Wednesday, November 08, 2006

Eat, Drink and Be Healthy?

Did you see the news this week? Red wine keeps you healthy even if you pig out – at least that's what the headlines read. It's true that there has been an established link between moderate red wine consumption and cardiovascular health for quite some time. A compound found in wine, called resveratrol, is prime suspect of the health-promoting benefits of red wine.

The new study published this week in Nature added fuel to that fire by showing that resveratrol was able to reverse many of the problems associated with eating a high calorie diet. The experiment worked this way: The scientists established three groups of mice. One group ate a standard diet and the other two groups ate high calorie diets; but one of the high calorie diet groups received resveratrol at the same time.

The mice stayed on those three diets until death (some are still alive) and the researchers looked at a lot of different things, including: how much weight the mice gained, how long they lived, insulin and glucose sensitivities (markers of diabetes), the conditions of their hearts and livers upon death, and a whole bunch of biochemical pathways related to disease.

It turned out that resveratrol treatment made the mice that ate a high calorie diet look a lot like the mice that ate a standard diet. So what does the media want you to believe is the bottom line . . . ? You guessed it – You can eat whatever you want as long as you drink red wine, you'll be fine. Do you believe it? Do you want to believe it? The study certainly supports that point of view.

Do you want to take preventative drugs?

In fact, the scientist in charge of the study is the co-founder of a pharmaceutical company that is now developing a high potency resveratrol pill as a drug to treat obesity and all kinds of diseases related to aging. Now I don't want to just leave that statement hanging there because that could obviously be construed as a conflict of interest – Big Time! However, most people have many conflicts of interest in their lives. The real question should relate to the ethics of the people involved – that's all that matters. I'm not going to suggest that the conflict is a problem in this case, but you should know about it nonetheless.

The bigger problem, in my view, relates to the notion that you can drug your way out of a problem that you behaved your way into. I have written posts in the past on this subject and in lieu of this new study feel that I have to bring it up again.

This is the 3rd study over the past couple of months that has been published in a very high profile scientific journal making this ‘magic bullet' type of claim. The other two studies promoted research that suggested you could inject a vaccine or a protein into rats and they would stay thin no matter what they ate. That is a little different from the new study, which says you can give mice drugs to keep them healthy, even though they get fat.

The first two studies focused on using drugs to stay thin and the last one focused on using drugs to stay healthy while you got fat. I know these conclusions are incredibly appealing but I ask again – do you believe it? I just have a hard time subscribing to the magic bullet theory of anything, especially when it comes to biology. Here's why. . .

Are we smarter than nature?

The human body has about 30,000 genes. We have a good understanding of what 1,000 – 2,000 of them do, and some idea about the role of another 5,000 – 10,000. This means that at least one half of our genes are complete mysteries to us. Why is this important?

Drugs work on the notion that when something is wrong with our biochemistry we can fix it with a drug that will interact with the problem-causing biochemical pathway, and set it straight. That's a simplistic view, but essentially that's how drugs work. And in many cases it works very well – for the specific biochemical pathway we are targeting. However, there are thousands of biochemical pathways that we don't understand and we cannot predict how they will respond to drugs – or in some cases we simply don't care as long as the desired effect is observed.

Here's an example. Most people know about statin drugs that are used to lower cholesterol. They are very effective at doing their job – lowering cholesterol. They work by actually inhibiting a part of the biochemical pathway leading to cholesterol synthesis and so reduce cholesterol. However, there are other important molecules that are also synthesized in that same pathway and by inhibiting it (which has the benefit of reducing cholesterol) you are also reducing the production of those. One such molecule is coenzyme Q, which is important for energy production, and very important for the heart and brain. Yes, statins also reduce coenzyme Q production. This is obviously not one of the ‘advertised benefits'.

The point is that while the drug is doing it's job, reducing cholesterol, it is also reducing conenzyme Q production. This is just one of hundreds of examples of ‘side effects' from targeted drug use. The real problem is that we probably don't even know about most of the side effects of most drugs because we know so little about the biochemistry. How can we predict the outcome of manipulating a system without understanding how the parts work?

Most drugs on the market enter clinical trials because they have some apparent benefit and then get tested for toxicity and side effects in larger studies. By the way, most fail at this point. Still, we can only measure toxicity and side effects for things that we know to look at. There are thousands of potential side effects that are not being looked at because we don't have a deep enough understanding of the system.

Your body knows best

So what does all of this mean? It means that in order to stay healthy – the best way is to live a healthy lifestyle. Don't buy into the media hype for ‘magic bullets'. Our bodies are designed to run optimally under healthy living conditions – eating nutritious foods, taking your vitamins, getting plenty of exercise and getting enough sleep. Our bodies have an innate wisdom, coded in our genes, that knows how to keep us healthy as long as we supply them with the right stuff. Trying to outsmart nature with drugs – like resveratrol – might sound appealing but I just can't believe that it will work in the long term. We're just not that smart!

Is this to say that all drugs are bad? Personally, I use things like ibuprofen or acetaminophen when I have a headache that I can't get rid of or a sports injury, but I try to minimize using them. I also believe that drugs can benefit people who are already very ill and just cant' seem to recover on their own. However, the studies I talked about above are geared toward developing drugs for relatively healthy people that don't want to live a healthy lifestyle. They are drugs developed to prevent the consequences of poor behavior. That is a recipe for disaster and I encourage you never to buy into that way of thinking. So feel good about having that glass of red wine with dinner, but please don't expect it to fix all your problems.

Copyright (c) 2006 The Brain Code LLC
Are you Feeding your Kids Dreams or Disaster? Get the scoop on the latest advances in neuroscience to maximize your own child's brain power. Visit www.thebraincode.com to take action today.

Dr. Simon Evans is a neuroscientist at the University of Michigan and a nationally licensed youth sports coach.

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