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Home Brewing Beer and diet (gulp)

For Father’s Day 2011 Sue gave me a home brewing beer kit. Since it came in such a large box, and since I was home the day it arrived, I got it a week early, and by Father’s day, had already brewed two batches–a wheat and an amber ale. The difference between an “ale” and a “lager”, I found out, is that an ale ferments at room temperature, whereas a lager ferments at a cooler temperature. The larger question is, as a self-proclaimed diet expert, where does home brewing beer fit into a diet?

I set up a little brew station in a corner in a basement that already holds a home theater, exercise area, painting/hobby work area, and a green screen video studio wall–all squished together somehow. The green screen conveniently hides a pallet of books.

Brew station

The "Brew Station"


My main problem with the home brewing beer thing is the carbohydrates. A low carb beer, like MGD 64 might have only 2.4g per 12oz. whereas a Sierra Nevada Bigfoot has a whopping 32g. And then, the calories–from 64 to 330 calories in the aforementioned beers. I’m guessing that a home brewed beer falls somewhere withing those two extremes. Hmmm…quite a conundrum.

I suppose my basic approach will be in moderation, which isn’t much of an issue for me personally because I’m on call half the time, and as a skier might say, “half the fun is waxing the skis,” I would say that half the fun is “brewing the beer,” oh, “and bottling it too.”

The truth is, I hated waxing skis, and was glad when God invented those plastic fish-scale bottoms so that I didn’t have to wax any longer. I think I must have waxed my skis less than ten times before ski wax became obsolete. Despite the ski wax analogy, brewing beer is fun; else, I’d not have already made a second batch. And levering a clam shell bottle capper down over a freshly poured bottle is satisfying–the soft muscular exertion as the corrugated metal edges snug down around the bottle top seems as the completion of a holy act.

I am three weeks away from facing the dilemma of the carbo-loading of a home brewed beer; but I’m not scared. I can handle  a couple of hundred calories and 15 extra grams of carbs–I can always exercise more, or skip an iced latte or something.


Strength Training in the Elderly

I stumbled across an article in a German medical journal that reviewed strength training in the elderly. Well, over half my patients probably fall in the category of “elderly,” so, I thought I’d summarize it briefly here. I addressed this in my book, and the conclusions reached in the article reaffirm my argument for resistance training as an important component of fitness across all age groups, and gender.

The review covered medical studies over the past five years that collectively totaled thousands of participants.

Without strength training, we begin losing muscle mass from our 30th year to our 50th year in a gradual fashion, but, from 50 years of age and on wards there is an acceleration of lean muscle mass of 15% per decade, which may approach 30% by the 8th decade. Currently, only about 10-15% of the elderly do resistance training, which is unfortunate.

A common misconception is that there are significant side effects to resistance training in the elderly, most commonly that of musculoskeletal injury; however, in the studies reviewed, the adverse effects of exercise didnt’ seem to be commonly reported.

The studies show that resistance training will reverse the age-related loss of muscle tissue, increase bone density, counteracting to some extent osteoporosis, and can even decrease the symptoms of fibromyalgia.

So, then, how much exercise?

Three times a week; 3-4 sets of 10 repetitions per muscle group at an 80% intensity of what you can lift with one repetition.

I would suggest working with a trainer, to get started, at the YMCA, or other local fitness center; especially if you’re a bit short in the weight-lifting experience department. I’ve read other literature that suggests that multiple sets are not necessary if the first set it performed to muscle failure, and that subsequent sets are of diminishing return.

Resistance training does not have to mean free weights, although three are convenient dumbbell stacks in which you can dial a specific weight. Other options would include a set of resistance bands of varying resistances, and of course a circuit weight machine (not free weights).

I think that a lot of elderly folks, especially women, discount the importance of resistance training, as a tool for improving the quality of life of those golden years.

Weight management, aerobic exercise,  and strength training are all components of a healthy lifestyle, longevity, and quality-of-life.


Mountains Beyond Mountains (Book Review)

Written by Pulitzer Prize winning Tracy Kidder.

This biography of Dr. Paul Farmer was picked as a book club selection; and like many of the picks, was a book I would not have otherwise read. The story of Dr. Farmer, and his charitable organization, Partners In Health (PIH) was compelling, and inspiratinal in the sense of “against all odds,” and it was not a chore to read, as some book selections are (notably, my last pick). In fact, I enjoyed reading it very much, other than the rankling irritation of Dr. Farmer’s political ideology, which ran as a strong undercurrent throughout.

Although possibly not a genius, as the book suggests, I think Dr. Farmer not far off, and his drive, his compassion, his conviction, and his singular accomplishments around the world speak for themselves. As I read the book, the image of Dr. Farmer forming in my mind was that of a perhaps mildly arrogant, incelebate, white male Mother Theresa who swore a lot, and preferred silk to horse hair; but as I progressed through the book, the image softened, and my admiration grew.

I found it interesting how he became enchanted with all things Haiti as a boy and young man in his exposure to migrant workers. He identified the cause for his existence early on in life, and pursued that cause with a passion and focus not commonly seen, or at least with results not commonly seen. His root passion I think he is saying is to be of service to the poor. I say, “I think” because I’m not sure if that is superseded by what he refers to as “inequality”, primarily medical inequality/medical justice, but also social inequality/social justice, which perhaps he views as different sides of the same coin.

What I didn’t appreciate about Dr. Farmer’s view of “redistributive justice,” medical or otherwise, was the seemingly blind eye he cast upon the real and significant role that capitalism played in the attainment of his dramatic results. The book implies that the primary role for the “rich” is as a source for equitable redistribution, which of course would only be possible if there were rich people to redistribute from.

How rich would have Tom White become if his earned income was redistributed in ratios of 50-90%,because, if 50% is fair, then wouldn’t 70% be more fair, etc. Bill Gates, and George Soros are mentioned as other major supporters of PIH, both of whom have made their fortunes in a capitalistic system; Mr. Soros, as a hedge fund manager, and Mr. Gates in technology. Had they not made their fortunes from the fruits of captitalism, where would PIH be then?

Then too, along those same lines, is Dr. Farmer’s admiration of the Cuban health care system, similar in respects to Michael Moore’s  I imagine. I can understand his point in regard to the public health care system; however, Cuba is in a small country, and a direct comparison cannot be made to our own country without accounting for the variables. The reality is that all that is good in medicine; antibiotics, pacemakers, cancer drugs, drugs for the treatment of hypertension, fertility, heart disease, impotence, all arise from the capitalistic system in which there is the driver of profit and wealth for those who exert themselves in these various pursuits.

Why did Tom White exert himself, or George Soros, or Bill Gates…To help PIH? I don’t think so. At least, not initially. But, by exerting themselves, and accumulating wealth, they eventually were able to make the conscious choice to do so.

Following the Hiatian earthquake, I wonder how much relief came from Cuba, Russia, China, and the European social democracies? I wonder how much relief came from the USA? I say I wonder, because I’m too lazy to look it up, but I’m pretty sure I know what the answer is.

Charity and benevolence does not eminate from communist countries or dictatorships; it emminates from capitalistic and free societies.

So to Dr. Farmer’s vision of redistributive justice, I say phooey. Instead, I choose to applaud the benevolence of capitalism that makes all else possible.

And to Dr. Farmer, who actually walks the walk, and is a true believer in his vision, even if faulty, I say, “Bravo.” And, “Carry on, Doctor.”

The Telomere Age Test

The telomere test for approximation of your biological age has been getting some press lately, so I thought I’d research it a bit and make it the topic for June’s NWTC “What’s Cooking” newsletter.

I’ve been interested in telomeres for a few years because of their relationship to aging.

Telomere Test?

Have you checked your telomeres lately? Do you need to? What the heck are telomeres?

There is a new test that you will soon encounter in the mass market media. The advertisement will read something like, “How much longer will you live,” or maybe, “Find out when you’re supposed to die.” Or, perhaps it will be more positively framed as something like, “Find out your biological age, and how to prolong it.” The test will require a blood sample (possibly saliva) and a payment of about $300, give or take. I’m guessing that the additional information, regarding the prolongation part, will be extra, likely having to do with daily supplements, specialty foods or other allegedly crucial interventions.

The telomere test is a provocative melding of actual science and the various human emotions in orbit around the all-too-real planet of our individual mortality. You have to admit that each of us has, at least to some extent, a morbid curiosity of if not the actual end-of-days, at least our own end-of-day; and, the desire to somehow impact it. This is what some selling the telomere test will promise—a calculation of your biological age, and how to prolong it…by taking vitamins, increasing physical activity, avoiding weight gain or obesity, and correcting insulin resistance (diabetes).

Telomeres are like protective caps on the end of chromosomes, and when the wear out, cells stop dividing and eventually die; so, long telomeres are good and short ones are less good, unless you’re 120 years-old, in which case short ones are expected; or so the argument goes. Of course, it’s not that simple, or predictable for a host of reasons. Let me explain.

You have 23 pairs of chromosomes (46 total) in each cell in your body. Each chromosome is made of your DNA that is specific to you alone in all the universe, unless you’re an identical twin. DeoxyRiboNucleic Acid is kind of like a zipper in that it is made of two matching molecular strands that can unzip and divide into two so that proteins in the cell can assemble new, matching strands so that where there was one, there now are two. This works because each zipper strand has four different kinds of teeth (nucleotide base pairs) call them A, C, G, and T. Each tooth will match up with only one other: G with C, and A with T. And it is the specific sequence of the base pairs that encodes specific genes, like blond hair and blue eyes, or risk of colon and breast cancer. Some genes might have only a few base-pairs, and others, thousands.

23 pairs, 4 different kinds of nucleotides, only two matching pairs—doesn’t sound like big numbers; but, each chromosome can contain up to 10 billion base pairs in a twisted tangled chain. 46 invisible threads in an invisible nucleus in an invisible cell that tell us what we are, if not who. Pretty amazing stuff; and all supposedly arising from a lightning bolt striking a primordial soup long ago; or God—it’s your choice.

The problem with cell division is every time the DNA unzips you lose 30-150 base-pairs off the ends. It’s called “the end replication problem.” Since the telomeres serve as the protective caps, losing a hundred pairs is no big deal—the gene sequences remain safe on the inside as the telomere sacrifices a little bit of itself. The telomeres have about 10,000 base pairs, which comes to 66.6 (10,000/150)  cell divisions before they wear out and die.

The age-related diseases; cancer, diabetes, atherosclerosis and heart failure have all been associated with shorter telomere length; as are also obesity and smoking. The question is, do short telomeres cause all this bad stuff; or, does all this bad stuff cause shorter telomeres?

In these studies of associations, and the telomere test itself, it is the White Blood Cell (WBC) whose telomere is being measured. All of our other cells (brain, heart, etc.) have telomeres too, which are widely variable at birth and across population groups; but, they are much harder to sample for obvious reasons, as opposed to a finger stick for a tiny drop of blood. Perhaps the WBC telomeres are more a marker of inflammation, which is the root cause of the metabolic syndrome, diabetes, heart disease, and many types of cancer. Perhaps the telomere test is more a marker of lifestyle choices, the results of which should be no surprise, than it is of longevity.

I don’t think the telomere test is ready for prime time. There are too many variables and too many assumptions; and more importantly, what will it tell you that you don’t already know: that you should stop smoking, lose weight, and control your blood sugars if diabetic? Well, let me say it then. Stop smoking, lose weight, and control your blood sugar. That will be $300 please, and you didn’t even have to give me a blood sample.

Additional Online Only Edition:

The nucleotides in DNA are; Adenine, Cytosine, Guanine, and Thymine; A, C, G, and T; and in humans, the telomere is made of repeating sequences of TTAGGG repeats for a total telomere length of 8-15 kilobase (kb) pairs, or 8-15,000 base pairs. This sequence is shared with mice, rats, and birds; and slime mold has an extra “T” (TTTAGGG). Hmmm…I wonder if there’s slime mold in primordial soup.

The cells in our bodies are called somatic cells; they have differentiated from stem cells into specific cell types; and as such, suffer from mortality, being good for about 50-70 divisions before cell senescence or apoptosis, which basically means cell death or disintegration. In contrast, embryonic stem cells are as immortal as a cell can be in that it has high levels of a protein complex, called telomerase, which can rebuild telomeres; so, in the stem cell, the telomeres don’t wear out. Some cancer cells also have high levels of telomerase, which is a factor in a tumors relentless growth.

Most of the studies drawing age-related associations have been with the telomere length of WBCs, which may be a more accurate measurement of the inflammatory state. The telomere lengths of various organs are widely variable from person to person, and from organ to organ within an individual. Do those individuals with shorter telomeres at birth of the heart cells have a shorter life span than those of an individual with longer ones? Do people that die at a young age from illness have shorter telomeres than age-matched controls?

I think the telomere is a factor in aging, and potentially, eventually, subject to interpretation and intervention for longevity; but at this time the test result is, I think, nothing more than a curious novelty, no more accurate than having your palm read at a carnival.