Leonardo Da Vinci - View Of A Skull c.1489 (Pen and Ink), Galleria dell’Accademia, Venezia

I spend a lot of time talking at schools about life, money, careers, and yes, health. I know it is next to useless to say to a teenager “Don’t Do Drugs!” - however, show then MRI scans of damage to the hippocampus from ecstasy use, or current statistics of early onset Alzheimer’s in chronic cannabis users, or psychiatric statistics of drug involvement in teenage schizophrenia and manic / depressive behaviour, or finally, amputees testimonies from collapsed veins cutting off circulation and how they just got started with gateway drugs, and yes, you get some interest.

So a little science regarding the incredible dangers of anorexia on the system is justified occasionally. The research lead by Dr Miriam Bredella, and presented at the Radiological Society of North America last weekend is compelling. Bone isn’t just there to hold up the muscle and stop us looking like a big pancake; it is essential for disease management, renewal of red and white blood cells, and for posture.

The damage to looks as well as the immune system is seriously dangerous, and even irreversible. Given that the largest source of fat in the human body is not our behinds but our brains. The body must have fat to survive and grow. It will take it from the last available source: the brain. Teenage brains are plastic; this means they are growing and changing, depriving the brain of its base composite has horrific effects on intelligence, IQ, careers, and emotional lives. Awful. Now we are seeing that the same is true for bone structure.

We need to find a way to get beyond media imaging into pictures of health and that starts with education. Hope it helps.

Children and teenagers with even mild cases of anorexia exhibit abnormal bone structure, according to a new study appearing in the December issue of Radiology and presented at the annual meeting of the Radiological Society of North America (RSNA).

“Adolescence is the most critical period for growth of bone mass, and the onset of anorexia interferes with that process,” said Miriam A. Bredella, M.D., musculoskeletal radiologist at Massachusetts General Hospital and assistant professor of radiology at Harvard Medical School in Boston. “Impairment of bone development may permanently alter bone structure and increase the risk of fractures and osteoporosis in adult life.”

Anorexia is an eating disorder characterized by emaciation, distorted body image and intense fear of gaining weight. People with the disorder are obsessed with weight control and often perceive themselves as overweight, even when they are dangerously thin. The disorder primarily occurs among young women and affects one in 100 adolescent girls, according to the National Women’s Health Information Center.

Among the many health problems associated with anorexia is bone loss. Typically, dual energy x-ray absorptiometry (DXA) is used to test bone mineral density in adolescents with anorexia.

Dr. Bredella and colleagues set out to determine if alterations in bone structure occur before significant decreases in bone mineral density become evident.

The researchers used high-resolution, flat-panel volume computed tomography (CT) and DXA to study 10 adolescent girls, age 13 to 18, with mild anorexia and 10 age-matched girls without the disorder. The new, high-resolution CT exam allowed the researchers to identify differences in bone structure between the patients with anorexia and the healthy controls, whereas bone mineral density measurements obtained using DXA did not.

The results showed that while there was not a significant difference in bone mineral density between the anorexic patients and the healthy control group, there were significant structural differences, indicating that changes in bone structure begin to occur in anorexic patients well before decreases in bone density.

“Our data suggest that reassuring values of bone mineral density obtained using DXA may not reflect the true status of bone structure in this undernourished population,” Dr. Bredella said. “In patients with anorexia, bone structure should be analyzed to detect abnormal bone health. Flat-panel volume CT allows the examination of bone at high resolution with relatively low radiation exposure making it a suitable technique for evaluation of bone structure in adolescent patients.”

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Article adapted by Medical News Today from original press release.
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“Distal Radius in Adolescent Girls with Anorexia Nervosa: Trabecular Structure Analysis with Very High Resolution Flat-Panel Volume CT.” Collaborating with Dr. Bredella on this paper were Madhusmita Misra, M.D., Karen K. Miller, M.D., Ijad Madisch, M.D., Ammar Sarwar, M.D., Arnold Cheung, M.D., Anne Klibanski, M.D., and Rajiv Gupta, M.D., Ph.D.

You may think that you’re a pretty positive person. But we’re betting no matter how hard you try, you wouldn’t be able to out-happy Matthieu Ricard, a French Buddhist monk who’s been nicknamed “the happiest man on earth.”

Seem like a stretch? We’re not just claiming that title based on the fact that Ricard is never seen without a smile, or that monks are generally a pretty beatific bunch – he’s got science on his side, too. In 2004, researchers at University of Wisconsin conducted a study on the brain patterns of hundreds of volunteers from different walks of life. The bell curve of the MRI measurements fell between +0.3 (a Sylvia Plath acolyte, no doubt) to -0.3 (Richard Simmons, perhaps?). But Ricard alone achieved an astonishing score of -0.45 – a level of joy so far above the others that his score was nearly off the chart.

So how did Ricard become the world’s happiest man? The 60-year-old monk didn’t always live a quiet life in the Himalayan mountains – as a young man, he was lauded as one of the world’s most promising biologists. But in 1972, he dropped out of the stressful world of French academia, trading in his laboratory for a monastery in Darjeeling, India, where he studied under Tibetan master Kangyur Rinpoche. In the years since, he has become well known as an author and photographer, and he serves as the Dalai Lama’s personal translator in France. He has devoted his life to the study of Buddhist philosophy and the art of happiness – and he firmly believes that the rest of us can achieve his incredible level of joy, too.

“The mind is malleable,” Ricard told The Independent. “Our life can be greatly transformed by even a minimal change in how we manage our thoughts and perceive and interpret the world. Happiness is a skill. It requires effort and time.”

To fill your life with joy, he said, you must recognize what already makes you happy, and work to change your mental balance. “You have to identify what it is in that situation that makes you happy. It’s as though you’re making a journey, and you look in your rucksack to find it half filled with provisions, half with stones. You need to take out the stones and put in more provisions.”

In his new book, Happiness, Ricard serves as your own personal cross-trainer in the art of happiness, with advice on meditative exercises to increase peace of mind, and his own philosophies on how to fill your life with joy. With his help, you might just be able to tune out your noisy neighbor’s Metallica cover band for a few minutes, and imagine you’re relaxing on a private beach instead. If you can’t make it out to visit a Buddhist monastery any time soon, his book might just be the relief you need.

<a href=http://www.ted.com/index.php/talks/view/id/191>Here</a> is video of Ricard speaking at the 2004 TED conference.

Day One: Introduction to the Neuroscience and Medicine of Stress

Welcome to Business Intelegant’s five day open course on stress, moods, the brain, and the neuroscience behind it all. There also plenty of sites on stress, aren’t there? But not that many that really get into the meaning of it all in well, a deeper way.

What will help us to understand the neurobiology - and what is going on? What’s happening to our physical bodies? How and why does it alter our mental state? What does it do at a, literally, fundamental level to our cognitive abilities? How do those various hormones, neurotransmitters, and proteins react, and what are they anyway? How can our understanding change?

So, let’s go instead deep into the human brain and suggesting some tools that will define stress more clearly, and show how understanding the physiology of stress makes a difference.

Before we get there we’ll need to look at an aspect of the history of medicine in the first half of the twentieth century.

Or rather one man.

Hans Selye (1907 - 1982)
Hungarian-Canadian Endocrinologist

Hans Selye was born in Hungary in 1907. He may be considered the first to understand, evaluate, and promote the meaning of stress. He even coined the term stress, much like the founder of organization development, Kurt Lewin, (see Business Intelegant’s iGuru guide) coined the word feedback in 1930s from the fact that output feedback to input allowing for self-correction in electrical circuits, from engineering. Obviously engineers use the word stress. Measured in Pascals, in continuum physics all matter is subject to forces (Gas, liquid, plasma, solid) and so stress. In tensile physics, it has come to mean how much pressure a body can withstand before it breaks. And we all get that analogy.

Claude Bernard (1813 - 1878)
The Father Of Modern Physiology

More correctly Selye borrowed from homeostasis as developed by the father of modern physiology Claude Bernard in his famous statement “La fixité du milieu intérieur est la condition d’une vie libre et indépendante.” (A stabile internal environment is the condition for a free and independent life). Homeostasis is more than just how the body controls its temperature, it is how a system, open or closed, regulates its internal environment. And your body is an open system. Food in - Non-food out for starters.

Walter Bradford Cannon (1875 - 1945)

Walter Bradford Cannon, another major influence on Selye, invented the term, homeostasis, in 1932, in his book The Wisdom of the Body. There is a wonderful page on Walter here.

Selye had begun, as early as his second year in medical school to wonder about forces on bodies, internal and external. It is important to note that he never considered stress to be en emotive word, it was simply an indicator that something was happening, good or bad. For example, simply flexing a muscle is stress, as is a feeling of anxiety. Both exert forces.

Selye experimented on mice with various toxins and noticed that even though they developed different diseases they seemed to share some fundamental symptoms, which we will come to in a moment. These are the symptoms of stress, or the General Adaptive Syndrome.

Selye went on to notice the same held good for humans: many different diseases, but the same symptoms boxes were consistently there along with those symptoms peculiar to that specific disorder. He died in 1982, having set up with Alvin Toffler (See Business Intelegant’s iGuru Guide for more details) and Richard Earle, the Canadian Institute of Stress.

For an outstanding personal reminiscence of Hans Seyle look no further than fellow Hungarian Dr Istvan Berczi’s wonderful accounts of his experiences. Just wish all webpages were so good at recording personal history.

OK. So far, so good.

So, what are the symptoms we’re talking about?

Well, Selye describes these, based on observation. He noted that before any major disease was fully apparent patients

“felt and looked ill, had a coated tongue, complained of more or less diffuse aches and pains in the joints, and of intestinal disturbances with loss of appetite.” They also generally “had fever, enlarged spleen or liver, inflamed tonsils, a skin rash.”

So, what are these symptoms caused by? That’s the right question. We have a set of observable symptoms, all common, across the sample population (Our observed patients), who then all go on to develop different conditions.

So, our first conclusion, is that it’s something that’s happening internally.

Generally, but not always, as a result of external stresses.

How do we know that?

Because some sick people with the same diseases seemed to not develop these symptoms, and the observation was that they seemed far more at ease. But we’re jumping some 10 years ahead of ourselves.

His initial observation was that their homeostasis was better. They were, literally, more in control.

Ironically, he was only a second year medical student and admitted quite cheerfully that with more education he would have had no interest in these general symptoms. His intelegant moment lay in the question: why in the history of medicine had so little thought been given to the “syndrome of just being sick”. He observed later in life that it was only observation and deduction, and could have been made anytime after the Renaissance.

Even more ironically, his ideas were poo-poo’d by the supervising staff at medical school. Until ten years later. Like any good scientist he never forgot his Prague patients.

The scene now switches to Canada, where Selye lived the rest of his life. And he got lucky. His real interest by this time lay in the endocrine system. Think glands.

The clever thing about glands is they work whether there are nerve endings between organs or not. They are molecules that signal each other. You could say that the glands are the flight towers and the molecules the planes and they’re going from a specific airport to airport. They’re carried in the blood.

They include steroids, (Androgens, estrogens, glucocorticoids, mineralocorticoids, progestagens), peptides and proteins (Lots of amino acid residues including, for example, insulin from the pancreas, follicle-stimulation, and any hormone from the pituitary gland - more on that later), and the rather significant amines (Such as noreprephine, epriphene, dopamine, and throxine) which are floating around the brain and perform the marvelous trick of being neurotransmitters too. (They make the neurons fire across the synaptic gap and so create the electricity that makes our brains, well, conscious. Smart, huh!)

So Selye looked at these symptoms and the endocrine system. And had his Eureka! moment. Being a good scientist he did test it for on while on small, furry creatures, and his initial hunch was confirmed. Yes, hormone release, when thrown into overload causes the unhealthy symptoms of stress.

He had also observed that some general medical care seemed to help everyone: easily digestible foods, keeping the room at a comfortable temperature, relaxation etc;

The genius was to put it all together.

He recognised that stress symptoms were caused by the hormonal overload which was augmented by a non-caring environment.

That on it’s own was significant.

But luck and hard work really do make for good inductive reasoning. Selye was trying to hard isolate hormones in from the placenta at the time. Here, I’ll let Istvan Berczi tell the tale:

“For a while it was thought that the adrenal enlargement and involution of lymphoid organs was specific for a particular hormone, but attempts to purify it always failed as the activity was lost. At some point it occurred to Selye that this, in fact, could be a nonspecific response to noxious agents, and, indeed, when he performed the control experiments, that was the case. He published a short note about his findings in Nature in 1936. During the same year a longer article was published by him in The British Journal of Experimental Pathology, where he demonstrated that the involution of the thymus was in fact mediated by the adrenal gland as it was absent in adrenalectomized animals if stressed. His experiments in chickens revealed that the Bursa of Fabricius is also extremely sensitive to steroid hormones.”

In other words, he had found out that it was not one hormone, or even one gland, and that was what had been confusing everyone, but rather the work of a combination of glands. More work followed between 1936 and 1946, he published an overview as a paper The general adaptation syndrome and the diseases of adaptation in the Journal of Clinical Endocrinology, which identified the ternary causes of the hypothalamus-pituitary-adrenal glands all working together. A triple whammy as it were.

So here goes:

You get stressed because:

The hypothalamus (It is the base of your brain and acts as the link between the brain and the endocrine system)

talks to

The pituitary gland, which releases ACTH (Adrenocorticotrophic Hormone) into the bloodstream and is pea-sized and sits at the base of the brain and is responsible for control of homeostasis - ah!)

Which activates the adrenal glands, just above the kidneys, to release the villain of the piece, corticoids.

So that’s: Hypothalamus -> Pituitary -> ACTH -> Adrenal -> Corticosteroids

Hans Selye in 1974

So goodbye and thank you, Selye.

And hello, corticosteroids….. more on them tomorrow.

Day Two: Deeper Down The Rabbit-Hole: The Physiological Effects Of Stress

I went in for a day at a school in a pretty tough area and as always got feedback. One week later I got this email from a 17 year old:

I just been waiting for this opportunity to thank you for the lesson you gave us for about a week ago. It was amazing. Every word you say makes me more inspired, and my self-confidence isn’t so good, not at all actually, but when you speak and tell us all these things, it all feels so much better.

I guess I just want to thank you, because you give me such an inspiration and you make me feel that studying is really fun, it’s fun to learn. I really do hope that you come back soon I really do.

And that’s why I do what I do: if it makes a difference, and can help one teenager see life as possible instead of impossible, as hopeful instead of hopelesss, as having a future that might actually lead somewhere. It’s always fun to work with those who already understand how life works and just need better tools, but to make a real difference you need to work with those who see it as gray, boring, and crushing…

I look forward to return visit in February very much…

It’s always good to see the future of work - and going to schools and doing the Way of Intelegance for schools is always rewarding.

I had a fantastic day at Bladins.

Bladins is one of the best International Baccalaureate schools in the Nordic region. The pupils are bright and have every chance of success. We had a great time together - and they were kind enough to give me a huge cheer and a standing ovation at the end - some of them even came up at the end to say how they enjoyed it - never easy for teenagers! I look forward to more visits - thanks to all involved!

I had a great day at Copenhagen International School, and look forward to another in February. Thanks to all involved.

Ben Ward, who instigated the process during our meeting at the excellent ECCN networking club in central Copenhagen, also co-ordinates and raises funds for Team Peru who work with Kiya Survivors, a charity for special needs, abused, and abandoned children in Peru.

Here is a wonderful video of the pupils’ trip in 2006

and a great fun video that sums up nicely their great attitude:

Thanks to all involved and I look forward to the return visit next month.

An unknown artist, called Invader, has a webpage at http://www.space-invaders.com/artworks.html, and proves that a Rubik Cube is art as well as the best puzzle ever.

Amazing….