Monday, March 28, 2011

Chew your calories and drink water: Industrial beverages and tooth erosion

Dental erosion is a different problem from dental caries. Dental erosion is defined as the removal of minerals from the tooth structure via chemicals. Dental caries are the result of increased site-specific acidity due to bacterial fermentation of sugars.

Still, both have the same general result, destruction of teeth structure.

Losing teeth probably significantly accelerated death among our Paleolithic ancestors, as it does with modern hunter-gatherers. It is painful and difficult to eat nutritious foods when one has teeth problems, and chronic lack of proper nutrition is the beginning of the end.

The table below, from Ehlen et al. (2008), shows the amount of erosion that occurred when teeth were exposed to beverages for 25 h in vitro. Erosion depth is measured in microns. The third row shows the chance probabilities (i.e., P values) associated with the differences in erosion of enamel and root. These are not particularly enlightening; enamel and root are both significantly eroded.

These results reflect a broader trend. Nearly all industrial beverages cause erosion, even the “healthy” fruit juices. This is due in part, but not entirely, to the acidity of the beverages. Other chemicals contribute to erosion as well. For example, Coke has a lower pH than Gatorade, but the latter causes more erosion of both enamel and root. Still, both pHs are lower than 4.0. The pH of pure water is a neutral 7.0.

Coke is how my name is pronounced, by the way.

This was a study in vitro. Is there evidence of tooth erosion by industrial beverages in people who drink them? Yes, there is quite a lot of evidence, and this evidence dates back many years. You would not guess it by looking at beverage commercials. See, for example, this article.

What about eating the fruits that are used to make the erosion-causing fruit juices? Doesn’t that cause erosion as well? Apparently not, because chewing leads to the release of a powerful protective substance, which is also sometimes exchanged by pairs of people who find each other attractive.


Leslie A. Ehlen, Teresa A. Marshall, Fang Qian, James S. Wefel, and John J. Warren (2008). Acidic beverages increase the risk of in vitro tooth erosion. Nutrition Research, 28(5), 299–303.

Thursday Night Film Screening at MMU

This Thursday evening at MMU in room JD CO-14 in the John Dalton Building (opposite the BBC see linked map building number 11
Starting 6:00 prompt till 8:30.

The Lost Generation Project is about finding the lost stories of people with intellectual disabilities, many institutionalised for most of their lives. It is about hearing these stories and recognising and celebrating people who have traditionally been socially isolated and aims to assist these people to connect to their communities through arts and culture. The Lost Generation Project has found unique people from across Australia and provided them with the technology and skills to tell their stories on film. Each core project participant or storyteller is offered the opportunity to make a short film that tells their story.

Simone Flavelle is the Manager/Executive Producer of this project and she will be giving us the opportunity to see some of these films and engage in a discussion.

To register for this event, email  There will be a small charge on the evening of £2.00 on the door to cover costs for this event.

Thank you to all those who have registered so far. 

Details of this work and 5 films are available to view on line at:
Now I'm not sure whether this is the true public face of Arts and Health...but I can certainly see the connection! MC NxtGen and a take on NHS 'reform'.

Thursday 30th June: International Arts and Health HEAD to HEAD (part of the Northern Uproar and m a n i f e s t o  events) 

Details of this unique event at MMU (which will offer members of the North West Arts and Health Network the opportunity to meet key figures from the Arts and Health field from the UK, USA, Ireland, South Africa and Australia) and will be advertised shortly.

Please note at this stage we are not able to take reservations, but details will be posted on the BLOG asap.

MoMA the Arts and Dementia
I have just returned from an intensive period of activity with the Museum of Modern Art (MoMA) in New York exploring synergies between the arts and dementia as part of an action research programme I am undertaking within an NHS trust between 2011-2015. A report relating to this work will be available via Arts for Health shortly alongside a dedicated BLOG. Thanks to Carrie McGee at MomMA and Dr Anne Basting at the University of Wisconsin.

BIG SOCIETY (a good read)
Arts Funding, Austerity and the Big Society: Remaking the case for the arts John Knell and Matthew Taylor

Recent weeks have seen much action towards the m a n i f e s t o, with events in Cumbriia planned...more details soon…

Tuesday, March 22, 2011

Fusing aging theories: Telomere shortening causes mitochondrial dysfunction

New research is adding insight and linking three theories of aging—one that suggests telomere shortening governs lifespan, and two others that suggest dysfunctional mitochondria or oxidative stress leads to aging.

At Harvard-affiliated Dana-Farber Cancer Institute, scientists have gathered data suggesting telomere shortening is the cause of mitochondrial dysfunction and diminished antioxidant defenses. Together, they decrease the body’s energy and diminish organ function, both characteristic of old age.

As telomeres—protective caps at the end of cell chromosomes—shorten with age and begin to fray, cells activate the p53 gene, which signals an “emergency shutdown” chain of events that turns off normal cell growth and division and compromise antioxidant defenses. Going one step further, data from the carefully orchestrated mouse study, published in Nature, show that the p53 gene also represses PGC1-alpha and PGC1-beta. These PCGs are considered the master regulators of metabolism and mitochondrial function.

Repressing PCGs increases the number of dysfunctional mitochondria (with mutated mitochondrial DNA) and leads to a decrease in functional mitochondria distributed throughout in muscles and organs. The dysfunctional mitochondria in aged tissues leak greater amounts of reactive oxygen species and the lack of functional mitochondria hinders normal energy production from cell respiration (the body’s main producer of ATP energy).

“What we have found is the core pathway of aging connecting several age-related biological processes previously viewed as independent from each other,” said Ronald A. DePinho, M.D., a cancer geneticist and senior author of the paper, in a press release.

“Because telomere dysfunction weakens defenses against damage by free radicals, or reactive oxygen species,” Dr. DePinho said, “we think this exposes telomeres to an accelerated rate of damage which cannot be repaired and thereby results in even more organ deterioration. In effect, it sets in motion a death spiral.”

In an article also published in the same issue Nature, Daniel P. Kelly, M.D., scientific director and professor at Burnham Institute for Medical Research-Lake Nona, Orlando, Florida, said that the “intriguing study… unveils a potentially unifying mechanism for cellular ageing.”

Mitigating the Toll of Aging

The new study further supports current thinking that the best defense against aging is to reduce the adverse affects of overproduction of free radicals produced from dysfunctional mitochondria, which cause additional oxidative stress.

Dr. DePinho said, “The findings bear strong relevance to human aging, as this core pathway can be directly linked to virtually all known genes involved in aging, as well as current targeted therapies designed to mitigate the toll of aging on health.”

Those current targeted therapies include boosting the human body’s antioxidant defenses by eating a healthy diet, reducing calories (by around 25 percent), and supplementing with antioxidant vitamins C and E, as well as with green tea, CoQ10 and resveratrol. These practices not only help to protect against oxidative stress, thereby protecting against telomere shortening, but also help boost generation of new, healthy mitochondria.

When we asked telomere biologist Bill Andrews, Ph.D., to comment on the new study, he answered that it was “tremendous news,” as it supports the need for more research into management of telomeres by activating the genetic expression of the enzyme telomerase, which re-lengthens telomeres.

Dr. Andrews wrote, “It’s the best support ever for the fact that telomere elongation’s role in aging far exceeds the roles played by mitochondria and oxidative stress.” In effect, telomere shortening is the root cause of the others.

Mitochondria become dysfunctional when telomeres shorten and fray, a new study suggests. In an article to be published in a forthcoming issue of IsaNews magazine, Dr. Andrews writes, “Mitochondrial dysfunction causes aging—but telomere shortening has turned out to be the primary cause of mitochondrial dysfunction. And humans’ natural defenses against oxidative stress are really quite exceptional (for example, our cells produce ten times more superoxide dismutase, a potent natural antioxidant, than mice)—until telomere shortening begins to degrade those defenses inside our bodies.”

He added that while “anti-aging therapies of years past merely treated the symptoms of aging. New research is devoted to identifying a new class of therapies that treat aging at its root cause, and hold great promise of one day allowing us to feel young and healthy at 120 years of age and beyond.”

An earlier study, of which Dr. DePinho was also the senior author, gives testimony to the benefits of telomerase, as found in mice that were genetically engineered to produce the enzyme. The study found that when the telomerase was restored in the mice, their age-related symptoms disappeared and several organs including the brain were rejuvenated.


Kelly DP. Cell biology: Ageing theories unified. Nature 2011;470:342-3.

Sahin E, Colla S, Liesa M et al. Telomere dysfunction induces metabolic and mitochondrial compromise. Nature 2011;470:359-65.

Sahin E, DePinho RA. Linking functional decline of telomeres, mitochondria and stem cells during ageing. Nature 2010;464:520-8.

Jaskelioff M, Muller FL, Paik JH et al. Telomerase reactivation reverses tissue degeneration in aged telomerase-deficient mice. Nature 2011;469:102-6.

Monday, March 21, 2011

Health markers varying inexplicably? Do some detective work with HCE

John was overweight, out of shape, and experiencing fatigue. What did he do? He removed foods rich in refined carbohydrates and sugars from his diet. He also ditched industrial seed oils and started exercising. He used HealthCorrelator for Excel (HCE) to keep track of several health-related numbers over time (see figure below).

Over the period of time covered in the dataset, health markers steadily improved. For example, John’s HDL cholesterol went from a little under 40 mg/dl to just under 70; see chart below, one of many generated by HCE.

However, John’s blood pressure varied strangely during that time, as you can see on the chart below showing the variation of systolic blood pressure (SBP) against time. What could have been the reason for that? Salt intake is an unlikely culprit, as we’ve seen before.

As it turns out, John knew that heart rate could influence blood pressure somewhat, and he also knew that his doctor’s office measured his heart rate regularly. So he got the data from his doctor's office. When he entered heart rate as a column into HCE, the reason for his blood pressure swings became clear, as you can see on the figure below.

On the left part of the figure above are the correlations between SBP and each of the other health-related variables John measured, which HCE lists in order of strength. Heart rate shows up at the top, with a high 0.946 correlation with SBP. On the right part of the figure is the chart of SBP against heart rate.

As you can see, John's heart rate, measured at the doctor's office, varied from 61 to 90 bpm. Given that, John decided to measure his resting heart rate. John’s resting heart rate, measured after waking up using a simple wrist watch, was 61 bpm.

Mystery solved! John’s blood pressure fluctuations were benign, and caused by fluctuations in heart rate.

If John's SBP had been greater than 140, which did not happen, this could be seen as an unusual example of irregular white coat hypertension.

If you are interested, this YouTube video clip discusses in more detail the case above, from HCE’s use perspective. It shows how the heart rate column was added to the dataset in HCE, how the software generated correlations and graphs, and how they were interpreted.


Kock, N. (2010). HealthCorrelator for Excel 1.0 User Manual. Laredo, Texas: ScriptWarp Systems.

Wednesday, March 16, 2011

Potassium iodide: Why you should avoid it

Ever since the news of Japan's nuclear crisis, there have been several claims made over the Internet that have panicked people in the U.S. about potential exposure to radiation (one culprit is this viral e-mail), which has led to me being the recipient of questions about whether or not people should be taking potassium iodide supplements to avoid absorption to radioactive iodine.

Should you take potassium iodide pills? My answer has been an unequivocal, "No, it's not necessary. There is little risk of any level of radiation exposure to worry about anywhere else other than in Japan near the reactors. If you're worried about getting cancer, try thinking more about losing weight, eating more dietary fiber, and eating more fruits and vegetables."

In the process of answering questions, I did find myself interested in learning more about radiation and health. By far the best, most in-depth article I've read on "How Radiation Threatens Health" is this one written by Nina Bai and published by Scientific American. Bai's article gives readers an excellent understanding on the typical radiation levels that people are currently exposed to (0.2 to 0.3 milliSieverts), how much they are exposed to by a typical CT scan (1 milliSievert) and what kinds of levels people should really be worried about—the kind of levels that lead to symptoms of radiation sickness ("a whole body dose of 3 sieverts, that is, 3,000 times the recommended public dose limit per year") and the kind that kills people within weeks (5 to 10 sieverts).

Yes, there are concerns over low-dose radiation over time, but as Bai's article points out, the increase of cancer risk is small and basically comes out to about an increase of eight potential cancer cases per 10,000 people. And, the point is that even if any radiation made it over the ocean and to the U.S. (which is unlikely) it would be at levels too low to cause concern.

As for potassium iodide (KI) supplements (not addressed in Bai's article), there is cause for concern because I keep reading that these are "flying off the shelves" in various articles.

The way KI works is by flooding iodine into the thyroid gland to become trapped by the thyroid's receptors, which blocks the uptake and accumulation of radioiodine that could lead to possible thyroid diseases or cancer. This is particularly important in children who are more at risk for radioiodine-induced cancer (as is what happened with the Chernobyl incident because of radioiodine0contaminated milk). The doses for preventing radioidine uptake are high: 50 to 100 milligrams for adults. If exposure is pretty certain, then supplementation with these pills make sense.

But consider that the Upper Limit for adults is 1.1 milligram per day. These pharmacologic doses could be potentially detrimental since excessive iodine can actually lead to hyper- or hypothyroidism and have been known to increase risk of thyroid cancers. Taking these doses should not be considered a safe precautionary measure, as marketed. There is a risk!

My concern is this: that the irresponsible Internet claims are leading people to actually take the high doses of the KI and that retail outlets selling them (like this one with 130 milligram per tablet!) are doing so without giving people any sense of what the risks are when taking high amounts.

Monday, March 14, 2011

We share an ancestor who probably lived no more than 640 years ago

This post has been revised and re-published. The original comments are preserved below. Typically this is done with posts that attract many visits at the time they are published, and whose topics become particularly relevant or need to be re-addressed at a later date.

Thursday, March 10, 2011

Are the Best Things in Life Free?
A Public Discussion and Debate

What matters most to you in life? If we wanted to measure wellbeing - what things should we include? These and other questions will form the focus of a stimulating public event which is being hosted by the Centre for Research for Health and Wellbeing at the Univesity of Bolton on Thursday 7th April at 4pm. The event will include a panel of experts who will make a pitch for the things they think play a role in wellbeing - and there will be lots of opportunity for the public to participate and join in the debate. The discussion and arguments will be fed back to the Office of National Statistics who have been asked by the government to devise a measure of national wellbeing.
Further details at 

Breakthrough are delighted to announce that they are holding another Arts in Health Event in Manchester on Friday the 10th of June, 2011. We are keen to build on the momentum generated from previous events, using the setting as a way in which to promote positive practice, showcase the talents of service users, bring people and ideas together and to work towards developing a unified, national strategy for moving forwards. It would be great to have you involved!
Please visit the website  or get in touch via  

The Triangle Trust 1949
Fund Opens for Applications (UK)
The Triangle Trust 1949 Fund is currently inviting applications from charity organisations to support projects that support:
  • Carers
  • Community arts and education
  • Disability
  • Older people
  • Poverty
  • Integration and rehabilitation
Grants are normally in the range of £1,000 and £10,000. The objectives of the Fund are; the alleviation of poverty and the promotion of good health and welfare; the advancement and furthering of education. Successful projects will either maintain an open, inclusive society or promote integration (or reintegration) of individuals or groups into society. Preference will be given to smaller charities; charities which serve a locality or region of the UK, rather than national charities; and causes which find it more difficult to raise funds from the general public. The next application deadline is the 14th May 2011. For more information visit:

Two Exhibitions at the University of Salford
Wed, 30 March 2011 to Sat, 30 April 2011
Ghislaine Howard: The Choreography of Walking

Personal experience drew artist Ghislaine Howard to the subject of walking: from charting the first hesitant steps of her children, to watching the determination and courage of her mother refusing to accept the debilitating progress of Parkinson’s disease. Central to this exhibition is the work Ghislaine has done in conjunction with the University of Salford’s Podiatry Department, which increased her wonder at the extraordinary choreographies of walking. “The simple act of putting one foot in front of the other - so natural it seems for most of us, so hard won for others.”

Venue: Chapman Gallery, Chapman Building, University of Salford, M5 4NT
Opening hours: Tuesday - Friday (12-5pm), also open Saturday 2 April & Saturday 30 April (12-5pm). The gallery will be closed on Bank Holidays Friday 22 & Friday 29 April.

Sarah Coggrave, Bronwyn Platten and others...: Mouths and Meaning
Tue, 24 May 2011 to Fri, 24 June 2011

Bronwyn Platten & Sarah Coggrave: Flumpy (2010) & Untitled (2010)
Mouths and Meaning is a research project and exhibition developed by Bronwyn Platten, towards her PhD based in the School of the Built Environment, the University of Salford. The focus of Mouths and Meaning is to explore and creatively represent experiences of embodiment, food and eating by those who have been affected by an eating disorder. Using a multisensory, holistic and interdisciplinary approach the exhibition will showcase a range of new works including photography, film and sculpture developed by Sarah Coggrave in collaboration with Bronwyn Platten; a selection of individual works by both artists as well as a series of drawings by workshop participants from England, Scotland and Australia.

Bronwyn’s studentship has been funded by EPSRC as part of the collaborative, multi-institutional Health and Care Infrastructure Research and Innovation (HaCIRIC), IMRC Centre, the School of the Built Environment, the University of Salford.
Venue: Chapman Gallery, Chapman Building, University of Salford, M5 4NT
Opening hours: 12 - 5pm, Wed to Sat
Preview/launch event: Tuesday 24 May, 6-8pm (free admission, everyone welcome!)

Monday, March 7, 2011

The China Study II: Fruit consumption and mortality

I ran several analyses on the effects of fruit consumption on mortality on the China Study II dataset using WarpPLS. For other China Study analyses, many using WarpPLS as well as HCE, click here.

The results are pretty clear – fruit consumption has no significant effect on mortality.

The bar charts figure below shows what seems to be a slight downward trend in mortality, in the 35-69 and 70-79 age ranges, apparently due to fruit consumption.

As it turns out, that slight trend may be due to something else: in the China Study II dataset, fruit consumption is positively associated with both animal protein and fat consumption. And, as we have seen from previous analyses (e.g., this one), the latter two seem to be protective.

So, if you like to eat fruit, maybe you should also make sure that you eat animal protein and fat as well.

Friday, March 4, 2011

Exclusive DADAA Film Screening and Call for Papers

The Lost Generation Film Project (DADAA Inc)

6:00pm to 8:30pm, Thursday 31st March 2011
At Manchester Metropolitan University

This is a unique opportunity to experience the work of DADAA and thanks to Durham University’s Centre for Medical Humanities, who have supported this event.

The Lost Generation Project is about finding the lost stories of people with intellectual disabilities, many institutionalised for most of their lives. It is about hearing these stories and recognising and celebrating people who have traditionally been socially isolated and aims to assist these people to connect to their communities through arts and culture. The Lost Generation Project has found unique people from across Australia and provided them with the technology and skills to tell their stories on film. Each core project participant or storyteller is offered the opportunity to make a short film that tells their story.

Simone Flavelle is the Manager/Executive Producer of this project and she will be giving us the opportunity to see some of these films and engage in a discussion.

To register for this event or get more details, email  There will be a small charge on the evening of £2.00 to cover costs for this event.

Thank you to all those who have registered so far. Confirmation of places and details of venue will be provided 1 week prior to the event.

Details of this work and 5 films are available to view on line at:  

Striking a Chord
Music, Health and Wellbeing:Current Developments in Research and Practice

Date: 9th-10th September 2011
Venue: University Centre Folkestone

Wednesday, March 2, 2011

Vitamin K2: Building bones while beating back arterial calcification

Vitamin K2's time to shine has come—move over vitamin D! Once only known for its role as a "koagulation" factor in blood clotting, vitamin K2 is emerging as another fundamental anti-aging nutrient. While vitamins D and E have garnered the majority of interest in the last decade, the impact of vitamin K2 on aging bones and hearts demands that we give it equal attention.

Whereas most vitamin and mineral supplements use vitamin K in its form of K1 (phylloquinone sourced from plants) because it is easily available and cheap, it is the natural form of K2 (menaquinone sourced from friendly bacteria) that is the most biologically active and shown to enhance both bone formation and vascular health.

The full compilation of recent research underscores the idea that K1 and K2 should be appreciated as separate nutrients with distinct physiological actions and benefits. K1 is the more familiar vitamin known for its key role in directing blood-clotting in the body and the one given as a shot at birth (a common practice in many countries to curtail hemorrhage incidents in newborns.) The picture for K2 seems to be a bit more varied and is key in regulating calcium balance.

Vitamin K2 acts by activating the bone-building hormone (carboxylating osteocalcin) to clear calcium from the arteries and use it in bone mineralization. It effectively removes calcium that would otherwise end up deposited in arterial plaques. Since protecting arteries and soft tissues from calcification is one of the most important ways to stave off the ravages of aging on the body, consuming enough vitamin K2 daily is key for a long, healthy life.

Getting Enough K2

Because vitamin K2 is synthesized by friendly bacteria in the intestine, nutrition scientists have long assumed that that deficiencies were rare. However, new data are showing that intestinally synthesized vitamin K is not absorbed as easily as previously thought. Vitamin K also preferentially accumulates in the liver where it does have a clotting factor role.

In fact, once overlooked because "time to clot" was the test for vitamin K status, it is here where we are now seeing new signs of vitamin K deficiency previously only seen with vitamin D deficiency—fragile, brittle bones and increased fractures—even with adequate calcium and vitamin D.

Most people in North America should increase amounts consumed daily. The evidence finds that only with much higher intake do bone cells get their share and the same holds true for removal of calcium in arteries.

People can obtain enough vitamin K2 by eating plenty of fermented foods such as cheese, sauerkraut, and natto (a traditional Japanese soy-based food). Supplementation is another viable option as achieved with a quality multivitamin.

Regardless of how one gets it, it’s important not to underestimate value of this underdiscussed nutrient and to understand that most people are not getting enough. Consuming sufficient amounts of K2 along with a healthy diet will increase odds of a healthier life with clear arteries and stronger bones.


McCann and Ames. Vitamin K, an example of triage theory: is micronutrients inadequacy linked to diseases of aging?. Am J Clin Nutr 90:889-907, 2009.
Vitamin K2. Monograph. Alternative Medicine Review 14(3):284-293, 2009.
Koitaya. Et al. Effect of low dose vitamin K2 (MK-4) supplementation on bioindices in postmenopausal Japanese women. J Nutr Sci Vitaminol. 55:15-21, 2009.
Gast, et al. A high menaquinone intake reduces the incidence of coronary heart disease. Nutr Metab Cardiovas Dis 19:504-510, 2009.
Shea, et al. Vitamin K supplementation and progression of coronary artery calcium in older men and women. Am J Clin Nutr 89: 1799-1807, 2009.
Shea MK, Booth SL Update on the role of vitamin K in skeletal health. Nutr Rev 66(10):549-57, 2008.

Tuesday, March 1, 2011

What a Life

What A Life! from Clive Parkinson on Vimeo.
On 15 February 1949, the Conservative MP for Twickenham, Edward Keeling asked the President of the Board of Trade in the House of Commons.

"Has the Lord President seen this film? Does he know that it shows two men so depressed by the conditions of life the in England today that they try to drown themselves, but make a mess of it? Does he really think that this is the sort of film on which £9,000 of taxpayers' money should be spent?"

This Richard Massingham film is a bizarre contribution from the Crown Film Unit, and addresses the challenges Britain faced in the austere post-war era. Wartime enthusiasm and self-confidence had become seriously eroded by the crisis-laden year of 1947. Domestically, the continuation of rationing, including for the first time bread (between 1946-48) and the fuel and economic crises, together with Indian independence, 1947 was largely a year that dented the immediate post war assurances.

Please enjoy this post-war austerity film and its relevance today!