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Vol 277 No 7416 p294
2 September 2006

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Onlooker

A healthy diet beats dietary supplements more
Life of the hunter-gatherer: nasty and brutish but not necessarily short more
Should children participate in clinical trials? more
Essential human freedoms / What is this culture? more


A healthy diet beats dietary supplements

An article on the myths attached for decades to some of the antioxidant supplements consumed in efforts to maintain good health appears in the 5 August issue of New Scientist. It is estimated that half the adults in the US take antioxidant tablets daily to stave off disease. Nevertheless, writes Lisa Melton in the article, recent evidence suggests that such efforts are of doubtful value.

Back in the 1950s it was discovered that heart disease, strokes, cancer, diabetes, cataracts, arthritis and neurodegenerative diseases were linked to free radicals acting on proteins, carbohydrates, lipids and DNA. But breathing inevitably exposes us to free radicals.

In the 1980s it was understood for many years that people taking a diet rich in fruits and vegetables showed a lower incidence of heart disease, diabetes, dementia, stroke and certain cancers than others and this suggested that the antioxidants present in green plants neutralised free radicals by donating electrons. Such a discovery promoted a massive industry concerned with producing antioxidants for dietary supplements.

The best known antioxidants were tocopherol, ascorbic acid, flavonoids and carotenoids. Although these counteracted free radicals in the test tube, they were less effective once they had entered body tissues.

Treatment with beta-carotene was recommended to protect smokers against lung cancers, but it was found to have the opposite effect.

Tocopherol became popular in the early 1990s for reducing heart disease, but was later discredited. It failed to halt the progression to Alzheimer’s disease in people with mild cognitive impairment.

Ascorbic acid apparently only prevented free radical damage in individuals with an existing vitamin C deficiency.

Polyphenols are powerful antioxidants, but their absorption into the blood and metabolic rate remains obscure.

The conclusion is being reached that a diet rich in fruit and vegetables has health benefits, but cannot necessarily be paralleled by taking vitamins and other dietary supplements. The fact that heart attacks, vascular disease, diabetes and cancer are reduced by a healthier lifestyle with more exercise may account for the phenomenon of the apparent beneficial effects of nutritional supplements./p

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Life of the hunter-gatherer: nasty and brutish but not necessarily short

Life of the hunter-gathererAt the annual meeting of the Human Behaviour and Evolution Society, held in Philadelphia early in June, it was suggested that, although life may have been nasty and brutish for our prehistoric ancestors, it may often have been longer than we have hitherto supposed. There used to be a belief that it was rare for someone in prehistoric society to reach the age of 40 but today it is thought from a study of modern hunter-gatherer groups that a substantial proportion of our remote ancestors survived into their 70s.

An anthropologist studying indigenous people in Bolivia collected mortality data from 10 modern groups of hunter-gatherers and forager horticulturalists and found that although 40-50 per cent fail to survive to age 15 the remainder thereafter have a 40 per cent chance of living to 60. By the time they reach 70 the mortality rate is no higher than for a resident of the US today.

Men in the groups reach the height of their physical powers in their 20s and become more efficient hunters until their 40s. By the time they are 50 they turn from hunting to agriculture.

The research indicates that once past the peak of mortality in infancy and early childhood, individuals are more likely to survive into the 65-75 age range than was previously thought.

The leading causes of death among middle-aged and older individuals seem to be infections and violence. However, these tribes seem to suffer the same scourges of ageing as their modern counterparts. By the age of 65 they suffer pain from orthopaedic problems, especially back pain.

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Should children participate in clinical trials?

An editorial published in the 17 June issue of The Lancet commends the recent draft amendments to EU legislation on medicines for children legislation that paves the way for more trials for paediatric prescribing.

Such a move is said to be overdue. The UN Convention on the Rights of the Child declared in 1990 that “children have the right to good quality health care — the best health care possible.” However, health decisions for children have often depended on extrapolations from adult studies. Lack of proper evidence means that potentially useful adult remedies have been untried while commonly used paediatric treatments have proved ineffective. One example of confusion has been over the treatment of depression, where there have been contradictory statements.

Defining a safe and effective paediatric pharmacopoeia requires goodwill and participation from children, parents or guardians and others concerned with health and welfare. Research has sometimes had a tarnished image. Good uncertainty-based investigations will benefit all concerned. Such research must offer worthwhile benefits while imposing no undue discomfort or risk to the children.

Public confidence in the scheme would be compromised if the research came to be seen as opportunities for marketing rather than genuine research. The foremost reason for undertaking trials in children must be for the clear benefit of current and future generations.

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And I quote …

Essential human freedoms
“We look forward to a world founded upon four essential human freedoms. The first is freedom of speech and expression everywhere in the world. The second is freedom of every person to worship God in his own way — everywhere in the world. The third is freedom from want. The fourth is freedom from fear.”
— Franklin D. Roosevelt, US president (1941).

What is this culture?
“Culture, the acquainting ourselves with the best that has been known and said in the world, and thus with the history of the human spirit”
— Matthew Arnold: Literature and dogma (1873).

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