What I'm Reading (Nov. 9)

By Chuck Dinerstein, MD, MBA — Nov 09, 2023
The Fourth Turning and Complexity Can a medication change our brain’s anatomy? Are colonoscopies helpful? Can the value of chicken soup be quantified?
Image by Alexandra_Koch from Pixabay

I am a huge fan of The Fourth Turning, a consideration of whether there is a cycle to history – are our times linear, circular, or, as they claim, spiral? I think it provides a fascinating lens to consider our current times, the fourth of the generational turnings. The media doesn’t use this particular lens and often couches its concerns of doom and gloom around our changing climate. And then I read this,

“By Turchin’s account, America has been at the brink of collapse twice already, once during the Civil War and again during the Great Depression. It’s not always clear how “collapse” differs from societal change more generally. Some historians define it as a loss of political complexity, while others focus on population decline or whether a society’s culture was maintained.”

This snippet from an article in Wired considers whether past complex civilizations were doomed by climatic change, like the dinosaurs, or what other forces may be at play. It's a great thought piece. Why Have Climate Catastrophes Toppled Some Civilizations but Not Others?

 

Clinical depression is debilitating, and of all the “mental” illnesses, which might be more appropriately described as an illness that presents with more cognitive symptoms than others, appears to be effectively treated in several ways. That includes serotonin re-uptake inhibitors, SSRI

“SSRIs often don’t work. Scientists estimate that over 30 percent of patients don’t benefit from this class of antidepressants. And even when they do, the mood effects of SSRIs take several weeks to kick in, although chemically, they achieve their goal within a day or two. … “It's really been a puzzle to many people: Why this long time?” says Gitte Knudsen, a neurobiologist and neurologist at the University of Copenhagen, Denmark. “You take an antibiotic and it starts working immediately. That's not been the case with the SSRIs.”

Some recent studies suggest it has to do with building new connections within the brain. From Wired, Why Antidepressants Take So Long to Work

 

Periodic colonoscopy is considered a valid screening test in the US, but not so much in other countries, say the EU. Why might that be?

“1. It’s hard to get Europeans to do any colorectal cancer screening, and exceedingly hard to get them to agree to colonoscopies.

2. Colonoscopies have not yet been proven to be cost-effective.

In America, neither of these apply. When setting recommendations, the US Preventative Service Task Force explicitly does not consider costs. …

So that’s my theory. Europe wants stronger evidence for cost-effectiveness. America is more aggressive and more willing to accept high costs.”

A recent study looked at colonoscopy efficacy, which created some turmoil. The article from Asteriskmag, You’re Invited to a Colonoscopy, examines the turmoil and breaks down the study, flaws and all.

 

Chicken soup can easily be the poster child for food as medicine. A recent article in The Conversation, Does chicken soup really help when you’re sick? A nutrition specialist explains what’s behind the beloved comfort food, seems to promise some science behind the hype.

“To truly understand the soothing and healing effects of chicken soup, it’s important to consider the soup’s ingredients. Not all chicken soups are packed with nutritious healing properties. For instance, the ultra-processed canned versions of chicken soup, both with and without noodles, lack many of the antioxidants found in homemade versions. Most canned versions of chicken soup are nearly devoid of hearty vegetables. The core nutrients in homemade versions of the soup are what set these varieties apart from canned versions.”

The quick dig at ultra-processed foods was a flag that the article was more scientism than science. Too bad, it was an opportunity lost.

Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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