Here’s an interesting study I recently came across that was published back in 2015. Researchers in England looked at 162 pairs of middle-aged female twins (thus making a total of 324 women in the study). They administered a baseline cognitive test to them, and performed brain MRIs. They also did tests of their leg strength and power. A decade later they saw the women back and repeated the cognitive tests and brain MRIs. What emerged was that even after controlling for any obvious variables they could think of (smoking, alcohol use, exercise habits, obesity, diabetes, etc), the women with the strongest legs at the start of the study fared better than their twin in terms of brain aging. Or put another way: having weak legs was a risk for starting to show signs of dementia a decade later.
Modern medicine tends to compartmentalize each illness. A typical patient might, for example, be diagnosed separately and at different times with high blood pressure, arthritis, gout, and depression. But increasingly, it is becoming clear that many of these diseases are in fact all downstream of the same few root causes, namely visceral fat, insulin resistance, and systemic inflammation. And while genetics do play an important role in our health (some people for example just never seem to develop diabetes no matter how poorly they eat or how obese they get; others do become diabetic after just a modest weight gain), lifestyle is by far the biggest driver of these issues.
So rather than viewing a patient as having several different chronic illnesses, it is more accurate to look for root causes, and understand that things like high blood pressure, high blood sugar, arthritis, and so forth are in turn downstream of those. Fix the root causes, and all of the other issues get better.
Recently a patient inquired about p-Tau217 testing, so I’ve been doing a bit of a dive on the topic, and thought I’d share my thoughts on it.
First, a bit of background. p-Tau217 is a protein that is found in abundance in the brain of Alzheimer’s disease patients. One of the tests that a neurologist might do when evaluating if a patient has Alzheimer’s disease or not is a lumbar puncture (aka a “spinal tap”) in which they stick a needle into a patient’s spine, withdraw some fluid, and send it to the lab to test for p-Tau217 as well as other proteins that are elevated in Alzheimer’s disease.
Recently a patient volunteered their anger and frustration about Dr. Anthony Fauci being dragged before a senate hearing and badgered with aggressive questions. “That man is a national hero. It’s a disgrace that they are treating him like this.” What I found so striking about this comment is that it came not long after another patient told me that “Dr. Fauci should be in prison for what he did.”
While I try to stay apolitical both in my office and on this blog, it’s not possible to completely disentangle medicine from politics. Besides, what I wish in this post is not to take one side or the other, but rather to use the case of Dr. Fauci as a prism by which to look at our current political dysfunction. The fact is that, increasingly, Democrats and Republicans live in alternative epistemic universes, which helps to explain much of our national polarization. It’s not just a question of which side is right or wrong on a particular issue, but that each side is consuming media that conveys a highly curated set of facts which cater only to their own view of the world, carefully neglecting to mention those facts which bolster the other sides’ points.
Let’s get back to the topic of weight loss, this time by highlighting a small but interesting Japanese study from 2010. Researchers took overweight women and had them practice a technique called “Senobi breathing” for one minute before each meal (since most people eat three times per day, that would be a total of 3 minutes per day). After doing this for 30 days, without any other changes, the women lost about 3 percent of their body weight. You can read the full study by clicking here.
Don’t worry, I won’t leave you hanging – an explanation of what Senobi breathing is and how to do it is coming in just a moment. But first a bit more explanation.
