Another benefit about red meat

Red meat, most typically beef, but also including some others such as pork in spite of its white color after cooking, has had a bad reputation in recent years. International Agency for Research on Cancer (IARC) of the World Health Organisation (WHO) classifies red meat as probably carcinogenic to humans, but scientists caution against misreading of the news. Consumers should not rush to conclude that eating even a moderate amount of red meat is bad. In fact, unlike certain things some of us may intentionally or unintentionally consume, e.g. tabacco, or mercury, which have no safe low limit, red meat with a moderate intake is good to us because it is very rich in nutrition, especially protein.

Now, a new research, published in Nature has just found that red meat, as well as dairy products, can boost cancer therapies. More amazingly, the research even found benefit in trans-fat, which we have for quite some time regarded as a heinous villain against our health. On the other hand, reading this research, we must keep in mind that red meat is said to boost certain cancer treatments and the specific type of trans-fat is involved, but this definitely does not suggest we should eat a significant amount of red meat or even a small amount of trans-fat, because (1) this research is still new, and (2) the cancer treatments in this research are specific, at least for now. Nevertheless, this research is something we may keep an eye on because it sheds new light on our conventional wisdom.

East Asians more likely to carry a gene variant associated with long COVID but ...

According to a preprint research article Genome-wide Association Study of Long COVID, "[t]he allele frequency of rs9367106-C at the FOXP4 locus varied greatly among the different study populations, with frequencies ranging from 1.6% in studies with non-Finnish Europeans to higher frequencies such as 7.1% in Finnish, 19% in admixed Americans, and 36% in East Asians". In other words, non-Finnish Europeans have a 1.6% chance to have this gene variant associated with an increased risk of Long COVID and East Asians have a 36% chance. This is clear enough. But some people misread these simple numbers. One journalist's article LONG COVID GENE FOUND says that "[t]he Long Covid FOXP4 mutations are 7x more common in Finnish people than in non-Finnish Europeans, and 36x more common in East Asians". The author must be interpreting the ratios in the research paper as a number (numerator) over some unit denominator. But if we do care about an inter-race comparison, we ought to say that the mutations are 7.1/1.6=4.44 times more common among the Finnish people than non-Finnish Europeans, not 7 times more. Likewise, East Asians are 36/1.6=22.5 times, not 36 times, more likely than the non-Finnish Europeans to have this mutation.

When that journalist's English article was translated into Chinese and posted to Weibo, the Chinese Twitter-like social media network, an even worse headline was added, "东亚人患新冠长期后遗症的概率是欧洲人的36倍" (East Asians are 36 times more likely than Europeans to suffer from Long COVID), naively equating the ratio of carrying a gene variant to the ratio of getting the disease, a mistake I pointed out in my Weibo posting (along with the Chinese translation). If the doctor of Angelina Jolie, the actress who opted for mastectomy to forestall a possible breast cancer, had told her she would definitely get breast cancer because she carries that gene, he could be instantly famous among the cancer researchers world wide, as a laughing stock.

So, what is the chance of getting long COVID for each race? According to a February 14, 2023 article summarizing data from the US census, Asian Americans are the least likely to get long COVID among the five race categories. However, Asian Americans with long COVID have the highest chance to experience severe symptoms. To put simply, Asian Americans don't easily get long COVID, but if they do get it, their symptoms are very serious, relative to any other race. It would be interesting to reconcile this data with the latest research about the gene variant. It's possible that Asian Americans, the relatively well-educated and well-off group of Americans, follow common hygiene practices better than other Americans, hence lower rate of COVID and therefore long COVID. But due to the FOXP4 gene variant which many East Asians carry, long COVID causes the most severe symptoms to East Asians. There are still missing links in this logic, though. For example, Asian Americans are not necessarily East Asian Americans.

Sleeping pills and Alzheimer

Two seemingly conflicting reports about sleeping pills and Alzheimer:

1. Sleeping Pills May Increase Dementia Risk: Study https://www.webmd.com/sleep-disorders/news/20230303/cm/sleeping-pills-may-increase-dementia-risk-study

2. Alzheimer’s Disease Protein Levels Reduced by Sleeping Pill https://www.insideprecisionmedicine.com/topics/patient-care/neurological-disorders/alzheimers-disease-protein-levels-reduced-by-sleeping-pill/

How do we reconcile these two reports? The key here is to make a distinction among these drugs. The good one, in the second article, is suvorexant, which according to a Google search, is sold under the brand name Belsomra. The bad ones, in the first article, are flurazepam (brand name Dalmane), triazolam (Halcion), temazepam (Restoril), trazodone (Desyrel and Oleptro), and zolpidem (Ambien). So if we ever need a sleeping pill, choose Belsomra and avoid the ones in the latter list, in which the first three here are benzodiazepine (benzo for short). There are more research articles confirming the association of benzodiazepine with dementia than otherwise. To be safe, avoid it.

But why bother with sleeping pills? If you do need one, why not take melatonin, which is naturally secreted in your body and has no truly harmful effect?

Higher Cancer Rates in Men and Alzheimer Rates in Women Due to Genes

It's interesting to read the following two articles together:

Higher Cancer Rates in Men Likely Due to Biological Differences
X Chromosome-Linked Enzyme May Explain Women’s Higher Alzheimer’s Incidence

While men and women have different health-related characteristics, they don't account for the large differences in cancer and Alzheimer incidence rates. This implies that regardless future progress in medical sciences (barring significant gene editing), there will always be more women than men in a high-age group, and at the same time, more of these women suffering from Alzheimer than men unless this disease is completely eliminated.

Acupuncture, TCM, or alternative medicine in general will be fully deciphered

M.D. Anderson (MDA) Cancer Center, the best cancer hospital in the US, posted a message to Facebook, "Pressing pressure points and energy channels that we can’t see may help with headaches, nausea and anxiety." Most readers cheer for or agree with the message. But one reader, a former MDA employee and also cancer survivor, criticized MDA for bringing alternative medicine into its toolbox when even the terminology used by alternative medicine is unscientific, thus tarnishing the image of MDA as a prestigious hospital. He says "What energy channels? What basis is there for the existence of these channels? I note that “Qi” is always placed in quotes. Why? If it’s something that can truly be manipulated, it ought to have an actual name and evidence of its existence. If not, then MD Anderson ought not be promoting something that has no basis in fact."

As usual, this type of questioning leads to a hot debate, and the original poster (MDA) decides to filter out all messages except this reader's initial message and MDA's direct response. My long response to the reader's message is among those filtered out as well. But I'd like to present it below.

The terms "qi", "energy channels" etc. indeed sound pre-scientific. But lack of understanding of the real mechanisms and temporarily using these terms should not blind us from tried-and-proved efficacy of acupuncture to improve certain symptoms, most notably pain. Your attitude is very understandable, and I'd like to compare that to Einstein's toward the probabilistic nature of small particles such as electrons; his "God does not throw dice" implies that he believes the true, non-probabilistic, definite time and place of any particle will eventually be revealed and the quantum phenomena are just one stage in the history of science. Well, we don't know if he'll eventually be proven right on that but we're quite sure many pre-scientific-sounding terms and the theories associated with them in alternative medicine are being rendered unnecessary. Just like we no longer say four humors of a human body, we're gradually substituting pharmacological findings for TCM's classification of herbs into hot-cold-mild-sweet-... The latter can still be retained for pedagogically convenient tools or mnemonics. As to acupuncture, for some reason, the study of the mechanism is far slower than pharmacology. (I recall reading an article about a Chinese Academy of Science biophysicist's research in 1980's.) But just because we don't know the true nature of it doesn't mean we should stop using it if it doesn't cause serious side effects and it works most of the time. (For instance, one pressure point, called 风池--I have to look up the English name--has remarkable reproducibility in temporarily relieving headache.)

The gold standard of double or single blind trials has its limitations, particularly when it comes to pain management (and I think one more field, psychiatry). It's almost impossible for the trial participant to not know if he's in control or intervention group. Instead of blindly blaming reported effects of acupuncture as placebo effect, other strategies such as N-of-1 trials may be adopted. For all its shortcomings, N-of-1 bypasses the said problem of blind trials and most importantly, tests a specific individual's response. When it comes to pain relief, psychiatric treatment, and probably more, it's a norm not exception for one intervention to be valid for John but not for Jack. Acupuncture falls into this category.

(By the way, I'm sorry to hear that you had cancer but I'm glad it was cured or is in remission. I think it's you that I worked with 16+ years ago on the leukemia project. Back then MDA probably did not have integrative medicine. But I think it's a welcome addition, because it helps relieve certain symptoms.)