Most Drug-Cancer Studies Not Published

According to a new study,

Fewer than 20% of cancer trial results are published in peer-review journals. . . Industry-sponsored trials only achieve publication one time in 20.

A new website hopes to increase visibility of clinical trials. Publication bias is one reason a method that allows you to see for yourself — self-experimentation — has value.

The study.

Games and the Business of Life

You probably know that plastics were first used for toys. You probably don’t know that the first metals were used by artists, as far as archeologists can determine. That’s material science, what about non-material science? Here’s Tyler Cowen:

I’ve been thinking of all those old puzzles where a bunch of guys enter the room and only so many of them have smudges on their foreheads and you have to find the algorithm to reveal that information.

The problem is to separate good banks from bad banks, so that good banks can continue business. A big reason I started self-experimentation was Martin Gardner’s Mathematical Games column in Scientific American. I could sometimes solve Gardner’s made-up puzzles, which gave me confidence when a non-made-up puzzle — waking up too early — came along.

More When I pointed this post out to Tyler, he replied, “Exactly what I was thinking in fact, when I wrote that…I even almost mentioned Martin Gardner.”

Science in Action: Why Did I Sleep So Well? (part 15)

Yesterday I went to San Francisco early in the morning. Because of my discovery about standing and sleep, I had slept very well. In Berkeley, it looked like morning: empty streets, angle of light. I felt jet-lagged: I should have been tired but I wasn’t. On BART, the same mismatch: Everyone looked tired but I was wide awake.

It is taking longer and longer to get enough one-legged standing to generate great sleep. Here’s a graph of how long I’ve been standing: Each point is a different bout of one-legged standing. Most of the points are from bouts where the standing leg was straight or bent (usually straight) but a few of them (“bent leg”) are from bouts where the standing leg was bent the whole time. Most days have two bouts: 1. On the left leg until I get tired. 2. On the right leg until i get tired. I’m pretty sure there’s no effect until it becomes difficult — until the muscles are so stressed that they send out a grow signal. The whole thing is pleasant because I watch TV or a movie at the same time but, as the graph shows, it has become seriously time-consuming.

So I have tested keeping the standing leg always bent. I get tired much sooner (2 minutes versus 20 minutes) but the effect is not quite as strong. Probably because fewer muscles are involved — you use more muscles when you stand on one leg in any possible way than if you stand on one leg in only one way.

I assume there’s a steady-state solution. The more muscle you have the more you lose each day. (Just as the theory behind the Shangri-La Diet assumes that the higher your set point, the fast it falls.) Eventually I should have enough muscle and will lose enough in one day so the exercise needed to merely replenish it will be enough to produce great sleep.

Fake Tans, Sun Blocks, and Self-Experimentation

I guess this is from a press release:

John M. Pawelek, Ph.D., a senior research scientist in the department of dermatology at the Yale School of Medicine, recently was awarded a U.S. patent entitled Cosmetic Melanins for producing and composing synthetic melanins that may be used in cosmetic products.

Through its Office of Cooperative Research, Yale licensed the Melasyn technology originating in a medical school laboratory to Vion Pharmaceuticals, Inc. of New Haven. This month, Vion announced an exclusive world-wide licensing agreement with San-Mar Laboratories of Elmsford, NY., to manufacture and market products containing Melasyn.

Throughout nature, melanin is used in such diverse areas as protection from ultraviolet radiation, camouflage and species recognition. It is insoluble and difficult to work with, making it impractical for inclusion in creams and lotions. “But we have invented simple methods for creating melanin substitutes that dissolve readily in water and, when incorporated into cosmetic creams, can be spread evenly on the skin to instantly produce a tan,” Dr. Pawelek states.

In inventing this unique product, Dr. Pawelek employed one of scientists’ historical approaches to research: self-experimentation. “For nearly four years, I have been applying the material daily to my own face, and it produces such a natural-looking tan that it even surprises my dermatologist colleagues at Yale,” he quips. “Scarcely a day goes by when someone on an elevator or in a hallway doesn’t ask me where I was on vacation.”. . .

The Yale laboratory work behind the patenting and licensing offers interesting insight into the process of research and development of potential new products. “It started several years ago with our basic research on skin enzymes that produce melanin,” Dr. Pawelek explains. “Melanin usually is insoluble in water and forms a gummy solid in test tubes. One day, however, we noticed that the melanin in one enzyme assay remained dissolved in water,” he recalls.

Dr. Pawelek credits his colleague, Jean Bolognia, M.D., who conducts her research in his laboratory, with the idea for cosmetic use of melanin. If the melanin were really soluble, she surmised, it should be useful as a cosmetic. “From that point on,” he says, “we began a search for the right combination of ingredients and methods to produce cosmetic melanin.

“We were motivated by the thought that melanin naturally protects our skin from cancer induced by ultraviolet light. Perhaps, we reasoned, synthetic melanin would do the same,” he says. “If we could design a melanin that produced a natural-appearing tan, we believed that people might be attracted to the product through its cosmetic qualities and simultaneously apply a sun-protectant, affording them added sun protection and potentially reducing the incidence of sun-induced skin cancer,” hopes Dr. Pawelek, a cancer biologist who studies melanoma.

I often do something similar: Use an activity I want to do to motivate something I don’t want to do. Drink wine to take vitamin pills, for example.

Science in Action: Why Did I Sleep So Well? (part 14)

Two more people have gotten results similar to mine. From a comment on an earlier post:

I’ve been doing these exercises – standing on one leg – and it’s helped my sleep immensely. About a year ago, I went through a pretty traumatic experience that disrupted my sleep patterns. The end result was that I couldn’t sleep for longer than 3 or 4 hours at night without waking up. For several months, the lack of sleep was like living in a nightmare, and prescription drugs just made the problem worse. I finally decided to go off medication all together and change my attitude, which worked wonders – I could get back to sleep after I woke up – but I’d still only sleep in 4 hour chunks.

About a month ago, I began doing these exercises, and now I’m sleeping 6 to 7 hours at a time. It’s amazing; and on the days I don’t do them, I don’t sleep well at all.

It’s amazing how easy they are to do – if I find myself standing in line, meeting friends for a happy hour, or even watching tv, I’ll do them.

Last night I told a friend to do them while he was at a happy hour, and this morning, he said he slept “like a log.”

As Pale Fire says:

If on some nameless island Captain Schmidt
Sees a new animal and captures it,
And if, a little later, Captain Smith
Brings back a skin, that island is no myth.

I have started to measure my sleep with a SleepTracker so I will have another way to measure the effects, in addition to (a) how rested I feel when I awake and (b) how long I sleep.

More The SleepTracker — my second, the first didn’t work — worked correctly for the first three nights but failed on the fourth.

Do Genes Matter for Health?

How much disease do genes cause? Sure, they cause some rare diseases that affect very few people but what about major health problems, such as depression, that affect everyone? The notion that genes make a big difference to human health — that some people are healthy and others sick because of genetic differences — was much of the rationale for funding the human genome sequencing project, which cost billions. The founders of the company 23andme (23 = 23 human chromosomes) often say genes matter, most recently in The New Yorker:

“It’s very useful if you know that you’re at increased risk for deep-vein thrombosis and you’re on a plane,” she continued. “You might want to stay vigilant about moving around.” Instead of finding out the hard way that their children are allergic to peanuts, parents may someday be able to test their DNA. Even small inherited traits, Avey added, can serve as health clues: “There is some correlation between your ability to metabolize caffeine and your risk for a heart attack.”

There is something breathtaking in the fact that someone who believes you can learn about allergies by studying DNA is taken seriously in The New Yorker.

Some rare non-hype on this issue has recently come from Dr. David Goldstein:

But David B. Goldstein of Duke University, a leading young population geneticist known partly for his research into the genetic roots of Jewish ancestry, says the effort to nail down the genetics of most common diseases is not working. “There is absolutely no question,” he said, “that for the whole hope of personalized medicine [where people with different genes are treated differently], the news has been just about as bleak as it could be.”

The researchers have been unable to find genes that make much difference.

If they had found such genes, I would have been stunned. My self-experimentation has led me to believe that our environments are far from ideal — in non-obvious ways. I believe that people don’t get sick because of their genes, or gene-by-environment interactions, they get sick because of their environments, which lack something essential or include something bad. Animal experiments have given us a decent understanding of nutrition; maybe we know half or more than half of the basic requirements. When it comes to subjects that don’t lend themselves to animal experiments, little is known — about what causes depression, for example. My self-experimentation took over where animal experiments left off; it provided a way to do experiments that generate ideas. (Which is crucial for knowledge advancement, as opposed to career advancement.) I have been able to find one big self-experimental effect after another (most recently, about omega-3s and sleep) related to common health problems only because (a) so little was known and (b) I accidentally picked up an effective tool (self-experimentation) that no one else had used this way (to find new experimental effects).

More More from the other side of the debate: 1. Elderly genetics. 2. Google co-founder has Parkinson’s gene. It is hard to find support for my side of the debate in print. It isn’t easy to notice when you don’t get sick (because of advances in the study of nutrition, for example) so it isn’t easy to notice how study of the environment has paid off in concrete ways. I’m in an unusual position: I can easily notice how my life has improved via self-experimentation.

Even more Dean Ornish agrees with me. Thanks to Carl Willat.

Treadmill Desks

As far as I know, I was the first person to have a treadmill desk. I wanted to be able to stand more easily. I had found that if I stand a lot I sleep better. I reasoned it might be easier to stand a long time if you are walking than if you are standing still.

Treadmill desks are now becoming mildly popular, the New York Times reports. I had nothing to do with this. They were popularized by James Levine, a Mayo Clinic endocrinologist, who believes that calorie burning is a good way to lose weight. I used my treadmill desk for a few years. There were two big problems: 1. The noise bothered my neighbors. The Times article says these desks tend to be placed in common areas, where that would be less of a problem. 2. It was tiring. After one or two years I mainly stood on it and rarely walked on it. Finally I replaced it with a standing-height desk.

The article describes non-weight-loss benefits: Walking makes it easier to concentrate.

“I thought it was ridiculous until I tried it,” said Ms. Krivosha, 49, a partner in the law firm of Maslon Edelman Borman & Brand.

Ms. Krivosha said it is tempting to become distracted during conference calls, but when she is exercising, she listens more intently.

“Walking just takes care of the A.D.D. part,” she said.

Allen Neuringer, a professor of mine at Reed College, found that movement helped him learn. I think an urge to be active builds up during inactivity just as thirst builds up when we don’t drink. Being able to be active while you work gets rid of that distraction — and no doubt is healthier in other ways than sitting all day. I would like to be able to use a computer while I am free to move around the room (or larger spaces) and move my arms, not just walk forward with my hands on the keyboard. I’d like to be able to write this blog post while strolling through my neighborhood, for example.

Thanks to Marian Lizzi.

New Way to Lose Weight: Don’t Eat Till Your Blood Sugar is Low Enough

Tim Lundeen‘s sister Miriam wrote this:

Tim and I have been having conversations about health, diet and blood sugars for several years and I figured I was insulin-resistant with mild blood sugar dysregulation, but never was more than interested. About two months ago after a move cross-country with the accompanying stresses, I became more acutely concerned about my metabolic damage and was in a place where I could pay attention and do something about it. At Tim’s recommendation, I read Dr.Bernstein’s Diabetes Solution and Jenny Ruhl’s Blood Sugar 101 and started monitoring my blood sugar with a glucometer. Initially, my morning readings were usually 91-94. Not too bad but not the 83-85 that is “normal” [i.e., optimal]. I started waiting till I was hungry or when I would normally eat and then take my blood sugar again. If it was 85 or below I would eat a normal meal with an awareness of the carb content and eat smaller portions of these foods. Then I would monitor my postprandial (post-meal) blood sugars about every hour and see when and how high my spike was. If it was too high (over 140 for sure, and in the 130′s probably) I would adjust the amount of carbs downward. If my blood sugar was over 86 and I wasn’t famished I would distract myself with some engaging activity and check my sugar again when I noticed I was hungry. If I became really famished but my sugar was still not under 86, I would have a no-to-low carb snack like almonds, walnuts, left-over meat or a salad. Then I’d wait till I was hungry again. After a few weeks of doing this my morning sugar was consistently 81-85. If I ate off-plan and had an occasional 94, that was fine by me. I was happy about my blood sugars, but the pleasant surprise came when I had a physical exam at my doctor’s. I had lost 20 pounds without even noticing! [She is 5 feet 5 inches tall. After losing 20 pounds her weight was 155.] I was amazed since I had tried to diet a number of times over the last 10 years and my weight just kept creeping up. This has been the most fun and healthy weight loss program I could imagine. I am hoping my carbohydrate metaboliism will eventually recover and I will again be able to eat more carbs without weight gain and metabolic damage.

I am doing something similar for a few days, too soon to tell the results. About six months ago, to help write a chapter in my self-experimentation book about diabetes, I got a glucometer and started testing myself regularly. I was displeased to find that my morning readings were about 91, like Muriel’s, and further displeased to find that eating less carbs didn’t help.

Blood sugar testing isn’t cheap, but it’s easy and painless. The glucometer I use is Abbott’s Freestyle Lite (which is free). It’s painless if you get the blood from your arm. The test strips cost about 60 cents each.

Science in Action: Why Did I Sleep So Well? (part 13)

When I talk about how standing on one leg has helped me sleep better, the inevitable question is how much standing? After I became sure the standing was making a difference, I started to record the durations. I always stood on one leg until it became a little hard to continue. As my legs have become stronger, this has taken more time, as this graph shows:

During the early days on this graph, I didn’t include time-of-day information. I usually stood on one leg three or four times per day. More recently, I have included time-of-day info and now stand on one leg only twice most days. In all of the cases shown on the graph, I was pulling my other leg back behind me at the same time, stretching the muscles. (If I don’t stretch the other leg, I can stand one-legged much longer.) In the very beginning, I only stood one-legged 2-3 minutes.

I’m sleeping better than any other period in my adult life. My sleep was pretty good before this period but the difference is still huge. Not only am I sleeping better, I suspect I’m also sleeping less (as happened when I improved my sleep by standing a lot).

I suppose one-legged standing counts as “exercise” — that source of so many claimed benefits (longevity, weight loss, less heart disease, etc.). I read today that exercise is supposed to improve your brain. But the differences between what I am doing and what is usually recommended are as large as the difference between the Shangri-La Diet and other diets:

1. Conventional exercise: Requires expanse (for walking) or, usually, special equipment (e.g., gym). Takes one hour or more, when you count changing clothes and showering, not to mention the drive to and from the gym. One-legged standing: Can do almost anywhere. Takes less than 30 minutes, so far.

2. Conventional exercise: Requires discipline if you want a decent workout in a reasonable amount of time. One-legged standing: Almost no pain involved. I can watch TV or read something at the same time.

3. Conventional exercise: Supposed to be aerobic if you want the main benefits. One-legged standing: The opposite of aerobic.

3. Conventional exercise: Some benefits accrue slowly, such as weight loss. Others are hard or impossible to detect, such as longer life. Runners’ high goes away, in my experience. One-legged standing: Benefit clear the next morning. Because I am strengthening muscles I use all the time (when I walk or stand) I notice my vastly increased leg strength all the time.

4. Conventional exercise: You want to get stronger. One-legged standing: You don’t want to get too strong or else it may take too long to get the effect.

5. Conventional exercise: Often difficult to measure increased strength. Hard to measure improvement in swimming, racquetball, or aerobics classes, for example. One-legged standing: Easy to measure increased strength.

6. Conventional exercise: Helped me fall asleep faster, but didn’t solve the problem of too-light sleep. One-legged standing: Utterly solves the problem of too-light sleep.

Could the benefits of conventional exercise have anything to do with the fact that it vaguely resembles one-legged standing?

Directory.