Health & Biotechnology

Optimal Nutrition: Are Fats Killers or Saviors?

USDA Food Pyramid, traditional, lots of carbs

Health, wealth, wisdom, work, love and freedom.
Those are the keys to the kingdom of happiness.

But, health always comes first. As the saying goes — without it, you've got nothing. Now, here are the keys to good health — nutrition, sleep, exercise, freedom from pain and stress, and freedom from infections and toxins. (Toxic relationships are also potent poisons. Stanford Biz school's Prof. Bob Sutton calls this the "No A**hole Rule!" )

Nutrition is a difficult piece to get right, but it's well worth the effort.

You're a community of thirty seven trillion cells each in equilibrium with what you eat. So, what's the optimal recipe?

Let's say you eat 2400 calories a day, and let's say 400 calories are protein. How many of the remaining 2000 calories should come from carbs and (hence) how many should come from fats.

This issue has vexed medical researchers for decades. Here, I examine this in detail and show you some of the best free articles and videos on nutrition.

Automated Medical Discovery: the RX Project

A computer, tirelessly combing through patient records, looking for new medical knowledge. That was my Stanford PhD thesis project almost 40 years ago — an early example of data mining and machine learning under AI control.

RX garnered many awards and contracts and was presented worldwide by myself and my co-PI and thesis advisor, Stanford CSD Professor (now Emeritus), Gio Wiederhold.

Imagine how hard it was to do in the late 1970s in the era of mag tape and crawling CPUs.

Nobody else (was foolish enough to try or) tried to do this in the seventies. Now, in the current era of big data, everybody's trying to do it.

Coronary Artery CT Scans

If famed newscaster Tim Russert had had a coronary CT Scan, he might still be alive.

Here, I argue in favor of getting scanned. (If you've got calcified arteries, they show up like Christmas tree lights.)

This is a story with a highly personal angle. (I've got coronary calcifications, and if you're a man my age you do, too.)

Ladies — your biology gives you a ten year reprieve. (But, here's what many of my women friends also do that contributes to their longevity: watch their weight, eat salads, relax, take care of themselves, and "tend and befriend.")

Carmat: Artificial Heart

Carmat Heart

This could be a stunning breakthrough — a permanent (goal is 5 years) artificial heart. This total heart prosthesis may become the second best option to receiving a donor heart (and the supply of hearts is quite limited.)

I've closely followed this story from French biotech Carmat. They were tight-lipped since their first patient died in early 2014 after surviving only 75 days. Their second patient, a 68 year old man, went home in January 2015 and had been pedaling his stationary bike like mad. He died in mid-2015 having lived a normal life for 9 months. Their third patient was implanted in April 2015 and survived to November, 2015.

The company's 2016H1 results (September, 2016) announced the initiation of their twenty patient PIVOTAL clinical trial. This patient population has had a higher baseline status than did the no-option, terminal heart failure patients implanted from 2014 through 2016.

In April, 2018 Carmat announced it had completed six more implants in its PIVOTAL study toward the goal of obtaining a CE Mark in 2019. All these patients have survived at least one month. In 2018 Carmat also opened a new, automated assembly plant near Paris to manufacture its prostheses. And, in September, 2018 they announced a second assembly plant that will be capable of producing up to eight hundred artificial hearts per year. This obviously reflects their great confidence that the product works.

October, 2018: Carmat announced their 2018H1 results and progress to date. In a very encouraging update, Carmat stated that they have implanted 11 patients in their PIVOTAL trial with only one patient not having survived for 30 days. On average, their patients are out of the ICU in 6 days and return home in 35 days. They expect to qualify for CE marking in 2019 (and subsequent marketing in Europe.)

The Carmat heart story was widely covered and (miscovered.) Some writers commented that "it'll be too expensive — at an estimated cost of $200,000."

No! 200K is rounding error compared to OR and ICU charges for many terminal heart patients. Besides, the value of a human life is > $5 million — about $100,000 a year (per the statisticians.)

"It's too large for women." That's because it's only version 1.0.

Also note that women's heart disease starts on average ten years after men's. Go visit residents in a senior facility (an "old folks home.") The vast majority are women — most of the men died from heart attacks years before.

Bridge to transplant — for many patients awaiting a donor heart, the Syncardia artificial heart has been the best solution. It's been implanted in 1400 patients enabling many to go home.

Another of my favorite cardio-companies is Heartware, maker of LVADs. Check out their Longhorn pump (preclinical.) It spins at 21,000 rpm and kicks out 7 liters per minute.

Also see these inspiring stories from Thoratec from recipients of their HeartMate II LVAD and also read about Thoratec's HeartMateIII, now in trials.

Here's former Vice President Dick Cheney "arrestingly" chatting about his heart transplant.

I frequently hear stunning bioengineering breakthroughs at Stanford from visiting investigators and our own faculty in biomechanical engineering, material science, and regenerative medicine.

Calorie Restriction Slows Aging in Monkeys

calorie restricted monkey

This was a "stop-the-presses" story that broke in July, 2009. A 20 year study found that Rhesus monkeys fed a nutritious, low-calorie diet had far less heart disease, cancer, and diabetes than controls that ate 30% more. Monkeys on the diet out-survived the controls by 50% and had much less cerebral atrophy. Lose weight now — if you want to look more like the sleek fellow on your left.

Transcend: Live Forever

Transcend is a 2009 work by Ray Kurzweil and Terry Grossman.

I had avidly read their previous health book, Fantastic Voyage and benefited by its recommendations.

This is my review, as posted on Amazon. The book rated a B+.

(My review got over a thousand upvotes — pretty good — but not as good as Bruno Mars, doing Uptown Funk, at 2.9 billion!)

My personal favorite longevity recommention is dancing.
Here's Dick Van Dyke, now 90!

Dick's agent wanted him to write a "secrets of longevity" book, and Dick replied, "it would only be two words long - keep movin'!"

Transcend Drugs!

After finishing Ray's and Terry's book above, I wondered which (if any) of their recommended vitamins and supplements I should take. I researched them all.

At that time I had access to the Natural Standard — an encyclopedic reference written by a group of university clinicians. Here, I posted my findings.

My general rule is — get your nutrition from food. Skip the supplements!

I do take a few of those recommended in the book (eg, vitamin D.)

Does Drug X Really Work?

Want a one-word answer? "No!"

(The snake oil merchants are always ahead of the scientists.)

This was a long overdue essay on evaluating medical evidence.

Every new vitamin or supplement is greeted by unbridled enthusiasm.

I spent a decade studying biostatistics. The default hypothesis is that drug X does not work. This essay shows you what it takes to show it does.
(It takes years of effort!)

Synthetic Coronary Artery Bypass Grafts

Atherosclerotic coronary artery disease is the major killer in the United States.

If the artery was a plugged kitchen drain pipe, you'd simply buy a replacement. So, why aren't replacement (synthetic) coronaries available?

This is a brief overview of one company's struggle to develop a synthetic graft. (2012 Note: That company, known as Cardiotech in 2009, discontinued this development.)

There's been plenty of R & D since then — that's a reminder to me to update this.

The Inner Life of a Cell

This beautiful animation was done for Harvard by BioVisions.

Their director, David Bolinksy (TED Talk) tells the whole story here.

And, this version labels the molecules and subcellular organelles.

All three videos somehow managed to omit the key topic of the animation — the biochemistry of atherogenesis. Atherosclerosis is the major killer in the developed world.

And here, biology animator Drew Berry shows us the incredible "nanotech" involved during cell division, when DNA replicates and is pulled apart by microtubules.

Meanwhile, kinesin (a motor transport protein) walking along a microtubule towing a vesicle manages to be simultaneously funny and instructive.

And, here's a brand new one (2016.) This supercomputer model/ animation of DNA wrapped around histones (from the Riken Institute, Japan) is must-viewing. Watch this now — and memorize it!

In each of your ten trillion+ cells, two meters of DNA is stuffed into a ten micron diameter nucleus. The DNA is tightly wrapped around histone proteins like thread wrapped around hundreds of spools. Thousands of segments of that DNA must be unspooled and transcribed by RNA in real-time.

Super-Resolution Fluorescence Microscopy

Among the hundreds of molecular biology and neurobiology talks I attend every year, none attract larger crowds than those presenting new tools for high resolution light microscopy. The 2014 Nobel for Chemistry was awarded to Stefan Hell, Eric Betzig, and William Moerner, each of whom contributed separately to these stunning advances.

In February, 2017, HHMI Prof. Eric Betzig presented his work on lattice light-sheet microscopy to an SRO crowd at Stanford's annual lecture honoring Linus Pauling. Some of Betzig's stunning videos are shown above. And here Prof. Betzig tells us how his twenty year collaboration with Herald Hess led to the elaboration of photoactivated localization microscopy (PALM.)

Diabetes Research Connection: DRC

The DRC is a brand new approach to funding research to prevent and cure Type 1 (insulin-dependent) Diabetes (T1DM.) Founded by entrepreneur David Winkler and inspired by Kickstarter, one hundred percent of donations goes to funding distinguished young investigators with new approaches to T1DM. During 2017 the DRC launched seventeen projects (at about fifty thousand dollars each.) And, one successful project (Replacement Beta-Cells from an Unexpected Source) has already precipitated an addition million dollar grant (from the Keck Foundation.)

Separately, in other T1DM news, in April, 2018, Eli Lilly announced a huge collaboration with beta-cell start-up Sigilon Therapeutics. Sigilon is a new, beta-cell encapsulation device maker that was spun off from work at Harvard from the lab of Douglas Melton and from MIT from the labs of Robert Langer and Daniel Anderson.

Whole Genome for a Hundred Dollars

One of the show-stoppers of the 2010 Foresight Nanotech Conference was the above video showing Pacific Biosciences' SMRT tech, which sequences DNA bases in real-time (msecs) as DNA polymerase incorporates each base.