Friday, 25 March 2011

Sex and Heart: more myths than Facts

Rehashing Old News but this time, proud to provide Numbers!

The information published recently and of course caught on the fancy of the media because of Sexual Activity was studied, has been known to generations of Doctors. But one has to be careful: many people may interpret the studies to say that you may die after exercise or having sex!

Even in this study the risk involved with EPISODIC exercise or SEXUAL activity was so small, but the numbers can be threatening: twice as much or three times as much , yes one in hundred thousand men years to two in hundred thousand men years!

'Episodic' Physical and Sexual Activity Linked to CV Risk

Shelley Wood

March 24, 2011 (Boston, Massachusetts) — It's a perennially sexy topic: just what are the cardiovascular risks of "episodic" physical and sexual activity, especially for the habitually inactive? A new literature review and meta-analysis published in the March 23, 2011 issue of the Journal of the American Medical Association provides some new numbers that authors say may be of use to patients and physicians going forward--providing they understand just what they mean [1].

Dr Issa J Dahabreh and Jessica K Paulus (Tufts University, Boston, MA) used a complex, multitiered study design to get at the issue of whether the risk of MI or sudden cardiac death was elevated during or shortly after an episode of physical or sexual activity--not an easy thing to measure, they say, because "exposure" to these events is infrequent and transient. Using a literature review, the authors found 14 studies: one study addressed the impact of both types of activity on cardiovascular risk, 10 focused solely on episodic physical activity, and three looked only at sexual activity.

By Dahabreh's own admission, their analysis is complicated, but not novel--by definition, a meta-analysis of previous case-crossover studies means that others have already addressed the very questions that he and Paulus were hoping to answer--namely, the question of cardiovascular risks associated with physical or sexual activity. But by combining multiple studies, he told heartwire , their analysis brings more "precision" and statistical power to the findings and provides "additional insights"--helping "discern patterns that are not possible to identify by looking at a single study."

Risk of Cardiac Events Occurring During/After Activity

For example, they write, episodic physical activity across multiple studies was associated with almost a 3.5-fold increased risk of MI and a nearly fivefold increase in the risk of sudden cardiac death. Episodic sexual activity was associated with 2.7-fold increased risk of MI.

These numbers speak to a relative risk "of a large magnitude," Dahabreh acknowledged, but he stressed that it is important to understand just what is being evaluated. He's worried that the media attention this paper has aroused may focus only on the sexual-activity component and may lead to confusion over the paper's findings.

"What is being compared here is the probability of being exposed to physical or sexual activity within a few hours of experiencing the heart attack, compared with control periods. This is a matched-case design only, so one would not interpret this by saying that there is a 3.5-fold increase in risk for people who exercise. Instead, the interpretation would be, for example, for physical activity and heart attack, that there is a 3.5-times increase in risk while the individual is exercising or immediately after physical activity, compared with control periods when the individual is not engaged in physical activity."

For any given person, Dahabreh stressed, the absolute risk was very small: the absolute risk increase associated with one hour of additional sexual or physical activity per week was 1 per 10 000 person-years for sudden cardiac death and 2 to 3 per 10 000 person-years for MI.

But of note, risk of both MI and sudden death fell dramatically if individuals reported engaging in some kind of habitual physical activity. For each additional instance of increased physical activity performed per week, risk of sudden cardiac death decreased by almost one-third, while risk of MI decreased by approximately 45%.

"You Need to Be Constantly Physically Active"

Dr Eileen Handberg (University of Florida, Gainesville), asked to comment on the study for heartwire , said that it confirms what most people already believe to be the case.

"I think this paper is going to get a lot of [media] play, but I'm not sure that this is anything more than what has already been said--that, basically, if you're not in good shape, and if you try suddenly to be active, then you put yourself at risk. And whether that physical activity is walking, running, shoveling snow, or having sex, you're at some risk," she said. "You really need to be constantly physically active, and you need to start that as a child, and you need to carry it through until you're 90."

As mentioned earlier, this association has been noted anecdotally for many years and of course there are many myths..

Myths About Sexual Activity and Heart Disease

Common Misconceptions about the Sexual Impact of Heart Disease and Heart Attack

Myth: People with heart disease should be fearful of sex.Myth: Having heart disease requires that you reduce your sexual activity.

Myth: People with weak hearts have to avoid “kinky" sex.

Myth: After a heart attack you have to wait 6 to 8 weeks before resuming sexual activity.

Myth: Your doctor will tell you what’s risky and when you can resume sex after a heart attack.

They are running out of interesting topics in Medicine? Of course, SEX does sell…

Wednesday, 23 March 2011


this article is reproduced from a recent issue of Boston newspaper. it was published n Arts and Literature Daily.

You hear it all the time: We humans are social animals. We need to spend time together to be happy and functional, and we extract a vast array of benefits from maintaining intimate relationships and associating with groups. Collaborating on projects at work makes us smarter and more creative. Hanging out with friends makes us more emotionally mature and better able to deal with grief and stress.

Spending time alone, by contrast, can look a little suspect. In a world gone wild for wikis and interdisciplinary collaboration, those who prefer solitude and private noodling are seen as eccentric at best and defective at worst, and are often presumed to be suffering from social anxiety, boredom, and alienation.

But an emerging body of research is suggesting that spending time alone, if done right, can be good for us — that certain tasks and thought processes are best carried out without anyone else around, and that even the most socially motivated among us should regularly be taking time to ourselves if we want to have fully developed personalities, and be capable of focus and creative thinking. There is even research to suggest that blocking off enough alone time is an important component of a well-functioning social life — that if we want to get the most out of the time we spend with people, we should make sure we’re spending enough of it away from them. Just as regular exercise and healthy eating make our minds and bodies work better, solitude experts say, so can being alone.

One ongoing Harvard study indicates that people form more lasting and accurate memories if they believe they’re experiencing something alone. Another indicates that a certain amount of solitude can make a person more capable of empathy towards others. And while no one would dispute that too much isolation early in life can be unhealthy, a certain amount of solitude has been shown to help teenagers improve their moods and earn good grades in school.

“There’s so much cultural anxiety about isolation in our country that we often fail to appreciate the benefits of solitude,” said Eric Klinenberg, a sociologist at New York University whose book “Alone in America,” in which he argues for a reevaluation of solitude, will be published next year. “There is something very liberating for people about being on their own. They’re able to establish some control over the way they spend their time. They’re able to decompress at the end of a busy day in a city...and experience a feeling of freedom.”

Figuring out what solitude is and how it affects our thoughts and feelings has never been more crucial. The latest Census figures indicate there are some 31 million Americans living alone, which accounts for more than a quarter of all US households. And at the same time, the experience of being alone is being transformed dramatically, as more and more people spend their days and nights permanently connected to the outside world through cellphones and computers. In an age when no one is ever more than a text message or an e-mail away from other people, the distinction between “alone” and “together” has become hopelessly blurry, even as the potential benefits of true solitude are starting to become clearer.

Solitude has long been linked with creativity, spirituality, and intellectual might. The leaders of the world’s great religions — Jesus, Buddha, Mohammed, Moses — all had crucial revelations during periods of solitude. The poet James Russell Lowell identified solitude as “needful to the imagination;” in the 1988 book “Solitude: A Return to the Self,” the British psychiatrist Anthony Storr invoked Beethoven, Kafka, and Newton as examples of solitary genius.

But what actually happens to people’s minds when they are alone? As much as it’s been exalted, our understanding of how solitude actually works has remained rather abstract, and modern psychology — where you might expect the answers to lie — has tended to treat aloneness more as a problem than a solution. That was what Christopher Long found back in 1999, when as a graduate student at the University of Massachusetts Amherst he started working on a project to precisely define solitude and isolate ways in which it could be experienced constructively. The project’s funding came from, of all places, the US Forest Service, an agency with a deep interest in figuring out once and for all what is meant by “solitude” and how the concept could be used to promote America’s wilderness preserves.

With his graduate adviser and a researcher from the Forest Service at his side, Long identified a number of different ways a person might experience solitude and undertook a series of studies to measure how common they were and how much people valued them. A 2003 survey of 320 UMass undergraduates led Long and his coauthors to conclude that people felt good about being alone more often than they felt bad about it, and that psychology’s conventional approach to solitude — an “almost exclusive emphasis on loneliness” — represented an artificially narrow view of what being alone was all about.

“Aloneness doesn’t have to be bad,” Long said by phone recently from Ouachita Baptist University, where he is an assistant professor. “There’s all this research on solitary confinement and sensory deprivation and astronauts and people in Antarctica — and we wanted to say, look, it’s not just about loneliness!”

Today other researchers are eagerly diving into that gap. Robert Coplan of Carleton University, who studies children who play alone, is so bullish on the emergence of solitude studies that he’s hoping to collect the best contemporary research into a book. Harvard professor Daniel Gilbert, a leader in the world of positive psychology, has recently overseen an intriguing study that suggests memories are formed more effectively when people think they’re experiencing something individually.

That study, led by graduate student Bethany Burum, started with a simple experiment: Burum placed two individuals in a room and had them spend a few minutes getting to know each other. They then sat back to back, each facing a computer screen the other could not see. In some cases they were told they’d both be doing the same task, in other cases they were told they’d be doing different things. The computer screen scrolled through a set of drawings of common objects, such as a guitar, a clock, and a log. A few days later the participants returned and were asked to recall which drawings they’d been shown. Burum found that the participants who had been told the person behind them was doing a different task — namely, identifying sounds rather than looking at pictures — did a better job of remembering the pictures. In other words, they formed more solid memories when they believed they were the only ones doing the task.

The results, which Burum cautions are preliminary, are now part of a paper on “the coexperiencing mind” that was recently presented at the Society for Personality and Social Psychology conference. In the paper, Burum offers two possible theories to explain what she and Gilbert found in the study. The first invokes a well-known concept from social psychology called “social loafing,” which says that people tend not to try as hard if they think they can rely on others to pick up their slack. (If two people are pulling a rope, for example, neither will pull quite as hard as they would if they were pulling it alone.) But Burum leans toward a different explanation, which is that sharing an experience with someone is inherently distracting, because it compels us to expend energy on imagining what the other person is going through and how they’re reacting to it.

“People tend to engage quite automatically with thinking about the minds of other people,” Burum said in an interview. “We’re multitasking when we’re with other people in a way that we’re not when we just have an experience by ourselves.”

Perhaps this explains why seeing a movie alone feels so radically different than seeing it with friends: Sitting there in the theater with nobody next to you, you’re not wondering what anyone else thinks of it; you’re not anticipating the discussion that you’ll be having about it on the way home. All your mental energy can be directed at what’s happening on the screen. According to Greg Feist, an associate professor of psychology at the San Jose State University who has written about the connection between creativity and solitude, some version of that principle may also be at work when we simply let our minds wander: When we let our focus shift away from the people and things around us, we are better able to engage in what’s called meta-cognition, or the process of thinking critically and reflectively about our own thoughts.

Other psychologists have looked at what happens when other people’s minds don’t just take up our bandwidth, but actually influence our judgment. It’s well known that we’re prone to absorb or mimic the opinions and body language of others in all sorts of situations, including those that might seem the most intensely individual, such as who we’re attracted to. While psychologists don’t necessarily think of that sort of influence as “clouding” one’s judgment — most would say it’s a mechanism for learning, allowing us to benefit from information other people have access to that we don’t — it’s easy to see how being surrounded by other people could hamper a person’s efforts to figure out what he or she really thinks of something.

Teenagers, especially, whose personalities have not yet fully formed, have been shown to benefit from time spent apart from others, in part because it allows for a kind of introspection — and freedom from self-consciousness — that strengthens their sense of identity. Reed Larson, a professor of human development at the University of Illinois, conducted a study in the 1990s in which adolescents outfitted with beepers were prompted at irregular intervals to write down answers to questions about who they were with, what they were doing, and how they were feeling. Perhaps not surprisingly, he found that when the teens in his sample were alone, they reported feeling a lot less self-conscious. “They want to be in their bedrooms because they want to get away from the gaze of other people,” he said.

The teenagers weren’t necessarily happier when they were alone; adolescence, after all, can be a particularly tough time to be separated from the group. But Larson found something interesting: On average, the kids in his sample felt better after they spent some time alone than they did before. Furthermore, he found that kids who spent between 25 and 45 percent of their nonclass time alone tended to have more positive emotions over the course of the weeklong study than their more socially active peers, were more successful in school and were less likely to self-report depression.

“The paradox was that being alone was not a particularly happy state,” Larson said. “But there seemed to be kind of a rebound effect. It’s kind of like a bitter medicine.”

The nice thing about medicine is it comes with instructions. Not so with solitude, which may be tremendously good for one’s health when taken in the right doses, but is about as user-friendly as an unmarked white pill. Too much solitude is unequivocally harmful and broadly debilitating, decades of research show. But one person’s “too much” might be someone else’s “just enough,” and eyeballing the difference with any precision is next to impossible.

Research is still far from offering any concrete guidelines. Insofar as there is a consensus among solitude researchers, it’s that in order to get anything positive out of spending time alone, solitude should be a choice: People must feel like they’ve actively decided to take time apart from people, rather than being forced into it against their will.

Overextended parents might not need any encouragement to see time alone as a desirable luxury; the question for them is only how to build it into their frenzied lives. But for the millions of people living by themselves, making time spent alone time productive may require a different kind of effort. Sherry Turkle, director of the MIT Initiative on Technology and Self, argues in her new book, “Alone, Together,” that people should be mindfully setting aside chunks of every day when they are not engaged in so-called social snacking activities like texting, g-chatting, and talking on the phone. For teenagers, it may help to understand that feeling a little lonely at times may simply be the price of forging a clearer identity.

John Cacioppo of the University of Chicago, whose 2008 book “Loneliness” with William Patrick summarized a career’s worth of research on all the negative things that happen to people who can’t establish connections with others, said recently that as long as it’s not motivated by fear or social anxiety, then spending time alone can be a crucially nourishing component of life. And it can have some counterintuitive effects: Adam Waytz in the Harvard psychology department, one of Cacioppo’s former students, recently completed a study indicating that people who are socially connected with others can have a hard time identifying with people who are more distant from them. Spending a certain amount of time alone, the study suggests, can make us less closed off from others and more capable of empathy — in other words, better social animals.

“People make this error, thinking that being alone means being lonely, and not being alone means being with other people,” Cacioppo said. “You need to be able to recharge on your own sometimes. Part of being able to connect is being available to other people, and no one can do that without a break.”

Thursday, 17 March 2011

Stress Free Life of an Endocrinologist who is also a Medical Anthropologist

Wandering Medical Anthropologist and Endocrinologist: A prescription for a Stress Free Life

Day 1 March 4th, 2011

EuroStar. Paris Gare du Nord to St Pancras, London. 2h 32 min. How quickly the time passes, through the Chunnel and then a different scenery. ( How did these two smaller countries dominate the world for centuries?). A very chilly arrival Hall under the dome of the Station, a huge clock welcoming you. Quick line at Tube Ticket Station to get the Oyster Card refilled. Russell Square. 5 minutes. British Museum, the mother of all Museums. Thai Lunch. Tasty. Good ambience. Nice to walk through the China town. Piccadilly Circus. 1 hr to Heathrow terminals 1,2,3.

Outside Bus 140. Station Road, Hayes. Short walk to Comfort Inn. Take out Lamb and Nan. Delicious

Day 2

3.45 AM. Up and ready for the bus at 4 20 but it is late, thus missing its connection at Terminal 5. London Buses will take you to Terminal 4 gratis. No bags to check in. Quickly through security. Skyteam Club. Quite luxurious. A nice shower and shave. First of the many good meals for the day. Left London, quickly through the security and Immigration at CDG. Enough time to check emails at the Air France Lounge at Terminal 2 E. CDG to IAH 10 hr 15 minutes, announced the Lady Captain of the 777-200ER. Still arrived fresh. Good time to read slowly. At IAH less than five minutes to go through Global Entry automatic immigration and a dedicated channel to leave the airport premises. Wait for the hotel shuttle. Comfortable hotel. Sound Sleep.

Day 3

After breakfast, back to the airport. IAH to OMA 2 hr. Lunch served. A glass of chardonnay as well. Greeted warmly by the AVIS rent a car staff at the OMA airport. A nice car to drive through the predicted snow. 95 miles to the REZ and the Blue House. Driving through the dreary I 29 but decided to enjoy looking at the Loess Hills. Missouri River. Bridge at Onawa exit. Chat with the toll keeper. Another Quiet day

Day 4

Endocrine Clinic at the Health Centre. Not very busy. Connecting with colleagues. Lunch with a patient who is also a teacher in the Indian ways to me. I told him I have an important meeting two days hence. He said: do not speak too much about yourself, may your voice have healing words to help the Indians.

Putting the final touches to the presentation I have to make two days hence.

Day 5

To Oklahoma City

Back on the road. 95 miles back to the airport. Flight to DEN and change planes to OKC. John arrives from San Antonio, rents a car and off we go to check into Marriott’s Hotel. Space. Sterile. Friendly. Bill from Indianopolis joins us, we go to Lakeside Grill. Typical American resto, décor to match. Large. Chicken. Marlborough Sauvignon Blanc. Pleasant Dinner. Restful night.

Day 6

To Shawnee and Ada

Breakfast at the hotel. Joined by Peggy from Vermont. A lovely lady with a budding anthropologist for a daughter, who is off to Nicaragua to do a short term volunteer job in the countryside with Fondation Albert Schweitzer.

We drive to Shawnee and pick up Bob. Delightful Onondaga man with expert knowledge of the workings of the Indian country.

We arrive at Ada, to meet with the Chickasaw Nation Lt. Governor who is also the Chairman of the National Council of American Indians. Humble. Gentle. Soft Spoken. Accommodating. Direct to the point. Honest. Attentive. Curious

I present a cultural interpretation of the process of our care for Indian patients at the Health Clinic of the Winnebago Tribe of Nebraska. Intrinsic motivation. Stress Management. Autonomy. Mastery. Purpose. Well received. (thanks for the Medical Anthropology training at Brunel University of London, England)

All of us are satisfied with our morning and we head back to OKC, stop at The Border, a Mexican café, once again American in taste and décor (after all we are in Oklahoma city?). Pleasant company. Back to the airport. OKC to DEN to OMA. Checked into the hotel near the airport where I usually stay, knowing I have to leave at 7 am to drive the 95 miles to the clinic, where the patients would already be waiting when I reach there, which was the case.

Day 7

Endo Clinic

Excellent Day at the Clinic. Our clinic is held away from the sterility of the hospital but in a warm and welcoming corner of the building. Each patient is greeted by the receptionist and then they are seen by a nutritionist, an exercise educator, a clinical case manager and then the Diabetes Educator who inspects their feet. This is repeated at each and every visit to the Clinic. So by the time they are ready to be seen by me, all the biomedical parameters are ready, and it is left to me to attend to their emotional, psychological, cross cultural needs.(thanks again for the Medical Anthropology training). One patient after another with stories and explanations. Most have complex stories but some are quite straight forward.

Even with all of us present, we can only care for 15 patients per working day (maximum) since between us, we wanted to make sure that all aspects are dealt with, not just the biomedical aspect which in my opinion accounts for no more than 25 % of the treatment of the chronic disorders of Diabetes and Hypertension and Renal Insufficiency.

A day like today, privy to enter the sociocultural life of so many American Indians leaves me euphoric.

In the evening, to Care Danh, a Vietnamese café 30 miles from the clinic, a perennial favourite of some of us. Apart from eating Bun Ga Xao, it is meet a young man, who came in with his family, who made sure he was seen by me, regarding his weight, his blood sugar and his blood pressure. This is the modern version of the Home Visit, the difference is that we do it at a Vietnamese Café at a very uninteresting Midwestern town in the USA. My colleagues make my stay and work at the Clinic-effective, enjoyable and a learning experience. Many Happy Indian patients today!

Day 8

Endo Clinic

Which was a repeat of yesterday, more satisfied patients, all aspects of their needs are attended to. Since American Indians area guaranteed health care under the treaty rights, no money is seen or heard or exchanged. All consultations and medications and investigations by lab and imaging are free.

Evening of socialization with young Indian friends: aged 10, 8, 5 and 1 and their parents. Invited them to a Thai resto in this northeastern desolate corner of Nebraska. An anthropologist’s dream to participate and observe, in a longitudinal fashion, the growth and enhancement of the life of these youngsters, children of the ancient people with their memories of their UmonHon, Navajo, Dakota ancestors etched into their faces. It is a moveable History Lesson!

Thai Resto run by Laotian refugees. Tom Kha Gai and Chicken Panang Curry

Day 9

Liminal Day

Medical work is over for this visit. On this Saturday morning felt a distance from loved ones from the other worlds. My Good Indian friend came over. Nice chats. Telephone calls. Chats over internet. Preparing for the next part of this journey.

Drove back to the airport, the fourth 95 mile trip on this visit. A sandwich from Subway. A glass of wine from Stellenbosch and a good sleep at the hotel near the airport

Day 10

To Texas

Early morning flight to Houston. At IAH changed my flight to a later one to SAT so that I can enjoy the lounge of the CO airlines. Ran into a friend MT who was coming in from Sydney and going to FLL! In the excitement of chatter, left behind the Macbook Pro charger, made me learn how to preserve the battery in the laptop! Short flight to SAT. At the Lounge, an extremely friendly and helpful CO person and attentive. She called the CO lounge at IAH, alors, the mac charger was never turned in, who would if they could have an extra charger, which was just lying around anyway, even if it was at an airlines lounge?

Texans are friendly even by American standards.

Rested for an hour or so at the Lounge and then took a taxi to the hotel nearby. Caught up on the emails, telephone calls and chat over internet(I chat with only one person, on line). The room at the hotel was large and comfortable.

The CEO of the tribe at the Mexican border had driven up, he came to the hotel, the drive from the border takes about three hours.

I chose the Tex/Mex cuisine at Los Burros and off we went.

Jolly giant of a man, jovial and can see he is content with his life. I realized that the internal motivating factors that I utilize for my patients, is blatantly present in him, which gives him the radiant look. And in good measure.

Autonomy( his job is very demanding but flexible), Mastery(CEO, administration) and purpose(to help the Indians). He had more of a sociocultural view of the health care delivery than a biomedical one, even though he has been involved in it for more than twenty years.

A good conversation over a mediocre meal(even my margarita was mediocre)and a possibility of duplicating the Peer to Peer Programme which has seen good results in the poor neighbourhoods of Phnom Penh Cambodia (MoPoTsyo directed by maurits van der pelt). A good meeting.

Back at the hotel, emails, telephone calls and chat on line. Good restful sleep.

Day 11

Journey to London

Back to the airport. Bad weather at IAH has forced delayed flights to IAH from SAT. The same helpful lady at the Lounge once again came to the rescue and made sure that I got a seat on a full booked flight. This is the beginning of Spring Break, a ritual among the recently pubescent college students on their way to their first ever hedonistic holiday and unexpected pleasures.

CO airlines does the best to accommodate its upper tier fliers, it is a good business idea to pay attention to people who give you their business.

AF club at IAH. A short stay. We boarded the flight quickly, 8 hr 40 minutes to Paris . seat 24 H with no one sitting next to me, but the seat did not feel that comfortable. At the AF Lounge at Terminal 2E, a certain urgency when you have to check your email and answer some of them, so an artificial urgency of the electronic interference.

A short flight to LHR. Slept most of the way. The skies over France was clear and as we crossed the channel, clouds gathered, but when we landed it was 15 C and sunny.

Heathrow Express from Terminal 1,2,3 which also houses the Central Bus Station. What a lovely way to go to Central 15 minutes .

Emerge from the station and you are surrounded by Middle Eastern Hospitality under different skies. They too are misplaced and I noticed that they have a cheerfulness absent in the faces of the Arabs who live in Paris. Colonialization, Past history and Oppression. Here they are refugees of the oppression of their own people: kurds, Iraqis, Iranians, Yemenis and other dictators who now kick out their own people, like they did the jews of arab lands soon after they came to power. May these unfortunate souls be incorporated as well into the societies of their choice like the jews of middle east now settled in Israel, UK, USA, Canada and Australia as well as France.

Colonialism of the bearded ones, ones with guns, the privileged of the desert. As I write these these dictators are confronting unrest in Bahrein, Libya, Jordan, Syria, Oman and Saudi Arabia.

A lovely hotel at 34 Sussex Gardens with Shaun directing the reception and doing a wonderful job of it. I have written about it at virtualtourist.

You can read about the Pavillion Hotel, at

Sundip at Apple Store, Regent Street

Tanzanian born Indian , 25 years in the UK

Pleasant helpful yet another spark of my reintroduction of life of london.

A student of Medical Anthropology from my alma mater, joins me for dinner at a Persian Restaurant. The chef is decidedly Persian, but the waitress is from Ulaan Bataar in Mongolia. Welcome to the new world of the metropolitan cities, where in the course of a few hours you have talked to Pakistani, irani, Iraqi, Kurdish, Mongolian, Tanzanian indian people who now call London their home. I prefer this new world to the old, staid one that I grew up in Melbourne, Australia.

Chelo kebab e barg

Jujeh kebab ba nan

A glass of sauvignon blanc from Stellenbosch.

A deep sleep of 12 hours at a quiet room at a Pakistani oriental decorated room in a Pakistani owned quaint hotel in the heart of London, while most of the inhabitants around are praying to Allah for better days.

Day 12

Journey to Paris

Yes, a very meaningful trip is ending but the journey will continue.

Eurostar to Paris Gare du Nord

Bonjour, paris and look forward to the French side of my life

Left St Pancras at 1502 (1602 in Paris) and reached Gare du Nord at 18 h15 ( two hours an thirteen minutes), RER E to San Lazare, train direct to BLesB. At home by 1915

Before anything, to taste two things I have missed on this trip: Nespresso and a piece of baguette with cheese..

Dinner was at a Creperie: Nordique which was a crepe of Ble Noir with smoked salmon, followed by a sweet crepe of chocolate and a little cider..

Monday, 14 March 2011



Hyperactivity. Fidgeting. Inattention. Impulsivity. If your child has one or more of these qualities on a regular basis, you may be told that he or she has attention deficit hyperactivity disorder. If so, they'd be among about 10 percent of children in the United States.

Kids with ADHD can be restless and difficult to handle. Many of them are treated with drugs, but a new study says food may be the key. Published in The Lancet journal, the study suggests that with a very restrictive diet, kids with ADHD could experience a significant reduction in symptoms.

The study's lead author, Dr. Lidy Pelsser of the ADHD Research Centre in the Netherlands, writes in The Lancet that the disorder is triggered in many cases by external factors — and those can be treated through changes to one's environment.

"ADHD, it's just a couple of symptoms — it's not a disease," the Dutch researcher tells All Things Considered weekend host Guy Raz.

The way we think about — and treat — these behaviors is wrong, Pelsser says. "There is a paradigm shift needed. If a child is diagnosed ADHD, we should say, 'OK, we have got those symptoms, now let's start looking for a cause.' "

Pelsser compares ADHD to eczema. "The skin is affected, but a lot of people get eczema because of a latex allergy or because they are eating a pineapple or strawberries."

According to Pelsser, 64 percent of children diagnosed with ADHD are actually experiencing a hypersensitivity to food. Researchers determined that by starting kids on a very elaborate diet, then restricting it over a few weeks' time.

"It's only five weeks," Pelsser says. "If it is the diet, then we start to find out which foods are causing the problems."

Teachers and doctors who worked with children in the study reported marked changes in behavior. "In fact, they were flabbergasted," Pelsser says.

"After the diet, they were just normal children with normal behavior," she says. No longer were they easily distracted or forgetful, and the temper tantrums subsided.

Some teachers said they never thought it would work, Pelsser says. "It was so strange," she says, "that a diet would change the behavior of a child as thoroughly as they saw it. It was a miracle, a teacher said."

But diet is not the solution for all children with ADHD, Pelsser cautions.

"In all children, we should start with diet research," she says. If a child's behavior doesn't change, then drugs may still be necessary. "But now we are giving them all drugs, and I think that's a huge mistake," she says.

Also, Pelsser warns, altering your child's diet without a doctor's supervision is inadvisable.

"We have got good news — that food is the main cause of ADHD," she says. "We've got bad news — that we have to train physicians to monitor this procedure because it cannot be done by a physician who is not trained."

And as usual there would be people who object to this for their own personal reason.

Here are two comments

Pelsser said there is no such disease as ADHD, and that two-thirds of kids who have attention and hyperactivity problems actually have a sensitivity reaction to certain foods. The solution, she says? They just need to limit what they eat.

Well, that interview prompted many of you to comment on our website. Some listeners welcomed the study, but others raised red flags. Kris De Lisle(ph) wrote: Very large-scale, double-blind studies have demonstrated that medication is a reliable mode of treatment for ADHD. Doctors have expressed concern about this particular study because it could not be structured as a double-blind study. This is the equivalent of reporting that vaccines cause autism.

And Carol Paton(ph) wrote: The purported link between diet and ADHD was thoroughly disproved long ago in well-designed studies. Genetics, not foods, are heavily implicated in ADHD. This study's results will not stand up to replication and verification, and its publication misinforms parents sincerely trying to help their children with ADHD.

Saying ADHD is genetic is like saying type 2 DM among the Indians is genetic, and they have spent millions of dollars to find a gene responsible for type 2 DM among the Indians without any result.

No one wants to take responsibility for the quality of the food, the amount of pesticides and herbicides and other chemical, like enriched wheat flour? What is that?

Do pesticides on fruits and veggies cause ADHD?

A new study finds a link between the pesticides in non-organic produce and the country's ADHD epidemic

posted on May 18, 2010, at 1:30 PM

Could pesticides affect the way your child learns? Photo: Corbis

In what could be a clue to the mysterious rise of attention deficit and hyperactivity disorder (ADHD) in kids, researchers have linked even low levels of a common pesticide to the disruptive behavioral disease. The study, published in the Journal of Pediatrics, looks at the organophosphate pesticide malathion, commonly used on fruits and vegetables. (Watch an ABC report about the ADHD study.) Here, a brief guide to the findings:

How big a problem is ADHD?
An estimated 3 percent to 7 percent of U.S. children are believed to have ADHD, with boys much more likely to be affected. The rate has mushroomed over the past 30 to 40 years, but it's unclear whether the actual incidence ADHD has increased or whether the condition was underdiagnosed in the past.

What did the study find?
The researchers looked at urine samples from 1,139 kids age 8 to 15. The 119 who were diagnosed with ADHD also tended to have the highest concentrations of malathion in their urine. And it didn't take much of the pesticide to raise ADHD risk considerably.

Is it conclusive?
No, but it is pretty suggestive. Previous studies of specific high-risk groups — like the children of farmworkers — have shown that substantial exposure to pesticides can affect brain development. The new research is evidence that the broader public could also be at risk. Epidemiologist Brenda Eskenazi of the University of California-Berkeley says the new study is "interesting and provocative … because the levels of pesticide are very low." Pesticide manufacturers caution that more study is needed to prove a causal link from malathion to ADHD.

What can I do, as a consumer, if I'm concerned?
Buy organic fruits and vegetables whenever possible, especially with pesticide-heavy produce like strawberries, raspberries, and peaches. Also, get rid of bug spray and other pesticides in your house, and pesticides you might use to maintain your lawn and garden.

What if organic produce is unavailable, or just too expensive?
The Environmental Working Group says that, based on government data, these fruits and vegetables are relatively safe, even if not certified organic: Onions, avocados, fresh local corn ears, pineapples, mangoes, asparagus, sweet peas, kiwis, cabbage, eggplant, papaya, watermelon, broccoli, sweet potatoes, and, surprisingly, tomatoes. Always wash produce under running water before eating it.

As early as 1999, studies were published about lower income and ADHD but of course scientific studies are ignored in front of the publicity for ADHD and the medications for its treatment

Psychosocial and Clinical Correlates of ADHD in a Community Sample of School-Age Children

LAWRENCE SCAHILL, PH.D.Description: orresponding Author InformationDescription: mail address, MARY SCHWAB-STONE, M.D., KATHLEEN R. MERIKANGAS, PH.D., JAMES F. LECKMAN, M.D., HEPING ZHANG, PH.D., STAN KASL, PH.D.

Accepted 2 March 1999.



To identify the psychosocial and clinical correlates of attention-deficit hyperactivity disorder (ADHD) in a community sample of children and to examine the validity of a subclinical form of ADHD.


The sample of 449 children (mean age 9.2 years, SD1.78; 53.6% boys) participated in the second stage of a community survey. Of these, 359 (80%) screened positive at stage 1. On the basis of a structured diagnostic interview with a parent, children were classified into 1 of 3 mutually exclusive groups: ADHD (n = 89), subthreshold ADHD (n= 100), and non-ADHD (n = 260).


As measured by the Children's Global Assessment Scale, the ADHD group was more impaired than the subthreshold group, which was more impaired than the non-ADHD group (p < .05 for each test). Children in the ADHD group were more likely to be male, to have mothers with a history of psychiatric treatment, to have fathers with a history of excessive alcohol use, and to live in low-Income families with higher levels of family dysfunction (p < .05 for all variables). A model containing male gender, family dysfunction, and low income was most predictive of ADHD status (p < .01). ADHD was also associated with psychiatric comorbidity, especially disruptive behavior disorders.


These results support a dimensional approach to ADHD. More severe forms of ADHD are associated with psychosocial adversity and psychiatric comorbidity. J. Am. Acad. Child Adolesc. Psychiatry, 1999, 38(8):976–984.

It is easy to prescribe the medications rather than

think about the income and social inequalities. That is unfortunate indeed for the Children…