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One study found that men who consumed eight to 14 drinks a week had a 59% lower risk of heart failure compared with those who didn't drink.

But experts warn that regularly drinking more than that can cause cardiovascular damage instead, raising blood pressure, increasing the risk of hemorrhagic stroke and leading to cardiomyopathy, a dangerous enlargement of the heart.

Benefits of moderate drinking, defined as one drink a day for women, two for men. •Reduces the risk of coronary heart disease by 30% to 35%. Increases HDL 'good' cholesterol. •Prevents platelets from sticking together, reducing blood clots, and lowers the risk of congestive heart failure. •Cuts the risk of heart attack by 40% to 50% in healthy men. •Reduces the risk of stroke and dementia.

Cancer risks linked to drinking. (Risks vary with the amount of alcohol consumed.)•Raises the risk of oral and pharyngeal cancer by 20% and risk of breast cancer by 8% among people who have one or fewer drinks a day. •Raises risk of oral cancers 73%, risk of liver cancer 20% and risk of breast cancer 31% among people who have two to three drinks per day. •Associated with a fivefold increase in risk of oral, pharyngeal and esophageal cancers in people who have four or more drinks per day. •Raises the risk of colorectal cancer by 52%, pancreatic cancer by 22%, breast cancer by 46%.

But these concepts are difficult for many to swallow. Specialists like urologists, radiologists and oncologists, who see patients who are sick and dying from cancer, often resist the idea of doing less screening. General practitioners, who may agree with the new guidelines, worry about getting involved in long conversations with patients trying to explain why they might reconsider having a mammogram every year or a P.S.A. test at all. Some doctors fear lawsuits if they do not screen and a patient develops a fatal cancer. Patients often say they will take their chances with screening’s harms if a test can save their lives.

And comments like Dr. Brawley’s give rise to other questions as well. Is all this happening now because of worries over costs? And in any case, is all this simply an academic argument, since most doctors, faced with real patients, still suggest frequent screening and their patients agree?

Often, preliminary studies fuel irrational exuberance about a promising dietary supplement, leading millions of people to buy in to the trend. Many never stop. They continue even though more rigorous studies — which can take many years to complete — almost never find that vitamins prevent disease, and in some cases cause harm

There’s no conclusive evidence that dietary supplements prevent chronic disease in the average American, Dr. Manson said. And while a handful of vitamin and mineral studies have had positive results, those findings haven’t been strong enough to recommend supplements to the general American public, she said.

The National Institutes of Health has spent more than $2.4 billion since 1999 studying vitamins and minerals. Yet for “all the research we’ve done, we don’t have much to show for it,” said Dr. Barnett Kramer, director of cancer prevention at the National Cancer Institute.

A big part of the problem, Dr. Kramer said, could be that much nutrition research has been based on faulty assumptions, including the notion that people need more vitamins and minerals than a typical diet provides; that megadoses are always safe; and that scientists can boil down the benefits of vegetables like broccoli into a daily pill.

when researchers tried to deliver the key ingredients of a healthy diet in a capsule, Dr. Kramer said, those efforts nearly always failed.

It’s possible that the chemicals in the fruits and vegetables on your plate work together in ways that scientists don’t fully understand — and which can’t be replicated in a table

More important, perhaps, is that most Americans get plenty of the essentials, anyway. Although the Western diet has a lot of problems — too much sodium, sugar, saturated fat and calories, in general — it’s not short on vitamins

Without even realizing it, someone who eats a typical lunch or breakfast “is essentially eating a multivitamin,”

The body naturally regulates the levels of many nutrients, such as vitamin C and many B vitamins, Dr. Kramer said, by excreting what it doesn’t need in urine. He added: “It’s hard to avoid getting the full range of vitamins.”

Not all experts agree. Dr. Walter Willett, a professor at the Harvard T.H. Chan School of Public Health, says it’s reasonable to take a daily multivitamin “for insurance.” Dr. Willett said that clinical trials underestimate supplements’ true benefits because they aren’t long enough, often lasting five to 10 years. It could take decades to notice a lower rate of cancer or heart disease in vitamin taker

For Charlsa Bentley, 67, keeping up with the latest nutrition research can be frustrating. She stopped taking calcium, for example, after studies found it doesn’t protect against bone fractures. Additional studies suggest that calcium supplements increase the risk of kidney stones and heart disease.

People who take vitamins tend to be healthier, wealthier and better educated than those who don’t, Dr. Kramer said. They are probably less likely to succumb to heart disease or cancer, whether they take supplements or not. That can skew research results, making vitamin pills seem more effective than they really are

Because folic acid can lower homocysteine levels, researchers once hoped that folic acid supplements would prevent heart attacks and strokes.In a series of clinical trials, folic acid pills lowered homocysteine levels but had no overall benefit for heart disease, Dr. Lichtenstein said

When studies of large populations showed that people who eat lots of seafood had fewer heart attacks, many assumed that the benefits came from the omega-3 fatty acids in fish oil, Dr. Lichtenstein said.Rigorous studies have failed to show that fish oil supplements prevent heart attacks

But it’s possible the benefits of sardines and salmon have nothing to do with fish oil, Dr. Lichtenstein said. People who have fish for dinner may be healthier as a result of what they don’t eat, such as meatloaf and cheeseburgers.

“Eating fish is probably a good thing, but we haven’t been able to show that taking fish oil [supplements] does anything for you,

In the tiny amounts provided by fruits and vegetables, beta carotene and similar substances appear to protect the body from a process called oxidation, which damages healthy cells, said Dr. Edgar Miller, a professor of medicine at Johns Hopkins School of Medicine.Experts were shocked when two large, well-designed studies in the 1990s found that beta carotene pills actually increased lung cancer rates.

Likewise, a clinical trial published in 2011 found that vitamin E, also an antioxidant, increased the risk of prostate cancer in men by 17 percent

“Vitamins are not inert,” said Dr. Eric Klein, a prostate cancer expert at the Cleveland Clinic who led the vitamin E study. “They are biologically active agents. We have to think of them in the same way as drugs. If you take too high a dose of them, they cause side effects.”

“We should be responsible physicians,” she said, “and wait for the data.”

The results from the phase 3 trial, involving almost 1,000 dying head and neck cancer patients, were early and not statistically significant but were still “clinically meaningful”, the ICR said, with some patients living months or years longer and suffering fewer side effects.

When the research nurses called to tell me that, after two months, the tumour in my throat had completely disappeared, it was an amazing moment,” said Ambrose. “While there was still disease in my lungs at that point, the effect was staggering.”

"We are truly in a paradigm change,

Now research is asking "when is histology [the microscopic structure of cancers] important, and when isn't it?" he said

the effort is "the largest and most rigorous precision oncology trial that's ever been attempted"

It no longer makes sense to categorise and treat cancer based on the site in the body where it originates when we know it is a disease of DNA mutations that modern technology allows us to understand, he said.

One way alcohol may lead to cancer is because the body metabolizes it into acetaldehyde, which causes changes and mutations in DNA, Dr. Gapstur said. The formation of acetaldehyde starts when alcohol comes in contact with bacteria in the mouth, which may explain the link between alcohol and cancers of the throat, voice box and esophagus

the rest comes from his multiple real world examples illustrating exactly why even the most reluctant mathophobe is well advised to achieve a personal understanding of the statistical underpinnings of life, whether that individual is watching football on the couch, picking a school for the children or jiggling anxiously in a hospital admitting office.

And while we’re talking about bias, let’s not forget publication bias: studies that show a drug works get published, but those showing a drug does nothing tend to disappear.

The same trade-off applies to the interpretation of medical tests. Unproven disease screens are likely to do little but feed lots of costly, anxiety-producing garbage into your medical record.

our immune system should hunt out and destroy mutated cells before they ever develop into cancer. Occasionally, however, these cells manage to sneak under the radar, reproducing until they grow into a full-blown tumour.

. In 2009, the researchers reported in the Journal of the American Medical Association that taking high doses of vitamin B12 along with folic acid (technically vitamin B9) was associated with greater risk of cancer and all-cause mortality.

There are legitimate and important uses for B-vitamin supplements, but the emerging evidence suggests we’re best to treat them more like pharmaceuticals than like panaceas to be shoveled into us in pursuit of energy, metabolic fortitude, “cardioprotection,” “bone wellness,” or whatever way in which we’d like to be better.

The research team is quick to note that the doses of B vitamins in question are enormous. The U.S. Recommended Dietary Allowance for B6 is 1.7 milligrams per day, and for B12 it’s 2.4 micrograms. The high-risk group in the study was taking around 20 times these amounts.That could seem nonsensical, except that these are the doses for sale at healthy-seeming places like Whole Foods and GNC. Many sellers offer daily 100-milligram B6 pills. B12 is available in doses of 5,000 micrograms.

Lung-cancer risk among men who took 20 milligrams of B6 daily for years was twice that of men who didn’t. Among people who smoke, the effect appeared to be synergistic, with B6 usage increasing risk threefold. The risk was even worse among smokers taking B12. Using more than 55 micrograms daily appeared to almost quadruple lung-cancer risk.

The current law gives consumers no reason to expect that risks will be listed on the labels of these products, or that health claims are accurate. A product like a high-dose B6 and B12 supplement hits shelves, and only decades later do researchers begin to understand the long-term health effects, who might benefit from taking it, and who might be harmed.  

This kind of modeling is already in use to study individual cellular processes like metabolism. But Dr. Covert said: “Where I think our work is different is that we explicitly include all of the genes and every known gene function. There’s no one else out there who has been able to include more than a handful of functions or more than, say, one-third of the genes.”

The simulation, which runs on a cluster of 128 computers, models the complete life span of the cell at the molecular level, charting the interactions of 28 categories of molecules — including DNA, RNA, proteins and small molecules known as metabolites, which are generated by cell processes.

They called the simulation an important advance in the new field of computational biology, which has recently yielded such achievements as the creation of a synthetic life form — an entire bacterial genome created by a team led by the genome pioneer J. Craig Venter. The scientists used it to take over an existing cell.

A decade ago, scientists developed simulations of metabolism that are now being used to study a wide array of cells, including bacteria, yeast and photosynthetic organisms. Other models exist for processes like protein synthesis.

“Right now, running a simulation for a single cell to divide only one time takes around 10 hours and generates half a gigabyte of data,” Dr. Covert wrote. “I find this fact completely fascinating, because I don’t know that anyone has ever asked how much data a living thing truly holds. We often think of the DNA as the storage medium, but clearly there is more to it than that.”

scientists chose an approach called object-oriented programming, which parallels the design of modern software systems. Software designers organize their programs in modules, which communicate with one another by passing data and instructions back and forth.

“The major modeling insight we had a few years ago was to break up the functionality of the cell into subgroups, which we could model individually, each with its own mathematics, and then to integrate these submodels together into a whole,”

In support of compassion fatigue, both self-report and physiological measures of affect showed that positive affect declined substantially when the group size was two or more.”

After several puffs of neurotransmitter are released, however, that channel may undergo a process called “desensitization” in which it closes and stops responding to signals from the presynaptic neuron.

“Observing that the tendency to mentalize with one person more than many people is built into our brains does not mean we should accept it as an excuse for acting passively when facing large-scale crises. This observation implies, however, that we can no longer rely on our moral intuitions.”

eople may cope with the enormity of the pandemic by trying to find ways to minimize or even dismiss it. Saying that there are other diseases that cause more deaths than COVID-19 could be one such emotional mechanism.

We need to tell more stories about real people who have had COVID-19 and experienced it as more than mild symptoms, including stories about people who have been killed by the disease. The stories need to be told one by one. That way, we will be harnessing what we know from cognitive neuroscience to bring the sad message home.

The new process may also help in other procedures where doctors need to analyze tissue while they are still operating, such as head and neck, breast, skin and gynecologic surgery, the report said. It also noted that there is a shortage of neuropathologists, and suggested that the new technology might help fill the gap in medical centers that lack the specialty. Video Advertisement LIVE 00:00 1:05

Algorithms are also being developed to help detect lung cancers on CT scans, diagnose eye disease in people with diabetes and find cancer on microscope slides.

The diagnoses were later judged right or wrong based on whether they agreed with the findings of lengthier and more extensive tests performed after the surgery.The result was a draw: humans, 93.9 percent correct; A.I., 94.6 percent.

At some centers, he said, brain surgeons do not even order frozen sections because they do not trust them and prefer to wait for tissue processing after the surgery, which may take weeks to complete.

Some types of brain tumor are so rare that there is not enough data on them to train an A.I. system, so the system in the study was designed to essentially toss out samples it could not identify.

“It won’t change brain surgery,” he said, “but it’s going to add a significant new tool, more significant than they’ve stated.”

Functional Medicine isn't a protected title and a medical qualification isn't a prerequisite to practice. The result is an unregulated and disparate field, with medical doctors, nutritionists, naturopaths and homeopaths among the many practitioners.

Some other chronic illnesses the field claims to treat include heart disease, type 2 diabetes, irritable bowel syndrome, ulcerative colitis, depression, anxiety and arthritis

ll kinds of different reasons, some might have gluten issues, gut issues, others might have a deficiency causing neurological issues, MS is a symptom."

"There are components of Functional Medicine that absolutely lack an evidence base and there are practitioners of what they call Functional Medicine, they charge people for intravenous nutritional injections, they exaggerate claims, and that is professionally inappropriate, unethical and it lacks evidence.

On Dr Mark Hyman's view of MS he says, "there are a lot of terms put together there, all of which individually make a lot of sense, but put together in that way they do not.

"What does FM actually mean? It means nothing. It's a gift-gallop of words thrown together. It's criticised by advocates of evidence-based medicine because it's giving a veneer of scientific legitimacy to ideas that are considered pseudoscientific. For example, it'll take alternative medicine modalities like homeopathy and then call them 'bio-infusions' or something similar, rebranding it as something that works.

"It's a redundant name, real medicine is functional."

Next month the third annual Lifestyle and Functional Medical conference will take place in Salthill, Galway on November 3. Last year's event was attended by more than 500 people and featured a keynote address by honorary consultant cardiologist Dr Aseem Malhotra, author of bestselling The Pioppi Diet (which was named one of the top five worst celebrity diets to avoid in 2018 by the British Dietetic Foundation).

Dr David Robert Grimes is physicist and visiting fellow of Oxford and QUB. His research into cancer focuses on modelling tumour metabolism and radiation interactions. For Dr Grimes, the lack of definition, or "double-speak" as he puts it, in FM is troubling.

As well as the cost of appointments, FM practitioners commonly charge extra for tests. An omega finger prick test is around €100. A vitamin D test can cost upwards of €60, full thyroid panel more than €150 and a gut function test €400. Prices vary between practitioners.

"If I, as a GP, engaged in some of these behaviours I would be struck off." Specifically? "If I was recommending treatments that lacked an evidence base, or if I was promoting diagnostic tests which are expensive and lack an evidence base.

GPs engage every year in ongoing continuous professional development, I spend my evenings and my weekends outside of working hours attending educational events, small-group learning, large-group learning, engaging in research. This is an accusation that was levelled at the profession 30 years ago and then it was correct, but the profession has caught up…

"Obviously promoting wellness and healthy diet is very welcome but going beyond that and stating that certain aspects of 'functional medicine' can lead to reduced inflammation or prevent cancer, we have to be very careful about those claims.

Often the outcome of such tests are seemingly 'benign' prescriptions of vitamins or cleanses. However, dietitian Orla Walsh stresses that even these can have potentially harmful effects, especially on "vulnerable" patients, if not prescribed judiciously.

FM has five basic principles. 1. We are all genetically and biochemically unique so it treats the individual, not the disease. 2. It's science-based. 3. The body is intelligent and has the capacity for self-regulation. 4. The body has the ability to heal and prevent nearly all the diseases of ageing. 5. Health is not just the absence of disease, but a state of immense vitality.

She began her Functional Medicine career while training as a medical doctor and now travels the world working with high-profile clients. Dr McHale charges €425 for an initial consultation and €175 for follow-up appointments. Straightforward lab tests are €250 to €750, for complex cases testing fees can be up to €2,000.

"The term [Functional Medicine] tends to be bandied around quite a bit. Other things people say, such as 'functional nutritionist', can be misleading as a term. Many people are Functional Medicine practitioners but don't have any real medical background at all... I think regulation is always probably the best way forward."

"There's an awful lot to it in terms of biochemistry and physiology," she says. "You do need to have a very solid and well ingrained bio-chemistry background. A solely clinical background doesn't equip you with the knowledge to read a test.

"Evidence-base is the cornerstone of medicine and that has to be maintained. It becomes problematic in this area because you are looking at personalised medicine and that can be very difficult to evidence-base."

GP Christine Ritter travelled from England to attend the Galway conference last year with a view to integrating Functional Medicine into her practice.

"It was very motivating," she says. "Where it wasn't perhaps as strong was to find the evidence. The Functional Medicine people would say, 'we've done this study and this trial and we've used this supplement that was successful', but they can't show massive research data which might make it difficult to bring it into the mainstream.

"I also know the rigorous standard of trials we have in medicine they're not usually that great either, it's often driven by who's behind the trial and who's paying for it.

"Every approach that empowers patient to work on their destiny [is beneficial], but you'd have to be mindful that you're not missing any serious conditions."

Dr Hyman is working to grow the evidence-base for Functional Medicine worldwide. "The future is looking very bright," he says. "At the Cleveland Centre we're establishing a research base, building educational platforms, fellowships, residency programmes, rotations. We're advancing the field that's spreading across the world. We're seeing in China the development of a programme of Functional Medicine, South Africa, the UK, in London the Cleveland Clinic will hopefully have a Functional Medicine centre."

For Dr Mark Murphy regulation is a moot point as it can only apply once the field meets the standards of evidence-based medicine.

"Despite well intentioned calls for regulation, complementary and alternative medical therapies cannot be regulated," he says. "Only therapies that possess an evidence-base can enter our standard regulatory processes, including the Irish Medical Council, the Health Products Regulatory Authority and Irish advertising standards. In situations where complementary and alternative therapies develop an evidence base, they are no longer 'complementary and alternative', but in effect they become part of mainstream 'Medicine'.

l What are the principles?

"There's a huge variation between therapists, some are brilliant and some are okay, and some are ludicrous snake oil salesmen."

He is so concerned that patients' health and wealth are being put at risk by alternative therapies that earlier this year he joined Fine Gael TD Kate O'Connell and the Irish Cancer Society in introducing draft legislation earlier this year making it illegal to sell unproven treatments to cancer patients. Violators face jail and heavy fines.

Dr Grimes says criticism of variations in the standards of traditional medical research can be fair, however due to the weight of research it is ultimately self-correcting. He adds, "The reality is that good trials are transparent, independent and pre-registered.

"My involvement in shaping the Bill came from seeing first-hand the exploitation of patients and their families. Most patients undergoing treatment will take some alternative modalities in conjunction but a significant portion are talked out of their conventional medicine and seduced by false promises

the government is paying more than $200 for each course of treatment.

But when stockpiling a smallpox drug was first proposed in 2001 after the Sept. 11 and anthrax attacks, it was expected to cost only $5 to $10 per course, said Dr. Donald A. Henderson, who led a government advisory panel on biodefense in the wake of those attacks. Dr. Henderson was a leader in the eradication of smallpox in the 1960s and is now at the Center for Biosecurity at the University of Pittsburgh Medical Center.

Smallpox has such a long incubation period that the vaccine can prevent disease even if it is given as late as three days after infection. Arestvyr may also prevent infection if given early enough, but that has not been proven.

the price being charged for a patented drug was a bargain compared with AIDS antiretrovirals that cost $20,000 a year and cancer drugs that cost more than $100,000 a year.

“There are 80 million courses of Tamiflu in the strategic national stockpile,” he said. “Smallpox is just as contagious and has 30 times the mortality. By measures like that, I’d say 2 million is on the low end.”

No one should seek to die or give in to a disease they can legitimately fight. God knows how many pills I take a day to keep the virus – and all its and their side-effects at bay. But I get to live healthily and meaningfully. The way some elaborate and cutting edge treatments all but kill the patient in order to save her troubles me. It’s a loss of perspective as well as immensely expensive for the entire system.

our culture’s gradual alienation from the fact of our deaths – our distancing ourselves even from the old and infirm in ways previous cultures didn’t and couldn’t – is not, in my view a healthy thing.

these sophisticated treatments are taking healthcare money away from the young, taking up more and more of our collective healthcare resources, and extending lives only be perpetuating continuous agony and nausea and pain for the patient and devastating consequences for families and friends.

We will all die. We should not seek it. But we should not flee from it for ever.

at some point what seems to me to matter more is not the length of our lives but the content of them and the manner of our deaths.

At some point, medicine is a function of a social disease of modernity: the flight from our own mortality. But fleeing it does not defuse it. Only facing it does.

In the new study, researchers, including chemist Shankar Balasubramanian, of the University of Cambridge and Cambridge Research Institute, crafted antibody proteins specifically for this type of DNA. The proteins were marked with a fluorescent chemical, so when they hooked up to areas in the human genome packed with G-quadruplexes, they lit up.

Next, they incubated the antibodies with human cells in the lab, finding these structures tended to occur in genes of cells that were rapidly dividing, a telltale feature of cancer cells. They also found a spike in quadruplexes during the s-phase of the cell cycle, or the phase when DNA replicates just before the cell divides.

the researchers think the four-stranded DNA could be a target for personalized medicine in the future

"What makes me personally very happy about this work is that it again demonstrates that mechanisms first described in ciliated protozoa hold also true for other organisms up to human, demonstrating the strength of this model organism," wrote Lipps wrote.