MedicalResearch.com Interview with:
Dr. Karen Hardy
ICREA, Catalan Institution for Research and Advanced Studies
Departament de Prehistòria
Facultat de Filosofia i Lletres
Universitat Autònoma de Barcelona
Barcelona, Spain
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Hardy: There continues to be little clear agreement on what quantitatively constitutes a healthy diet. The global increase in the incidence of obesity and diet-related metabolic diseases have intensified interest in ancestral or “Palaeolithic” diets as it is clear that to a first order of approximation our physiology should be optimized to the diet that we have experienced during our evolutionary past. However, reconstructing ancestral diets is very challenging, and exactly what was eaten during the Palaeolithic remains largely unknown.
Until now, there has been a heavy focus on the role of animal fats and protein in the development of the human brain and there is little doubt that increases in meat consumption from around 3.4 million years ago, was a major driver. However, the role of carbohydrates, particularly in the form of starch-rich plant foods, has largely been overlooked. But the human brain today uses up to 25 % of the body’s energy budget and up to 60 % of blood glucose as a general rule, while pregnancy and lactation in particular, place additional demands on the body’s glucose budget. In this study we integrated multiple lines of evidence from human genetics, archaeology, anthropology, physiology, and nutrition, to hypothesise that cooked carbohydrates played an important part in the evolution of the body, and particularly the brain, over the last 800,000 years.
Our results suggest that while meat was important, brain growth is less likely to have happened without the energy obtained from carbohydrates. While cooking has also been proposed as contributing to early brain development, it has a particularly profound effect on the digestibility of starch. Furthermore, humans are unusual among primates in that they have many copies of the salivary amylase gene (average of around six salivary amylase genes, other primates have only two) leading to more efficient starch digestion. This suggests that cooking starch-rich plants and having more amylase coevolved. We don’t know exactly when the number of amylase gene copies multiplied, but genetic data suggest it was in the last million years; a timeframe that brackets archaeological evidence for cooking and when our brain size increase accelerated (around 800,000 years ago). Salivary amylases are largely ineffective on raw crystalline starch, but cooking substantially increases both their energy-yielding potential and glycemia.
MedicalResearch.com Interview with:
Lainie Rutkow, JD, PhD, MPH
Associate Professor
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
Medical Research: What is the background for this study? What are the main findings?
Dr. Rutkow: Rates of prescription drug diversion and misuse, as well as overdose deaths, have increased throughout the United States. CDC estimates that each day, 44 people die from a prescription drug overdose. In the mid-2000s, Florida was viewed as the epicenter of this epidemic, with prescription drug overdose deaths increasing more than 80% from 2003 to 2009. In response, Florida enacted several laws to mitigate prescription drug abuse and diversion. Its pill mill law required pain management clinics to register with the state and prohibited physician dispensing of certain drugs. Florida’s Prescription Drug Monitoring Program (PDMP) collects data about dispensing of prescription drugs and can be accessed by physicians and pharmacists. Little is known about how these laws have affected prescribing of opioids.
We applied comparative interrupted time series analyses to pharmacy claims data to examine four outcomes related to opioid prescribing in Florida, with Georgia as a comparison state. We found that in the first year of implementation, Florida’s Prescription Drug Monitoring Program and pill mill law were associated with modest reductions in prescription opioid volume, prescriptions written, and the dose per prescription. These declines were statistically significant among the highest volume prescribers and patients at baseline.
