and cheese instead.

Let’s hope she doesn’t read this!

The Financial Times recently ran an article about Jerry Morris, a London epidemiologist who did the most famous study of the effect of exercise. He compared London bus drivers with the ticket takers on the same buses. The ticket takers got a lot more exercise than the drivers. The health differences between them were attributed to exercise:

“There was a striking difference in the heart-attack rate. The drivers of these double-decker buses had substantially more, age for age, than the conductors [= ticket takers].” [said Morris]

The data were so telling because drivers and conductors were men of much the same social class. There was only one obvious difference between them. “The drivers were prototypically sedentary,” explains Morris, “and the conductors were unavoidably active. We spent many hours sitting on the buses watching the number of stairs they climbed.” The conductors ascended and descended 500 to 750 steps per working day. And they were half as likely as the drivers to drop dead of a sudden heart attack.

Morris found that bus conductors had fewer heart attacks than sedentary drivers

Today, almost everyone understands that physical exercise can help prevent heart disease, as well as cancer, diabetes, depression and much else besides. But on that day in 1949 when Morris looked at the bus data, he was the first person to see the link. He had inadvertently — “mainly luck!” — “ stumbled on a great truth about health: exercise helps you live longer.

It’s not that simple. There are two big confounds in the study (two other differences between drivers and ticket takers) that surely caused Morris to overestimate the benefits of exercise. One is well-known to epidemiologists: Bus driving is very stressful. Much more stressful than a dozen other equally sedentary jobs. Stress certainly causes heart disease. The other is based on my discovery that standing a lot improves sleep. (The standing needn’t involve movement.) I don’t know if better sleep specifically reduces heart disease but it certainly increases resistance to infection and heart disease seems to have an infectious component.  The ticket takers were on their feet all day, the drivers were not.

You may remember that James Fixx, a famous advocate of jogging, died of a heart attack.

Thanks to Dave Lull.

Some have phosphoric acid, which leaches calcium from your bones. Not all soft drinks have phosphoric acid:

In a survey designed to measure the amount of phosphoric acid in twenty different soft drinks, the following were found to contain the highest amounts: Tab, Coke, Diet Coke, caffeine-free Coke, and Mr. Pibb. The formulas may have been changed for the better since this survey was conducted. . . . Pepsi Free, Diet Pepsi Free, Like Cola, 7-Up, and Mountain Dew had no phosphoric acid.

Female Fertility and the Body-Fat Connection (2004) by Rose Frisch, an excellent book, tells about a 25-year-old college tennis player nicknamed Miss Tab because she drank 8-10 bottles of Tab a day.

When her bone mass was measured, her tennis arm was normal for a 25-year-old woman (it should have been a greater mass from the exercise) and her other arm had the bone mass of a 70-year-old woman.

I started drinking Diet Coke a week ago. Oops. I will switch to Diet Pepsi. Eventually I will learn the Chinese for phosphoric acid.

Someone read this blog and wrote this:

The one that was most interesting to me was “standing on one foot”,
because I’ve definitely felt a difference in sleep after doing lots of
work.  (I used to sleep really well when I did a 54-mile commute on my
bike.)  Maybe standing on one foot (knee bent) until failure causes the
muscles to send similar chemical signals to intense exercise which are
picked up elsewhere?  Whatever, it was free, easy, and safe, so I tried
it.  You can’t do a double-blind experiment on yourself, of course, but
at least some of the time when I’ve tried it I definitely felt as
though I slept more soundly when I got up the next day.

I still do this. Lately I have been varying the dose — how many times I stand on one leg. So far three (e.g., right leg, left leg, right leg) produces slightly worse sleep than four (right leg, left leg, right leg, left leg). If I eat plenty of meat, my legs get stronger and stronger; if I eat little meat, they don’t.