Category: health

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Own Insulin

People who suffer from type 1 diabetes do not produce enough insulin themselves. The World Health organization estimated that „in 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries“ (WHO 2023). The report on successful reprogramming of stem cells of a person to produce insulin again and subsequently transplanting these cells into the same person allowed to produce own insulin again for that same person (Mallapaty, 2024). The hope for millions of people with type 1 diabetes is high that eventually there will be a cure to the disease. Scientists caution that there are no data yet for how long the transplanted own stem cells will produce insulin. Hence, the hope is driving research forward on a promising way forward. The case of type 2 diabetes is very different as additionally the absorption of insulin in the body causes problems. We keep walking and building muscles to facilitate the insulin absorption in the body to guard against the onset of type 2 diabetes. Interaction of diabetes and aging is another topic that needs our attention as rapidly aging societies are at higher risks to face many more people with various forms of diabetes.

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Walking Danger

Autumn brings color into nature. This is for some the bright side of life. However, the sun sets much earlier every day and many people begin to walk to school or work and back during the dark time of the day. Unfortunately, this entails an additional danger to those walking the cities as bad light conditions cause many accidents of pedestrians. The statistics provided by Destatis (2024) for Germany show a marked increase of walking accidents from September onwards and lasting throughout winter. Equip yourself with bright colors and reflectors to avoid being a walker in danger or a walking danger. On Sunday it is pretty safe to go for a stroll. City life is less stressful and professionals in a hurry usually take a rest on that day. The conclusion is to choose your track wisely in order to feel safe on weekdays.

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Waiting time

A new report by Darzi, a former cancer surgeon and past minister of health in the UK, paints a dismal picture of the British health service (NHS) over the last 15 years under conservative rule. The public service has seen no increase in its budget accounting for population growth and the aging of the population. The service is no longer able “to give patients the timely care they need” (The Guardian 2024-9-12 title page). Increased waiting times lead to an estimated 14.000 premature deaths per year. Darzi presents data that show 300.000 persons had to wait longer than one year for a treatment that should have been performed within 18 weeks.

The staff seems desperate for changes as well as they have to spend more time on management of waiting times, time which is lost for real treatment. The quality of care is another issue which awaits urgent attention. Health cannot wait for most patients, but the neglect of investment in hospitals and people is expensive in the longer run. Even the reform efforts should not wait any longer. Time is a precious good and each life matters. (Image back cover of exhibition catalogue Käthe Kollwitz at MOMA 2024).

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Health GDP

A report by the WHO and the World Bank (2023) on universal health coverage and financial hardship has emphasized the difficulties to reach the goals defined by the strategic development goals (SDGs) by 2030 in this policy field. Moreover, the paper by Mazzucato and Ghebreyesus (2024) invites us to reconsider the importance of health in the overall assessment of development and progress. The authors ask us to “rethink the narrow focus on growth in gross domestic product (GDP) that typically dominates economic decision making”. There is of course a long debate on the status of health, GDP or wellbeing as major policy issues or even foundations of the a state’s major objective. For economists the question has been answered for decades to favor GDP growth and more or less the other objectives can be achieved with a time delay. Recently social scientists have highlighted the overall importance of wellbeing or happiness rather than GDP as stated in some constitutions. Health as an overall objective is another challenge to the existing economic framing of societies. In a traditional economic perspective the health sector is part of the GDP increasing public and private sector of the economy with insurers, equipment and persons contributing to it. On the other hand, health enters into the distribution or consumption part of the economy. Each country strikes its own balance between production and consumption. Put simply, in form of an equation where production equals consumption, health enters on both sides of the equation in each country. On the global, scale the distribution between costs and benefits of health have not narrowed over the past. The challenge for the world population remains steep. Considering unequal population growth across continents, the situation might get worse before it hopefully gets better. We still have to continue huge efforts to increase overall health on earth for example through large scale vaccination programs. (Image The tombstone of Molière in Paris 2024)

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Desertification

Since 2018 we have evidence of the progression of desertification into some Member States of the European Union. The mediterranean countries are concerned as well as regions of Bulgaria and Romania near the Black Sea. There are multiple sources of desertification. The 3 main reasons of desertification are soil erosion, loss of soil fertility and loss of natural and desirable vegetation besides wind or water erosion and salinization. We also know that man-made climate change is at the root of the past and recent problems. The statistical indicators of land degradation are collected by the European Joint Research Centre and these data show a dismal picture of land degradation in general and desertification as part of this process. A study by Ilea et al. published in Nature 2024 projects an intensification of extreme weather in the coming years. Higher temperatures will most likely enhance desertification and more frequent flooding will contribute to more soil erosion as well. It is a rather strange process that we know we are creating severe problems for some regions which endanger the roots of their existence and yet we do not act upon those undeniable facts (United Nations SDGs list). The amount and dynamics of land deterioration put the global South under severe pressure, but also the wealthy parts of the Mediterranean basin will be affected. It about time to acknowledge that we are all part of the global changes and challenges. (Image palm tree in Paris, Jardin du Luxembourg, 2024)

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Heat Stress

Heat causes cardiovascular and pulmonary stress. This has been well-known for a long time. A newly published epidemiological study for Germany reiterates this finding and adds more details to the picture of who is affected most by heat stress and heat-related mortality. Old age and being female increase the heat-related deaths in Germany according to the study by Zhang et al. (2024) published in the Lancet Regional Health. Our body’s thermoregular responses to heat stress like vasodilation or hyperventilation cause additional stress to our cardiovascular and pulmonary system. Excessive sweating and dehydration, possibly increased through medication, amplify heat-related risks. The study corrects the estimates by using fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) data on the district level in the analysis. High concentrations of PM2.5 and NO2 increase heat stress and related deaths as well. Inner cities are, therefore, not the best place to be during the hot season. Most southern European inhabitants of big cities are aware of these health hazards and act accordingly. In Germany it is much less a habit to quit inner cities during the hot days in summer, but climate change will make this a major concern. Greening inner cities is an urgent necessity, which is not just nice to have, but saves lives. (Image Berlin Bears, Berlin City Center 2023)

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Paralympic Happiness

It is with great pleasure that we watch the paralympic athletes in Paris compete for Olympic medals. For many the emotions of participation and being applauded by so many people in a sport arena are great experiences. Happiness derives from such great games and audiences. The accomplishments of the athletes and their supporting teams are truly outstanding. The progress towards such high skill levels is remarkable for each of them. The adaptation to what appears to be a handicap with adequate support and technique allows to surpass limitations. Well exercised skills like swimming are possible to be performed with great skill to achieve incredible performances. The Paralympic Games in Paris 2024 are a great reminder that besides the athletes some artists had to struggle with handicaps, but achieved some of the finest pieces of art. Matisse, for example, is called frequently “le peintre-du-bonheur”, the painter of happiness. In his last few years he faced a severe handicap to paint, however the pursuit of abstraction helped him to continue to create masterpieces. The rather radical pursuit of abstraction and maybe simplification are uncovered in the exhibition “Matisse: The red studio” at the “Fondation Louis Vuitton”. This marks an important step in the artistic life course of Matisse and enabled him to continue his work in later life when his health made it very difficult to pursue his artistic work. (Image at Fondation Louis Vuitton 2024-9-1 exhibition Matisse).

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Olympics for All

The Paris 2024 Olympic Games and the Paralympic Games have demonstrated the extraordinary competence, professionalism and competitiveness of all athletes. The television spectators and live participants in the events have been involved to a great deal.
After all this hype around sports let us consider the probability of getting involved in physical activities and sports. Additionally, it is of interest, whether people are encouraged to continue sports, maybe at higher ages as well through these sports events like Olympia.
High level athletes are most likely to continue their sports activities. In many countries the extraordinary athletes of the Paralympics faced tough challenges to pursue their sport interests and passion.
However, the public health challenge is the big unresolved issue of how to best raise an awareness for the pleasures and benefits of sport for the masses. (bibliography by BNF “Santé et activité physique). It is not only a matter of suitable infrastructure, but also the question of sports in your neighbourhood. This issue has implications for urban and rural communities and how they organize the practice of sports in an inclusive way. Each step may be a stepping stone into sports for all ages and pathologies.
The pleasure and benefit to walk or something simple as walking to or walking after work, are part of the solution to many public health issues.
The visitors of the Paris Olympics walked a lot.
This fun experience in an enthusiastic city will encourage many to continue the simple exercise without thinking about exercise. This will do the trick. Just do it, without thinking to much about it.

BNF Paris 2024-8
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Paris Trees

Preparing metropolitan cities like Paris for the heating up of the globe due to climate change is a huge task. As early as 2020 Paris started an ambitious greening program. 170.000 new trees by 2026 in a densely populated city is a steep challenge. With 114.000 trees planted by 2024 as the Olympic athletes and spectators gathered in Paris the city is right on track. The 2 parks “bois de Boulogne et bois de Vincennes” have jointly 25.000 new or renewed trees. The cemeteries, for example “Père Lachaise” has received new cooling trees as well. Most trees, however, were planted along the notoriously hot and overcrowded “périphérique” with 50.000. Only with the use of a Colbert-like planning exercise and rigorous implementation against even some initial resistance, it is possible to achieve this result and the ultimate objective. Visitors of the Olympic Games already experienced the differences during the summer of 2024. Detailed planning by means of a “Bilan par arrondissement” facilitates monitoring of progress. Publishing the information is part of the communication strategy to keep citizens informed and engaged in this silent transformation for the benefit of inhabitants and visitors. (Image City of Paris webpage 2024)

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Burden of Disease

For the planning of health and care systems it is important to measure the so-called burden of disease within societies or related to specific diseases or social groups. A large-scale analysis of several longitudinal data bases of the populations 50 years of age and older shows that we have underestimated the burden of disease to societies of psychiatric disorders, like depression, in most societies.
A meta-study and overview of previous studies showed already that depression (age 60+) is more common in lower-income countries (between 25 and 33% of 60+population age group). High income countries, studied by Wang et al. 2024 in The Lancet Healthy Longevity, have rates of depression well below these levels, but a link to socioeconomic status, inactivity and loneliness is still evidenced. A five-year follow-up of persons aged 50+ years shows that the probability to develop a depression (hazard rate) is twice as high for persons with low socioeconomic status, who were socially
inactive and lonely than for socially active, high socioeconomic status and did not feel lonely at the beginning of measurement. The conclusion of the research highlights the need to develop and implement integrated and simultaneous initiatives to addressed the growing burden of disease related to depression in older persons. (Image, Jules Desbois, “Misery” 1887-89, Musée Rodin, Paris)

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Stress Ageing

The relationship between stress and aging is a complex one. Stress is known to accelerate aging and aging caused different reactions to stress. In short causality does not run only in one direction. Additionally new research published in Nature Medicine 2024 demonstrates that different genetic preconditions determine different response patterns to stress and subsequent brain aging. From anecdotal experience we are well aware of different persons coping very differently with stressful situations. Mastering of various coping mechanisms may attenuate the stress experience but the impact on preserving our brain remains an open question. Various other forms of lifestyle conditions like drugs and smoking cause specific forms of brain damage as well. 2 separate forms of dementia can be identified from brain MRI-images as well. The brain is no longer the black box of missing information about what is going on in humans. Put to the right purposes this is good news. (Image: break dance shooting Paris St Denis 2024)

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Alzheimer Research

Alzheimer disease has reached unprecedented levels in line with population aging. The study by Martino-Adami et al. 2024 has raised the hope that more people can receive an early diagnosis of Alzheimer and potentially start treatments. The study used plasma biomarkers rather than much more expensive and rare MRI scans for diagnosis. The rather exceptional results allow even to test for severity of Alzheimer according to established evaluation measures. Additionally, the probability of an Alzheimer trajectory on a time scale is feasible. The authors suggest that the data and statistical methods applied allow to identify Alzheimer before the outbreak of impairments. The data sample stems from “patients of advanced age visiting primary care”. This remains a limitation for generalizations, but the hope that other studies test the same approach with samples from younger populations will spur additional investments into such research. The list of institutions and foundations that contributed to make this study possible is really long. Thanks go to all involved, researchers, donors as well as the reviewers and editors of the journal. (Image Paris Metro Help Column 2024)

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Paris Experiment

The Olympic Games 2024 were prepared years ago. Already the application procedures to prepare “un dossier” has to bring in lots of ideas and imagination what is desirable and feasible. Paris opted for a celebration of sustainability in a city proud of its medieval heritage and the Haussmann tradition of radical transformations of a city with large boulevards and representative buildings. From the “Arc de Triomphe” the major axes of communication between “arrondissements” become visible. 100 years ago the city had already been transformed according to this master plan. At that time sanitation of a city meant different things than today. The invasion of inner cities by Diesel-driven cars made life unhealthy again. Now, the Olympics gave reasons to restrict cars and lorries passing the inner city and the great boulevards. More tourists need more space and shall keep a much better memory of how pleasant Paris was during the Olympic Games. This could be a game changer for urban development in general. The proportion of pedestrians versus cars has to be shifted in favor of the walking population for many reasons. Tourists will flock to the city, if the overall and shopping experiences are great. Back to the future sounds crazy, but it has an interesting flavor to it for urban renewal and residents as well. (Image Paris 2024-8, b/w color filter applied, enlarge to see vasque)

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Olympic Virus

We tend to believe or want to believe that the horrible SARS Covid-19 crisis is completely behind us. However, science signals that we need to stay alert with respect to the mutations of the virus. International events like the Paris 2024 Olympics bring together athletes and spectators from all continents and some of them still seem to carry the virus with or without symptoms. A report in the LANCET Respiratory Health mentioned that dozens of athletes were tested positive for the virus and a largely unaccounted number of spectators had carried the virus FLiRT variants. As tracking is difficult with more or less absent testing strategies the tests rely on waste water analyses and reports from health care institutions. The Olympic Games are over but the virus still lives on and variants keep popping up. Games during the summer months should be much saver than winter games as the time spent outside is much longer. Traveling in crowded transport, however, remains a potential health hazard. Huge crowds at Olympics are inevitable. After all, birds of the same feather flock together.

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Green Olympics

Paris 2024 has won a medal for the Green Olympics. Sustainable building of Olympic sites is a crucial element in this struggle for saving resources. Just as important is the CO2 footprint of the transport within the city if you cannot prevent thousands of people from flying to the venues. Public transport in Paris used the occasion to improve its services considerably. The restrictions to cars driving around in the inner city also for security reasons made the Olympic experience for Paris a healthy walking experience for all. The view from the “Arc de Triomphe” during the Olympics in Paris is even more pleasant and relaxed as the noisy and polluting traffic is reduced to minimal levels. You were able to grasp the feeling what inner cities could be like if people were the overriding concern of cities rather than circulation of automotive vehicles. Redressing this balance in favor of people living, working and visiting is overdue and we all know this. The city of Paris used the occasion to demonstrate that another way or compromise is possible. This is also a way to write history and create unforgettable moments. Paris discusses already what to keep from the Olympics for longer. Maybe the vasque, maybe the cleaning crews. New Metro lines, of course. Why not the different traffic and mobility patterns? It’s well worth a lasting Green Olympic medal.

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Olympic Prevention

In the streets near the Stade de France at Seine Saint Denis the team of street workers addressed spectators with little presents. Each of these little items served the purpose to remind people of the prevention of disease or later consequences of the Olympic atmospheres in PARIS 2024. Sex, booze and drugs, but also noise were the topics of the prevention patrol around popular venues. Great way to bring home a message for visitors and the local population as well. Health and Olympic Games is a huge topic with many facets to it. Not only athletes are concerned, but also spectators. The team agreed to pose for media coverage as this is their reason of existence. Reaching big crowds is essential especially if big sugar is among the big sponsors of the games. It is another kind of competition with rather unequal starting conditions. You might loose some fights against yourself, but trying to overcome alcohol addiction or sugar overdose is worth a repeated game. Prevention is key.

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Olympic Celebrating

Paris 2024 gives lots of reasons to celebrate athletes and teams. France has already achieved a large number of medals and shops in Paris start to decorate their windows with their emotional expressions of various forms. Merchandising seems to work well and some shops add a personal touch to special heroes. Walking the marvelous streets of Paris from one monument to the next is a pleasure as the streets are surprisingly empty and many are closed for cars and lorries. Hence, walking in Paris is a rather healthy exercise at this special moment in time. It is a great way to welcome all nations to Paris and allow a rather stressless visit of the city and its tourist attractions. Riding bicycles and buses becomes a pleasure too as roads are rather empty and circulating around the city is much easier than at any time before and probably after as well. Thanks for the great experience and the welcoming atmosphere.

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Olympic UNESCO

The headquarters of UNESCO are in Paris. Therefore, it is no surprise that UNESCO joins the Olympic drive to bring home the message of the importance of sports for international understanding and the spreading of the message to advance human rights. The exhibition in summer 2024 honors the role of sport to overcome stereotypes and advances inclusiveness through joint practice of sports. Respect of ethnic and cultural diversity is a fundamental principle of sports and especially during the Olympic Games. The benefits of sports go beyond the physical competition between athletes. Team spirit is another necessary condition to excel in sports. The message of the Olympics goes beyond the tough competition and raises issues of solidarity within and between teams. The large number of countries that participate demonstrates that we all live on one planet and we have to take care of it. Many of the policies in the fields of education, science and culture can be easily explained through reference to sports. The exhibition “Fit for Life” at the headquarters manages to get this simple message across. Rather than endless documentation the exhibition makes a choice of the most relevant and accessible topics in each of the domains of competence of UNESCO. (Image UNESCO 2024, Paris)

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Olympic Equality

Of course, first of all the Olympic Games are about making a difference with respect to your opponent. However, there has been a thrive to achieve an equality of genders for more than 100 years as well. Women had to battle such a long time to achieve the right to participate in the Games in the same disciplines as men. For the first time in Paris2024 men and women are represented with the same amounts of athletes. Each gender is participating with 5.250 athletes and astonishing progress has been made to ensure that male and female athletes perform in the same or similar disciplines. Even if it took decades for women to run a marathon at the Olympics, the inclusion of a triathlon for women was already much more rapid.
This constitutes a real milestone in the progress towards equality in Olympics. Equal numbers of athletes is a quantitative form of inclusion, the qualitative level of inclusion remains to be accomplished. The qualitative dimension consists in the inclusion of women at equal footing in media reporting and sponsoring. On the organizational level of the IOC the organizing committee is still dominated by men and statistics on the accompanying teams of coaches, therapists and representatives a lot of progress still needs to be accomplished. Paris made already a huge difference and several exhibitions of the “cultural games” around the city during the Olympics 2024 make this point quite forcefully.
The sociology of the Olympic Games has a lot of topics. It is great to see the progress made in Paris on Olympic Equality, after all “égalité” figures prominently in the definition of modern France.
(Image: BNF 2024 exhibition “A History of Women in Sport” own translation)

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Olympic Village

The newly built Olympic Village in Seine Saint Denis consists of 82 buildings and offers 3000 appartements. With up-to-date cooling and heating technology from a nearby geothermal source the eco friendliness is assured as well. Inclusive accessibility allows for games for all and the needs of an aging society. The price level of renting apartments remains a difficult to solve issue as demand will exceed supply for years to come. Universal accessibility is a necessary precondition to host the Paralympic games also in 2024. Historic sites are notoriously difficult to adapt to aging societies and inclusive approaches. However, the adaptation takes a large step towards the realization of inclusiveness of extraordinary people. The care for environmental sustainability has been honored as well. The exhibition in the Museum of the city of Saint Denis at the outskirts of Paris demonstrates the significant size of the urban renewal project. The socioeconomic and environmental benefits are evident and will give a push towards this previously deprived suburb. A lot remains to be done but the new trajectory for urban development is already put on track. The oblivious factories and enterprises give way for urban renewal of housing for people with easy access to the Paris city centers as well. (Source of Image)

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Swimming Pool

Summer time is the time to enjoy outdoors. Hiking, biking, climbing as well as swimming are high on the agenda. With the Olympic games 2024 around the corner we rise to the challenge and get started again with more sports activities. Swimming has many health advantages. Most people think of cardiovascular training and relieve of back pain. Exercise without carrying your body weight is great for your joints and ligaments. The benefits for psychological wellbeing have long been underestimated. Diving into silence under water even if it is only for some seconds or a minute calms your spirit. The water pressure holds you tight without restricting your movements. Breath control is an almost meditative experience. Everyone can do it, again and again. Childhood memories, good and bad, are associated with swimming. Choose your style, costume and pool. The summer break is an ideal occasion to test the marvelous experience again of cold or warm water. The cold water bucket challenge of everyday life takes a break. Time to find your pool again. (Image extract from Susanne Hay, Swimming Pool II, 1996 in private collection, exhibition in Yerres, summer 2023)

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Live longer

It is an old dream of mankind to live longer and longer. The Covid-19 pandemic has taught us many lessons that there are powerfully viruses and their continued mutations which threaten this. Life expectancy declined slightly during the pandemic and we learned that long Covid is yet another threat to our life expectancy. Scientists have found other sources that are crucial for survival. Like sepsis, it is the constant inflammation processes in our bodies. Long working times, stressful commute to work and interrupted or shortened vacations all contribute to keep inflammation at higher levels than is healthy from a longevity perspective. The research note published in Nature on the inflammation enhancing protein IL-11 highlights the chain reaction process of inflammation causing cancer and autoimmune disorders and diseases. Hence, it is essential to watch the biomarkers of inflammation and probably adjust our lifestyles accordingly. The sources of inflammation are manifold, but the potential rewards to address the issue are huge as well. Among the easy to address sources is nutrition, exercise and working life. Changing just a little bit here and there can make already a change. Monitoring how you feel about such changes puts you on a learning curve for your own inflammation levels. Vacation times are also perfect for adaptive behavioral changes. We just need to keep trying.

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Greening Brussels

We tend to believe that inner cities have lost the fight against traffic jams and climate change. However, the number of projects that stem the tide is growing and some have gained visibility beyond their immediate neighborhood. This is the case of an urban planning project in Brussels that has taken back space from urban traffic to the citizens living there. Planting new trees and a gardening space reserved for flowers changed the street into a pleasant environment where people meet and greet again rather than hold their breath and disappear as quickly as possible. Parking of cars has been reduced on the street and instead bicycle parking has become a hint towards more sustainable mobility in inner cities. Walking the city, staying and shopping nearby will allow behavioral change for healthier lifestyles. It needs a lot of persuasion to accomplish this impact and years of reaching majorities for such projects and the ability to raise sufficient resources to implement them. The additional challenge is the need to take care of the green spaces that only works with the support of neighborhoods assisting in the care and protection of the urban lungs. As the awareness to act against inner city heat and pollution increases the number of persons willing to act and devote resources as well as time for such projects increases as well. It is a long way to improve inner city health again, but these signs of exemplary projects will convince many other people that urban renewal can work to the benefit of people.

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Back pain

Most people know some form of back pain. This is understandable as an ever increasing share of people work in seated positions and spend additional leisure time in a similar position (gaming). Recurrent back pain is a frequent diagnosis. An Australien study has found a rather simple remedy for the widespread pain. The WalkBack experiment succeeded to significantly reduce recurrent lower back pain in study participants. Individualized and progressive walking accompanied by an education program did the trick. Keep on walking and try to extend the range of the exercise. It’s amazing to witness how the human body adapts to being challenged. Learning about the mechanics at work like the release of own personal “pain killers” hormones helps to trust in your body’s positive response to each dose of the challenge to pain. Do not walk too quickly too far. Stretching is a must and not an option. Go for it. Modern technology (in any smartphone) supports your efforts with counting your steps and measuring distances. Keeping track of a “pain diary” might give you guidance not to overdo the exercise and pause activities. Join a group of friends or people who are like-minded and get adequate shoes and clothes to feel comfortable while walking and afterwards as well.

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Nutrition Competence

Nutrition is a good example of how a long lasting disregard in education and learning systems has led to huge medical costs for individuals and societies nowadays. The obesity pandemic calls for urgent action and policy changes in the field of nutrition policies and learning goals for children and adults. Medical doctors have mostly discarded that it is also their responsibility to provide medical guidance on nutrition, as this is highly controversial at times and asks for behavioural changes of the patient. School teachers see little scope to act on the issue due to increasing demands in fields of literacy, numeracy, problem-solving, digital and communication skills. Hence, the hope is to fill the instruction and learning gaps with a hybrid approach of nurses taking on both roles and communicate with children as well as adults alike. This is a tough challenge for these persons, but hopes a high that they can make a significant improvement to the nutrition competences of individuals, pupils, their parents and specific target groups.
The starting point is to recognize that there is an issue with nutrition. The next to establish the best evidence and based on this to develop a curriculum for the nurses to be well-prepared for the challenge in the field. Even with the differentiation of different levels of competences, the learning has to be rather encompassing several related fields as well. Individual, behavioural as well as society-level factors like biology, technology, religious beliefs, economic and social factors determine nutritional choices and consumption. Just because there are so many factors to consider  does not justify to keep nutrition out of school curricula for example. Nutrition is a fine example of a topic which links disciplines across a broad range. It is a tasty, at times spicy mixture of issues to learn and apply. The former is the beginning, the latter the real challenge which needs ample and repeated guidance or coaching. (Image: Extrait of Abraham Mignon, 1640-1679, Undergrowth with flowers, animals and insects, MRBA Brussels)

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Nutrition Policy

The evidence on nutrition policies has accumulated a series of policy recommendations based on the best available evidence. The German Institute of Human Nutrition has presented these results repeatedly not only to the scientific community, but also to the interested public at the Science Week or the Long Night of Science. Their leaflet on the tools to improve our human nutrition in market economies highlights “nutrition competence” as a key component of a broad strategy to improve our food and subsequently health. Nutrition goes beyond the biological ingredients of food to include basic understandings of human metabolism including the times and timing of meals. This competence has to be transmitted to preschoolers, pupils as well as adults to stem the waves of obesity (ARTE Docu). Learning how to manage your own nutrition is a crucial competence to strive and survive. In schools it can have substantial impacts on performance and inequality of opportunities as well.

The science-based policy recommendations propose to alter the structure of costs, for example via tax reductions, in favor of healthy food. Plain water should be substantially cheaper than sweet beverages or alcoholic drinks. Nuts and proteins from vegetables fall in the same category as plain water. It is in the longer term interest of all of us that schools, canteens at work places or homes for the elderly offer also healthy nutrition at least as a daily option. More sustainability in food production is last, but not least part of nutrition policies. A lot to chew on to improve nutrition.

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Food Future

What do we have for dinner today, tomorrow or in 10 years from today? Research Institutes presented some of their insights based on solid evidence in the open door event in Berlin. The 5 years of the project “food4future” are over and my glance through some of the results suggests that we shall have many more proteins, most from vegetable sources, on our plates. The arguments for improved sustainability are rather compelling. The taste of these products that currently have higher amounts of bitter taste might be solved. Similarly sea food beyond fish like halophyte will enter our diet. The salty taste can be incorporated in meals in which we add salt or other spices anyway. These elements might make it possible to feed the 8 billion people on our planet. We probably also need to include protein rich insects in the meal plans of the still growing human species. It appears like a rather long shot into the future of nutrition, but if we do not think ahead and start the change in our mindsets we shall be badly prepared for the future and more people will decide to seek food in other places of the earth rather than stay hungry. It also helps us to refocus our priorities in nutrition and aim for a better balance of the pleasures of eating and sustainability. The issue of food for future generations starts with food for thought in the abundantly nourished Northern parts of the planet. (Image: AI Copilot, Prompt: 2 couples enjoy eating a meal of halophytes and insects, 2024-6-25)

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Betting vice

Betting is considered a vice. The industry has moved from the local bookmakers to the internet and is spread across countries and continents. Some legal advisers have classified betting as the fastest growing vice industry and it is about time to launch a wake up call for more oversight of what is going on in the sector. As betting like gambling seems to be working in conjunction with other addictions the potential of cumulative risks is quite high. Our brains tend to wire things together which frequently occur jointly. It is difficult to disentangle these co-occurrences later again. The major angle of attack is prevention.
Health journals start warnings of the detrimental effects persons and observe that the industry follows similar strategies as the tobacco industry to address as many people as possible. And this is very successful and profitable for them. Hence, prevention strategies should also follow what has been applied to smoking like the ban from restaurants and bars as well as the restrictions on advertising. We will have to accept that betting and gambling should not be as easily accessible as it is currently. Age restrictions have to be applied stringently. I bet this will take quite a long time until Europe and elsewhere the regulations will change. Some of the young get interested in even more stimulating activities like exploring arts (image below class at Neue Nationalgalerie Berlin 2024-6) rather than betting on who is going to win the Euro 2024 football matches.

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Smoke Gamble

Smoking is like a gamble. Your input is your health and money. This is not including those who might rely on you or family relationships that might suffer one way or another. The other link has gambling at its source and smoking goes along with the continuous risk taking or the belief to be able to master the risks involved with both forms of potential addictions. Research has accumulated evidence that in fact both smoking and gambling occur frequently in combination with each other. Taking risks against the odds of suffering losses, maybe only in the medium or longer run perspectives like for health seems acceptable for those people. Society has put rather high taxes on both activities to discourage people and invests in prevention of addictions. However, it does not have substantial effects on people as smoking remains around the same level and gambling (poker online) or betting on sports (Euro 2024) are rising rapidly. Vaping and internet gaming have broadened the spectrum of addictive behaviors mostly for younger persons and young adults. The risks are manifold and increasing in their addictive potential since the smartphone is always in some pocket just like the smoking device. The behavioral turn in the social sciences has been well understood by the industries as well. The stakes for human development are high in this endeavor to offer young people equal opportunities at entry into adulthood.

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Cannabis Alcohol

The use of cannabis and/or alcohol is yet another question where we are used to ask questions in the form of: either the or the other? Over generations we have gotten used to no longer ask for each do you or don’t you. With the controlled liberalization or legalization of cannabis in some Western European states the framing of the question is more like you do the one or the other, particularly for many younger persons.
Decriminalization of both drugs in small quantities is apparently reducing crimes link to drug use and drug dealing. On the other hand, the thresholds for doing drugs are lower than they used to be. In inner cities it is therefore no longer a surprise to find both kinds of drugs with addictive potential next to each other (see image below). We know that it is a slippery road from regular drug use to uncontrolled dependency and personal disaster. For cannabis a study published in the Lancet (Petrilli et al. 2022) added the importance of the potency of tetrahydrocannabinol to the estimate of risks. This is similar to the studies that differentiate the level of alcohol in drinks consumed. The higher the concentration, the higher the risks. A simple proportional relationship prevails in both drugs. The cumulative effects of consuming both together might have quite surprising non-linear effects.
The big issue is the risks of mental health related to these drugs. However, the causal direction is not easy to detect. Drugs induce mental health problems, but also mental health issues lead to drug abuse. This remains quite a puzzle for scientists to disentangle.
Additionally, the link to smoking and addiction to nicotine is a frequently observed corollary. Studying just one single source of health problems and addiction might be too restrictive to learn about the whole set of causal effects and casualties. For the time being we seem to jump from one field of attention to the next one ignoring the multiple interrelated factors at hand.