Should doctors own [the keys to] your genes?

The title of this post is weak, we know. We spent a long time crafting a clever, eye-catching one so that the one regular reader of Trading Kellys would spot it on her feed--because this is a fascinating topic, even if you won't get that from the post. But we failed, and are running with this bland title.

So, everyone knows that the human genome has been mapped & opened up the world to comprehensive genetic testing. (Or not: the editors haven't stayed up on this, but let's assume it's true for now.) You, a person on this planet, could have your genes tested for genetic disorders.

Except, maybe not. The U.S.D.A. needs to figure out if you actually need a doctor to tell you it's okay to test your own genes. There are hearings going on right now to figure out:

Agenda: On March 8 and 9, 2011, the committee will discuss and make recommendations on scientific issues concerning direct to consumer (DTC) genetic tests that make medical claims. The scientific issues to be discussed include:

(1) The risks and benefits of making clinical genetic tests available for direct access by a consumer without the involvement of a clinician (i.e., without a prescription). The discussion will include consideration of the benefits and risks of direct access for different tests or categories of tests that would support differences in the regulatory approach. Clinical genetic test categories that have been proposed to be offered directly to consumers include:

(a) Genetic carrier screening for hereditary diseases (e.g., cystic fibrosis carrier screening);

(b) Genetic tests to predict risk for future development of disease, in currently healthy persons (e.g., tests to predict risk of developing breast or ovarian cancer); and 

(c) Genetic tests for treatment response prediction (e.g., tests to predict whether individual will respond to a specific drug).

In order to find out what you are---your genes being you; to find out what diseases you may be prey to; to find out what drugs will work for you: You might need a prescription. Which means you'll need a doctor. Which means you'll need insurance or pay out of pocket; which means you'll have to wait however long it takes for an appointment; which means the doctor might not give you a prescription. 

Consider that: Not only do you have to go through the time & expense of getting the prescription to find out the most instrumental things about yourself: You might not be allowed to do it at all.

This is a problem. One editor has sufficiently bitched to the world about needing a prescription for an A-1C test. It's just par for the course for the current state of medicine. You are expected to be a lapdog to your doctor; to have no ownership over your health; to take the pills you are told to take, eat what you are told to eat, and return as often as feasible for the tests you are told to take--and expected to be grateful for the privilege.*

It's criminal. As the illustrious author Igna Muscio has written: "Western medicine . . . is based on a law opposed to the one the rest of the universe seems to go by, namely: Healing Has Nothing to Do with You, Just Follow the Directions on the Label." 

*Certain other proprietors of Trading Kellys are welcome to write about the regulatory capture, public-choice theory, and other economic incentives that are fueling these regulations. This editor has to go back to work.

PlanBetter

There's some circumstantial evidence that Charlie Sheen---though off all drugs except Charlie Sheen---is onto primal. Perhaps ketones are contributing to his (seeming) mania. 

We reserve judgment on this until more evidence comes in. But will say: We have experienced mild mania* ourselves brought on by high levels of ketones. It's an often-reported side effect of deep ketosis. (Or it's never reported at all, and was only an excuse for our editors to eat butter-soaked mashed sweet potatoes every night at 11 p.m. to help get to sleep.)

But it's been a while for the Trading Kellys team since we've cut out all the booze & dark chocolate long enough to turn the ketone strip purple. The Charlie Sheen episode has us motivated, though, to see if a little low-carb stretch could get the #tigerblood running & #adonisdna expressed.

*Editor's wife's note: Mr. Sheen probably has some psychological disorder. It's impossible to know, of course, & Trading Kellys does not mean to underplay, in any way, nor glorify, his potential mental-health issues.

Baby steps from the Times

My illustrious co-editor pointed out that the NY Times had the unabashed gall to publish an article saying that not all saturated fats are bad:

 And while it’s true that most of the fats in virgin coconut oil are saturated, opinions are changing on whether saturated fats are the arterial villains they were made out to be. “I think we in the nutrition field are beginning to say that saturated fats are not so bad, and the evidence that said they were is not so strong,” Dr. Brenna said.

Plus, it turns out, not all saturated fats are created equal.  Marisa Moore, a spokeswoman for the American Dietetic Association, a nonprofit association of nutritionists, said, “Different types of saturated fats behave differently.”

Wow. Look at that. Nutritionists backing off the "saturated fats are evil" myth. 

Of course, instead of embracing the overwhelming research that saturated fats are positively correlated with good physical & mental health, and longevity---and making a real attempt to stop the freight train of awful advice to replace saturated fats with polyunsaturated ones---they couch their new insight.  Saturated fats are "not so bad," and "not all created equal," and "behave differently."

Whatever. It's a start. I'd advise sucking down some raw, grass-fed cream and slathering your eggs in  grass-fed butter before you start hitting coconut milk.

When you know nothing, stop talking.

I've consulted frequently with the Trading Kellys editors about really getting this thing going, or just packing it in. We're currently in the netherworld of uselessness: We want to do it, but refuse to put in the effort. And then we see an article like this:

And read this masterly sentence:

The initiative, dubbed "Soldier Athlete," bans soda, refined grains, and fried foods in favor of healthier options such as low-fat milk, whole grains, and veggie wraps.  

That first line is awesome. As someone who is nutritionally competent, you know that "soda, refined grains, and [seed-oil] fried foods" are garbage. But, because you competent, you also know that "low-fat milk, whole grains, and [gluten-loaded] veggie wraps" are also garbage.* So you naturally walk away from those two lines puzzled. 

Let me shed some clarity. It's not you; it's the author. Everything listed in that sentence is, in fact, horrible for you [to one degree or another] and should be avoided if possible. It is a slavish adherence to U.S.D.A., the pharmaceutical industry, & counter-logical [alleged] logic that would lead to such a sentence.

But what should our fine military personnel eat? The author gave us an answer, actually:

Two years into the Revolutionary War, a surgeon general in the Continental Army issued a pamphlet on nutrition. "The diet of soldiers should consist chiefly of vegetables," Dr. Benjamin Rush wrote[.] "The nature of their duty, as well as their former habits of life, require it." [Dr. Rush's] counsel ... probably fell on deaf ears. It was routine, in Rush's time, for soldiers to consume a "pound or two of flesh in a day."

It should come as no shock to the reader that the Continental Army, surviving as it did on pounds of flesh, beat down the Redcoats, who no doubt survived on the their beloved whole grains in the form of biscuits & English muffins. The good Dr. Rush, like 99.7% of doctors today, clearly knew nothing about nutrition.

*Why would refined grains be worse than whole grains? They are terrible for identical reasons. Whole grains might actually be more destructive. 

**If the preceding footnote vexes you, please do not return to Trading Kellys. 

Why I workout, part 0.28

My esteemed co-writer and proprietor of this site texted me this afternoon and reminded me of something very important. He observed:

Drinking good beer on an empty stomach is awesome.

I can't agree more. But I will add that drinking good beer on an empty stomach after a fasted morning workout on a Saturday is also awesome, and maybe awesomer.


(It also spikes insulin, destroys the gut, wrecks the liver, and suppresses HGH & testosterone production. As the title of this blog suggests, life is about trade-offs.)

More [allegedly] mysterious causes of obesity

Now it's taking out tonsils.

The articles I've seen don't talk much about the method of figuring out causes, but I do love these theories for the weight gain: 

There are several theories about why some kids may be putting on pounds.

One is that when children have enlarged tonsils, they're spending more energy (calories) to breathe. Once they're removed, breathing is easier and uses less calories, Jeyakumar explained.

Another is that when tonsils are big and swallowing is difficult, children may limit the foods they eat or have less of an appetite. After the surgery, kids typically feel better and food probably tastes better, too.

This is really just amazing. Those theories might be true; it does, after all, suck to eat when your throat is sore. 

[Of course, both theories imply that the kids lost weight due to the inflamed tonsils, then just went back to normal when they were removed. But the studies imply that the kids were at a normal weight, then got fat. Is weight loss a symptom of tonsillitis? Did the kid's charts include notation that they had lost weight in the previous few weeks? The logical breakdown was obvious to me after one second. Good to see the journalists pointing it out.] 

But again, two theories that just recite the "calories in, calories out" hypothesis and ignore the endocrine system and hormones, and gut bacteria and inflammation. (Maybe the study itself mentions insulin & leptin and every other hormone that effects fat storage (all of them), but I doubt it.)

A better guess would be that going under the knife to have tonsils removed means taking powerful antibiotics for a decent amount of time (maybe even a few different kinds); those antibiotics kill off the kid's good and bad gut flora; the kid's gut flora is then repopulated with only bad bacteria; that leads to inflammation, inability to process some foods, and maybe hypothalamus issues.  


All of those are  well-established side effects of antibiotics—and also well-established causes of obesity. 


But I'm sure you already knew that. That's what turns me on about you: Your attention to detail. 

Michael Caine is My Father, and Harry Brown

I imagine myself in good company when I say this: I fucking love revenge films. Braveheart is my torchbearer; this, the most ambitious ["This time it's personal." Unreal.] I'd recommend Law Abiding Citizen to anyone who shares this passion--a horrendous film for which Jamie Foxx should have committed seppuku.  Whenever I need a little spark in my life, I turn to this genre*, which led the lady and me to watch Harry Brown last night.


Before Mr. Brown went on his rampage, I said this: "He needs to get a least five kills to make it worth it. But I'd love to see fifteen." Five kills is the minimum for good revenge. In a film going for realism, like this one, 15 is the max. Mr. Brown hit six. It was perfect.  


And, for a moment, like a shot of Jack on an empty stomach, I felt warm & energized. Then I switched over to Spaceballs--The Animated Series and I was back to normal. My wife must fantasize about killing me 47 minutes a day.


*Others might prefer the underdog story--Rudy, A Few Good Men, Rocky, The Godfather--when looking for a lift. Fuck that. Those stories depress me.