7 Paths to Mental Illness

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Stimulant drugs like opioids, cocaine, meth and alcohol are devastatingly effective pathways to addiction, but there are much more subtle everyday routes to the same destination, and they all start with overstimulation of dopamine.

Dopamine is a neurochemical that motivates us to take action and focuses our attention.  It makes us run towards pleasure and away from danger.  If, however we overstimulate dopamine our brain becomes semi-permanently rewired into a significantly more fragile state. In that state we overestimate both the probability of receiving rewards and the danger posed by threats.

The rewiring for extreme alertness helps us cope with the high dopamine environment, but it is only meant to be a temporary fix. When we hold ourselves in that overstimulated state for too long we will initially become clinically anxious and then, eventually, depressed.

We can do that by using chemicals that we know stimulate dopamine but many more of us are achieving the same result without consuming any of these.

Social media and dating apps stimulate oxytocin, our socialisation hormone which in turn gives us a hit of dopamine.  Porn follows a similar path with the assistance of testosterone. Gambling and danger simulating games like Fortnite get to the same destination by stimulating cortisol, the same hormone released when we are in real-life danger.  Chronic uncertainty caused by housing insecurity, job insecurity or, say, COVID has the same effect.  As does exposure to trauma, pain or violence.

All these starting points promote overstimulation of dopamine. Because both stress and addiction produce the same state, stress makes us easier to addict and addiction makes us more susceptible to stress. Our brain adapts by decreasing our sensitivity to dopamine by dialling up an epigenetic control called DelatFosB.  Unfortunately, that leaves our brain in a fragile state which makes us overestimate rewards (craving more dopamine) and risks (high anxiety about everything).  Even worse, any dopamine stimulating behaviour will temporarily provide relief but ultimately make the problem worse.  This is why addiction is so hard to break and anxiety is so hard to cure.

In between dopamine hits, the edgy state of our brain biochemistry leads us into low dopamine states we recognise as depression (a lack of motivation) and ADHD (a lack of focus).

It doesn’t matter (to our biochemistry) if the next dopamine hit comes from looking at Facebook, or playing Fortnite, or smoking a ciggy, or inhaling cocaine, or hitting the booze, or being evicted, or stress about COVID, or being a victim of violence, and of course any combination of these.

The affect is the same, the effects are cumulative and left unchecked, over time, will continue to drive the growing epidemic of anxiety, depression, and mental illness.

Excerpt from Brain Reset

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Introduction

If I were to call you an addict, I doubt you’d take it as a compliment. Addicts are nasty people. They steal, they cheat and lay unconscious in the gutter, oblivious to the world around them. Am I right? Yet, in the sense I will use that word in this book, you probably are an addict.

You probably wouldn’t be too keen on me describing you as having a mental illness either. But according to the latest statistics, if you are standing in a room with four other Australians, one of you currently has a mental illness such as anxiety or depression, and two and half of you will, at some point in your life. It is even worse for younger people. More than one in four people aged 16–24 currently suffer a mental disorder. Between 2005 and 2019, depression in the US in people under 25, the age group most easily addicted, increased by 73 per cent. One in eight US teens is depressed and twice that many suffer from anxiety. The Australian statistics are similar. Those numbers tell us that every family is in some way dealing with mental illness.

This is a book about how addiction, anxiety and depression are all part of the same spectrum. It is a book about mental health but it is not an attempt to explore the vast universe of mental illness; just a very important part of the equation. It is a detailed look at the way seesawing dopamine, caused by stress, uncertainty and addictive behaviours (smoking, drinking, gambling, screen use, eating sugar and many more) create imbalances in our brains. This in turn causes anxiety and depression. This matters a lot because it is rapidly creating an epidemic of mental illness the likes of which we have never before experienced. If we do not stop it, it will have disastrous consequences for each of us and our communities.

This is not to say that addiction or stress causes all mental illness. Like all human disease states, there is an underlying level. The power of sexual reproduction continuously recombining our DNA is that every one of us has a different propensity to any given disease to the person next to us. Some people can drink 50 cans of Coke a day and live to 127. Some people put on 400 kg merely by reading the word ‘Coke’ in the preceding sentence. We are all different. What we can say with confidence is certain factors take disease states from background noise into population-wide epidemics. That’s what sugar consumption did for type 2 diabetes when it went from a non-disease in the 70s to affecting one in ten of us now. And it is what addiction and stress is doing to our mental health.

I am not a doctor. I am a researcher. I write about evidence with the singular motivation of providing you (and me) with information that helps us make better choices about our health. I firmly believe that knowledge gives us the power to change our lives for the better. There are many very large, very rich companies making very good money out of keeping that knowledge from us and keeping us addicted.

Because I have no relevant qualifications, I really have to know my stuff. I am very aware that my lack of formal training in the area means anything I say is open to criticism. This is how it should be, but this important reality forces my research to be more thorough, my references more current and my conclusions more defensible. My outsider’s view allows me to connect silos of knowledge where the evidence says it is necessary. The only relevant skill I bring to the table is knowing nothing about the area. This means I can’t accept a fact until I see the evidence. I can’t operate on the basis of ‘this is what my lecturer told me’ or ‘this is what everyone knows to be true’. Everything you are about to read is referenced. You can read all of it in the original journals. It is all there for everyone to see, but nobody is laying it out for us ordinary people in a way that makes any sense.

I have researched sugar, education, seed oils, psychopathy and teenage addiction and, as disparate as they are, a common theme has consistently emerged. There is always someone who will try to profit from human vulnerability. It could be the private school network pressing parents’ status anxiety button. It could be the processed food industry adding sugar to everything to increase sales. Or it could be Facebook harvesting our need to be liked.

When it comes to your brain there are loads of people fighting for your neural real estate. There is a reason the processed food, alcohol, gambling, social media, tobacco and pharmaceutical industries account for the lion’s share of our business landscape – and they are just the legal addictions. And they don’t stop at addicting individuals either. They make sure our leaders are addicted to their money. Our governments believe they would struggle without the rivers of gold generated from taxing our addictions. For all the nice feel-good campaigns about mental health and addiction, there is a very strong financial undertow pulling all of us in the other direction.

Addiction is not just messy drunks, coke-heads or junkies. The biochemical reality is we can become addicted to many things that are much more subtle and that are so socially acceptable, we’d happily give them to a toddler. In 2009, an advertising campaign kicked off on the side of London buses that said, ‘Nice People Take Drugs’ in large bright red letters. The campaign was paid for by a charity campaigning for the decriminalisation of drugs. It was immediately banned and removed. The UK was not ready to hear that nice people are addicts too, and things have not changed much since then. Denial is one of the first signs of addiction. It is a reflexive defensive mechanism aimed at keeping the addiction alive and hidden from view. That’s worth remembering as we look at the nature of everyday addiction.

Addiction is a loss of self-control when presented with potential rewards. Our brains operate a biochemical reward system to make us get off our bottoms and do stuff that keeps us alive long enough to produce the next generation. Without it, we wouldn’t get out of bed, we wouldn’t eat even if food was put in front of us, we wouldn’t go to the trouble of meeting other people and we certainly wouldn’t bother with getting to know them well enough to have children with them. This same system keeps us safe from danger by providing us with the motivation to run away or stand and fight.

That reward system, however, can be broken. We can like things too much for our own good. This can happen if we do rewarding things at very high frequency, or use substances to mess with the biochemistry of dopamine, a key neurotransmitter responsible for messaging in our reward system. For most of the history of addiction, substances have been the only path to addiction. We discovered pretty early on that the alcohol produced by overripe fruit made us feel good. As the centuries passed, we added to the collection of stuff we knew would give us a buzz – tobacco leaves, tea leaves, coffee beans, kola nuts, opium poppies, coca plants and, of course, sugar.

I was addicted to sugar. I didn’t know I was addicted to sugar until I wasn’t. Had you asked me at the time, I would have denied it till the cows came home – and then bought a Coke instead of water because it was more ‘fun’. When I compare the way I felt about food before to the way I feel about it now, I definitely was. Sugar pushes exactly the same biochemical buttons in our reward system as cocaine, alcohol, nicotine and many others. Just because the cravings are less intense and it has stayed under the regulatory radar doesn’t mean the biochemistry is any different or it is not addictive.

When we consume one of these substances, we ratchet up our need for reward. The brain is not evolved to deal with this. It foolishly assumes our environment is largely free from anything that can mess with its biochemistry because until very recently in evolutionary terms, that was true. To make things even more dire, in the last decade, we have invented and deployed powerfully addictive software to every person on the planet. While this software doesn’t administer a substance that breaks our reward system, it manipulates our brains into doing it.

In just a decade, software that simulates the most common real-life rewards, like sex, gambling or the oxytocin-enhancing feeling of being liked, has become ubiquitous. Now addiction is not just for the adventurous few, it can be enjoyed in the bedroom, bathroom, on the bus, at work and school and during parliamentary question time. No one can have sex 100 times a day or meet real people 1000 times a day or place 500 bets a day, but with the high-speed simulations now available on every portable device, our pocket has become a seething cesspit of potential addiction. This is why the generation who have never known life without these devices will not know life without addiction.

In a similar way, our bodies and minds never evolved to be under extreme stress for long periods of time. We are fine with stress while we are running away from a woolly mammoth. We are not designed for the kind of persistent low-level stress created by constantly having $100 in our account when the rent is $500. Unfortunately, our brains save resources by using the reward system to handle chronic stress. This means that stress increases addiction and addiction increases stress and both flow through to anxiety and depression.

Addiction and stress are not the only ways to create anxiety and depression but they are now the dominant pathways for most of us. The good news is that knowing the enemy is the key to stopping it. Once we know exactly how our operating system works and how it can be manipulated, we can use that knowledge to give ourselves the edge.

Part of the reason I didn’t think I was addicted to sugar was that I didn’t think I was eating that much of it. Then I started reading food labels. I found out that just by eating a bowl of Sultana Bran and a glass of orange juice, I had consumed 20 teaspoons of sugar before I pushed back from the breakfast table. That was just the start. BBQ sauce can be half sugar, some yoghurt has more sugar than ice-cream and there is often more sugar in low-fat mayonnaise than Coke. Knowing how much I was eating, and reading the science of exactly how it addicted me to make sure I kept eating, was the key to me stopping. I am hoping this book can do the same for all of us, with the addictions we may not be aware we have.

Addiction is loss of control. It is not being able to say ‘no’ when offered just one chocolate. It is settling down to a quick look at your socials and then wondering what happened to the last three hours. It is having just one more game, then realising the night has disappeared. It’s putting on one more multi-bet because you are sure your luck has changed. We may not feel like rats in a cage being manipulated to press the lever for reward, but that is the subtle art of addiction. If you want to see if you really are exercising free will, just try to stop.

Anxiety and depression are a direct result of dopamine signalling. Too many dopamine hits too often will lead to mental illness as certainly as night follows day. We can get those dopamine hits by becoming addicted to substances or behaviours that deliver them or by living in a state of stress. Both of these processes are significantly accelerated by uncertainty. Uncertainty takes an interesting and rewarding experience and at least doubles the perceived excitement and the size of the consequent dopamine spike. Equally, when bad things may or may not happen, the uncertainty at leastdoubles the dopamine hit, to make sure we are on full alert. It is like a free supersized dopamine hit for no extra effort.

Either way, the reward system turns uncertainty-boosted dopamine hits into a semi-permanent change to the brain biochemistry that helps us cope with our high-dopamine environment. Unfortunately, that coping mechanism comes at a cost – our mental health. Dopamine-adapted brains are anxious and depressed and work much less well than brains that are not in this state. They are irritable, have no impulse control, have weak memory, make poor decisions and are able to contribute much less to our overall welfare. If we allow that mental state to go on indefinitely, we place ourselves and others at mortal risk, either from the addictions or from self-harm, domestic violence or suicide.

The key to undoing the damage done by addiction or stress or, usually, both is to reset the biochemical switch, ΔFosB (DeltaFosB). This controls how we react to a surge in dopamine generated by reward or danger and amplified by uncertainty. It would be really nice if we could just access the neurochemical program that runs our brains and flick the switch to reset DeltaFosB to normal. While that is possible, it is nowhere near that easy or quick. Unfortunately, there is no such thing as a free lunch in biochemistry. Resetting the switch flicked by years of addiction or stress takes a bit of effort. To do that, we need to delete addictive behaviours and substances, replace them with rewarding real-life experiences that are not addictive. We also need to remove as much stress and uncertainty from our lives as possible.

Once we know how our reward system works and how it is manipulated, we can regain control. We can push the profiteers out of the driver’s seat and own our destiny once more.

This is not a book about stopping pleasure. You will not be told all fun must end. Our reward system works perfectly well when it isn’t being messed with. We can enjoy life and do things that provide us with shots of dopamine without the risk of addiction, anxiety or depression. The catch is we need to do a system reset before we get to that point. This is a book about how to do that. I will guide you through what the science says about how to reduce and remove the substances and behaviours that drive addiction and how to increase the behaviours that recalibrate our reward system. The pay-off will inevitably be reductions in levels of anxiety and depression or avoiding them altogether.

You don’t need to be diagnosed with anxiety or depression to find value in these pages. A common pathway to diagnosable mental illness starts with insomnia, feeling low, feeling trapped, feeling like we are not living the life we want to lead (and can’t work out why) or worrying about things that never used to bother us. For many of us, our reward system has been broken for so long that we have no idea what life can look like on the other side. I didn’t know I was apathetic, moody and low on energy until I wasn’t on sugar. Life without addiction can take us to a new level. Suddenly, we can concentrate better, think through complex situations, set and reach goals and get more enjoyment out of life in general. Our moods will be less volatile, we’ll be more motivated, sleep better, lose weight and have better health overall.

There are also dramatic benefits for the higher functioning addict, one who feasts on a smorgasbord of smaller addictions but isn’t incapacitated by any single one. They will experience high of contentment, less reactivity, better focus on work and more connection with family and friends.

And it is not just you who will benefit. As a society, we are neck-deep in addiction for profit. Governments are as addicted to revenue from the addiction industries as we are to straight bourbon and unfiltered Camel cigarettes. If governments divest themselves and genuinely try to help, we will all benefit from living in a society where there is less violence, less addiction-driven death and less preventable disease. Our businesses will be more productive because of the massive reduction in mental health costs and our families will more robustly handle any stressors they encounter. The local leagues club will be a lot smaller but, then again, it won’t need to house so many pokies. And there won’t be as much money for pork-barrelling the local pollie into power, but there will be a lot more money for community services left over from our taxes because society will be relieved of the costs of addiction.

This is a book about mental health. It is about what we can do to decrease our levels of anxiety and depression and the many disease states that can cascade from them. It is a book about real science and practical outcomes. It is not a book about being nice to yourself or talking yourself out of depression or herbal gerbil knit your own pseudo-scientific counselling techniques. It is a book about neuroscience and hard, knowable, measurable outcomes.

What we know about how our brains work has advanced significantly in the last decade but so far very little of that knowledge has made it past the cover of a medical journal. Our society is struggling to contain a tidal wave of mental illness and addiction that disables families and dismantles communities. Worse, turning our teens and young adults into addicts robs them and our society of a future. Once the young have no vision beyond the next dopamine hit, human civilisation is in real peril. This is not hyperbole. There needs to be an honest desire to fix this. There needs to be an uncomfortable accounting for the true costs of generations burned at the altar of addiction for profit.

This is a book about what the evidence really says so that you can apply it, if you wish, in your own life. This book will not eradicate all mental illness alone, but if we listen to the science, we can remove the static and clear the white noise driven by corporate profiteering so resources can be freed to help those whose illness would exist even in a world free of addiction.

This book takes a good hard look at the science behind resetting our reward and punishment pathway and what that science implies about how we should behave. But it isn’t all science. At the end, you will find an actionable plan to help you to reduce your addictive behaviour and set you on a path towards understanding your mental health.

The solution is in your hands.

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The ACL epidemic is caused by sugar-water

By | Sugar | No Comments

Last week Gold Coast Suns co-captain Jarrod Witts collapsed with a season ending ACL injury. This week Carlton defender Caleb Marchbank suffered the same fate.  They are just the latest high-profile examples of the rapidly growing list of ligament injuries in the AFL and AFLW. Ironically, the science tells us the damage is being done by one of their sponsors’ products.

ACL injuries are not a problem exclusive to the AFL but they do keep very good stats on them. The average male professional AFL player will suffer an ACL injury after playing 1,428 hours of footy.  The average AFLW player will do her knee after just 133 hours. In general, women are up to 10 times more likely to injure an ACL than men because the wider female pelvis makes a knee collapse, or movement towards the other knee, more likely. ACLs in sports are not generally caused by contact with another player but by landing.

The dreaded ACL injury is a tear in the anterior cruciate ligament, one of the four ligaments that hold our knee together.  The ACL is inside the knee joint connecting the bottom of the thigh bone (the femur) to the top of the lower leg bone (the tibia).  It is attached to the tibia by a little spit of bone called the tibial spine.

ACL rates have been accelerating massively over the last few decades.  Between 2000 and 2015, the annual incidence of ACL’s requiring surgery increased by 43 per cent. In people under 25 they increased by 74 per cent.  The fastest growing group are children aged 5-14 where the rate of injury is growing at around 8 per cent a year.

Twenty five years ago kids didn’t tear their ACL, they broke the tibial spine.  Orthopaedics textbooks from the nineties warned doctors to look for tibial spine fractures because children don’t tear their ACLs.  In essence, they thought they were immune to ACL tears by virtue of being children. This was because in growing children the bones are not at full strength, but the ligaments are.  In a stressed situation, where the ACL is yanking on the tibial spine, the bone gave way before the ligament, hence the fracture.

Fortunately, there is good science that tells us why our ACLs are suddenly failing.  Sugar.

The massive increase in our consumption of sugar is responsible for us producing substandard ligaments and cartilage.  If we make knees out of rubbish material its little wonder that they are suddenly not up to the job.

A byproduct of human metabolism is that sugars can become randomly attached to proteins in a process called glycation. Glycation results in the formation of all sorts of unpredictable (and haphazard) molecules called AGE’s (Advanced Glycation End-products).

All sugars can form AGE’s but the fructose half of table sugar (sucrose) is ten times as likely to do so as glucose (the other half). AGE’s are dangerous because they bond easily (and randomly) to each other and to other proteins in a process called cross-linking. Cross-linking significantly degrades the quality of the protein.

Our bodies are used to garden variety (glucose-produced) AGE’s. And we are pretty good at breaking them down and disposing of them. But even so, over time they accumulate in our organs and tissues and we, well, age (the acronym AGE is very much on purpose).

Unfortunately the AGE’s made with fructose molecules are resistant to our disposal system. So not only they made at 10 times the rate, they hang around.

Long-lived proteins such as collagen, elastin (both used in ligaments), lens crystallins (used in the eyes) and cartilage are much more susceptible to the effects of AGEs because once we make a bad batch, they’re part of us for an awfully long time.

Collagen degraded by AGEs makes less elastic ligaments.  And substandard ligaments, rather like rubber bands left in the sun, tear much more easily. So it would seem that it is less than intelligent to be telling people who play sport to drink sugar that will significantly increase their chances of never playing sport again. That is, of course, unless you are the one selling the sugar-water.

Coca-cola sponsors the AFL and many other sports under the Powerade brand and Pepsi does the same for an array of sports under its Gatorade brand.  They are not doing this because they want to give money to professional sports. They are doing it so young players will see their heroes knocking back blue, green, yellow and pink sludge during and after games and come to the conclusion they need to do the same.  And it’s working, sport drinks are the one part of the sugar water industry doing well.  The global sports drink market is worth $30 billion and it is growing rapidly.

ACLs and other ligament and cartilage damage are now a standard part of sporting life because fructose is being consumed at unprecedented rates (ironically, particularly by those playing sport) and the group suffering the most explosive growth in injuries are those kids emulating their sporting icons.

ACL’s can be repaired (by transplanting other ligaments) but even a well repaired ACL is likely to have debilitating long term consequences.  A Swedish study for example found that half of all adult soccer players who tore their ACL had developed severe arthritis of the injured knee within 14 years. Apply that timeline to an 8 year old and it means they will spend most of their lives battling severe debilitation.  And that’s from an injury that 8 year olds are supposed to be ‘immune’ to.

Let’s stop paying professional sportspeople to suck down sugar. Let’s stop advertising sugar nonstop during broadcast sport. Most of all, let’s stop teaching our kids that sugar and sport go together. And then hopefully we can stop putting severely injured teenagers and their sporting idols in the back of ambulances every weekend.

 

Picture: Adelaide’s Taylor Walker was one of 15 AFL players to tear their ACL in 2013. (Joe Castro: AAP Image)

Don’t give kids sugar flavoured seed oil masquerading as Health Food

By | Big Fat Lies, Sugar, Vegetable Oils | No Comments

Do you have a fussy eater? Are your kids refusing to eat their greens?  Worry no more, you should just give them a chocolate milkshake instead. Well, that’s what the makers of PediaSure would have you believe.  But is filling a kid with flour, sugar and seed oil really a better alternative to telling a kid to eat their greens for dinner or risk getting them for breakfast?

The latest Television Commercial for PediaSure shows a ‘busy kid’ playing basketball, riding his bike and sucking down a ‘delicious PediaSure health shake’ to ‘help support immunity, growth and a healthy appetite.’  The ad was in high rotation on Sunday night prime-time telly. The packaging looks a little like an infant formula tin but was clearly being sold as something active kids should be inhaling by the bucket-load. So what is it?

Here’s the ingredient list for vanilla PediaSure:

Hydrolysed corn starch, sucrose, PROTEIN (milk protein concentrate, soy protein isolate), VEGETABLE OIL (canola oil, high oleic sunflower oil, sunflower oil, medium chain triglycerides (MCT) oil), maltodextrin, MINERALS (potassium citrate, sodium citrate, calcium phosphate tribasic, potassium chloride, magnesium chloride, potassium phosphate monobasic, calcium carbonate, potassium phosphate dibasic, sodium chloride, magnesium phosphate dibasic, ferrous sulfate, zinc sulfate, manganese sulfate, cupric sulfate, potassium iodide, chromium chloride, sodium selenite, sodium molybdate), oligofructose (FOS), EMULSIFIER (soy lecithin), flavoring, DHA from C. cohnii oil , choline chloride, VITAMINS (ascorbic acid, Vitamin E, niacinamide, calcium pantothenate, thiamin hydrochloride, pyridoxine hydrochloride, riboflavin, Vitamin A palmitate, folic acid, phylloquinone, biotin, Vitamin D3, cyanocobalamin), ascorbyl palmitate, taurine, myo-inositol, carnitine tartrate, Lactobacillus acidophilus, mixed tocopherols

As delicious as that explosion in a chemical factory sounds, it boils down to garbage. Here’s my translation of the ingredient list (in descending order by calories supplied)

  1. Seed oil (35% of the calories)
  2. Pre-digested corn flour (for volume and ‘creaminess’ – also used in cosmetics) (30%)
  3. Table sugar (20%)
  4. Protein extracted from milk and soy (12%)
  5. Multi-vitamin
  6. Man-made soluble fibre
  7. Emulsifier (so the oil doesn’t layer out)

Yes, that’s right, this swill can summarised as Seed oil, Corn Flour and protein extracts with a serious dose of sugar to make sure the ‘busy kid’ will actually swallow it. It has a very similar make-up to so-called Toddler formula, the completely unnecessary marketing extension to actual infant formula. It also looks pretty similar to the shakes being sold to the elderly.

The omega-6 fats which dominate the seed oils are implicated in (at least) osteoporosismale infertilityrheumatoid arthritisParkinson’s diseaseallergies, asthmamacular degenerationimpaired intelligence and cancer. And the sugar will put the kid on track to an even more spectacular array of chronic diseases including Type II Diabetes, Kidney Disease, Fatty Liver Disease, Heart Disease, Erectile Dysfunction and Alzheimer’s.

This is all part of powder-creep. Baby formula is a, sometimes, vital food for infants who cannot be breast fed. But manufacturers are legally prohibited from filling infant formula with sugar and the margins are thin. If the manufacturers want to grow their revenue, they need new tummies to fill. So, we can expect more and more ‘nutritional supplements’ that look and taste like a milkshake but spouting dubious medical sounding benefits.

The reality is that a child in Australia today has about as much risk of being clinically undernourished as I do of being elected Pope. Yes, there are an exceedingly small number of Australian kids who could be considered at risk and they probably already have the support of a medical diagnosis and supervision.  So, let’s stop pretending that flogging this sugar flavoured seed oil on prime time TV is anything other than a cynical attempt to sell cornflour at a massive markup.  If you really want a kid to be well nourished give them a glass of milk or an egg.  Both are almost perfect foods from a human nutritional perspective.

Corn flour, sugar and seed oil will not boost the average kid’s immune system or help them grow (well at least not vertically).  PediaSure is no more a health food than the similarly composed seed oil and sugar effluent sold as Up&Go.  It should be avoided with just as much diligence. And under no circumstances should it be given to children.

Will COVID-19 finally drive us to do something about poverty?

By | covid-19 | One Comment

SARS-CoV-2, the virus that causes COVID-19 is the third major outbreak of a dangerous beta-coronavirus.  We have known about beta-coronaviruses in the human population since the 1960s but have never been able to develop a vaccine.  The most likely scenarios are that the virus fizzles out like SARS or it simply becomes part of the normal ‘flu’ season.  The real concern is not COVID-19 but the next virus that tramples its well-worn path into the human viral landscape.

Beta-coronaviruses are descended from the bat gene pool, but some can directly or indirectly (via other mammals such as camels, mice, anteaters and cats) infect humans.

These viruses have been bothering humanity for at least a century, that we know of. The common cold is a beta-coronavirus (CoV OC43) that was first detected in 1965 and another common cold variant (CoV-HKU1) has been in widespread circulation in the population since at least 2005.  A 2016 study of 1208 patients with respiratory disease in Cleveland, Ohio for example showed that 18 had HKU1, 18 had OC43 and 7 had other less common cold variants (NL63 and 229E).  A similar study in Malaysia in the same year detected 26 OC43 and 22 HKU1 cases in a 2060 patient sample. A genetic study of OC43 and HKU1 suggest both share a common ancestor and have been in human circulation since the 1950s.

In late 2002, we discovered that beta-coronaviruses can be more dangerous than the common cold. A new variant, later christened SARS-CoV, the virus that causes SARS, was something very different.  Death from viral pneumonia was a real possibility. It became our first know coronavirus pandemic during its brief run over the northern winter of 2002-2003. It was limited to 8,096 cases resulting in 774 deaths, mostly in southeast Asia.

One of the earliest known cases was a chef in Shenzhen, near Guangzhou, Southern China. He regularly handled recently butchered wild game. His wife, two sisters, and seven hospital staff who had contact with the family were all diagnosed with SARS-CoV. From 16 November 2002 to 9 February 2003, a total of 305 cases were reported in mainland China, with more than a third of those cases involving health care workers.

The virus reached Hong Kong on 21 February 2003, when a Guangzhou doctor, infected by his patients, visited the city. Within a day, he’d infected 16 other people in the hotel he was staying in. Those people unwittingly carried the virus to 30 other countries over the following 6 months.

Subsequent analysis established that the likely natural reservoir for the virus was Chinese horseshoe bats.  SARS-CoV is a zoonotic virus, which means it is a virus that is transmitted between animals and people, but once established in the human population it is easily spread from person to person.

The incubation period was between 2 and 14 days and the average person with the disease would infect between 2 and 4 others. Unlike influenza viruses, which are most infectious in the first 2 days of illness, infection from symptomatic SARS patients usually occurred on or after the fifth day of onset of disease. That is in line with the rising viral load in nasal mucus which peaks at around day 10. Fever, chills, dry cough and muscle pain were the major symptoms. Infections in children were milder than those in adults. And SARS in pregnant women carried a significant risk of death.

The most important route of person-to-person spread was inhaling infectious airborne droplets or touching hard surfaces those droplets have landed on (and then touching the face, or food). The virus can survive on hard surfaces for up to 7 days but is easily inactivated by soap, alcohol or other common disinfectants. The virus lasted longer on disposable plastic hospital gowns than on cotton gowns. Cotton gowns were therefore preferred in hospital care settings. Subsequent tests also revealed that transmission risk from paper was very small.  Even where a page was sprayed with a significant viral load, viable virus particles could not be recovered after the paper dried.

By far the most likely place to become infected was in hospital. Hospital transmission was much more likely where nebulizers, suction, intubation, bronchoscopy, or cardiopulmonary resuscitation on SARS patients were used.  All those procedures generate large numbers of infectious droplets. Around half the Hong Kong SARS cases were acquired in hospitals.

The SARS pandemic eventually fizzled out, not because of anything we did to stop it but because it developed an, as yet unexplained, mutation which impaired its ability to spread.

Subsequent studies showed the virus infected between 13 and 40% of asymptomatic food animal handlers in southern China. It is likely the sustained exposure of the animal handlers to live and recently deceased infected animals was a perfect testing ground for mutations which could jump from animals to humans.  Handlers were constantly exposed to variants of coronaviruses, with one eventually breaking through by successfully developing the ability to infect humans.

Like other viruses such as influenza A or Ebola, SARS-CoV possessed the ability to evade the innate immune system, the part of our immune system that reacts instantly to a foreign pathogen. Our long-term immune response, the adaptive immune system is not fooled.  It begins manufacturing anti-bodies against SARS-COV at around day 7.  Manufacture plateaus at around 60 days but is maintained for over 12 months, probably conferring immunity against reinfection.

A decade after SARS-CoV wiped itself out, another lethal outbreak of a coronavirus was detected in Saudi Arabia.  MERS-CoV, the beta-coronavirus that causes MERS (Middle Eastern Respiratory Syndrome) has since infected around 2,500 people and caused around 750 deaths.  MERS was directly transmitted by camels which at some time in the distant past acquired it from bats.  MERS is significantly less transmissible than SARS, requiring lengthy, unprotected close contact with an infected person undergoing medical treatment.  It is still an active infection in the Middle East.

SARS-CoV-2 is the latest and by far the most virulent member of the family.  It appears to be almost identical to SARS-CoV except it has not, so far, acquired the self-limiting mutation which stopped SARS in its tracks.  We are now learning what SARS would have been like if that had not happened. So far it has infected 1.8 million people and directly or indirectly caused almost 110,000 premature deaths worldwide. This is between a third and a sixth of the number of influenza deaths each year.

Bats are a major reservoir of beta-coronaviruses, but they are not the only risk for zoonotic diseases.  COVID-19 is just the latest to join a list which includes Rabies, Ebola, bird flu, Hendra and over 200 others that we know have crossed from wild animals to humans.

The biggest driver of the explosion in zoonotic diseases is fast growing urban population in poverty-stricken parts of the world.  The human population growth results in the destruction of rainforest habitat, bringing large groups of humans into close contact with animals and the diseases they carry.  Feeding those populations is a significant problem and has accelerated the growth in informal markets which provide fresh meat to those people.  A lack of refrigeration often means the best way to transport and keep meat fresh is to keep the wild animal alive until it is sold and butchered on the spot.

A virus is significantly more likely to be transmitted from a recently deceased and butchered wild animal than from traditional farming and butchering methods.  Markets like these exist in China and throughout west and central Africa.  They are essential sources of food for hundreds of millions of the world’s poorest people.

The world will get through COVID-19 once the virus either wipes itself out, we develop herd immunity or (much less likely) we develop an effective vaccine.  But that is not the end of the problem.  The same things which created it, will create its successor.  And next time it could be something far worse.  It is pure random chance that COVID-19 is not a disease as deadly as Ebola (it kills half of those it infects) and as transmissible as measles (every infected person infects 12-18 others).

There is probably nothing we can do to totally eliminate that risk, but a significant step towards lowering it is to ensure the people reliant on so-called wet markets don’t need them anymore.  This means lifting them out of poverty and providing sufficient high-quality nutrition.  And we need to do it very quickly or prepare now for the human and economic destruction that will inevitably accompany the next zoonotic outbreak.

Photo by Nathalie van Vliet

We’re looking at the wrong Nordic Country when it comes to PISA

By | Education | 2 Comments

Australia has just done worse than it ever has on the international academic benchmark, PISA (the Program for International Student Assessment).  The usual suspects are telling us to copy Finland, the darling of the early PISA tests.  But with the Fins now in a nosedive like ours, perhaps it would be smarter if we looked to their Nordic neighbor, Sweden.

PISA is conducted every three years by the OECD (The Organisation for Economic Co-operation and Development).  It compares the performance of 79 countries using standard and consistently applied testing.  It is the international equivalent of NAPLAN, the Australian national standardized test.

The latest round of data has just confirmed that Australia is in serious trouble. According to the test, more than 4 out of every 10 Australian 15-year olds now do not read well enough to meet the minimum national standard.  Even more shockingly 1 in 5 Australian 15 year olds cannot read well enough to actively participate in a modern society.

Our scores in Maths, Science and Reading have been consistently falling since the testing started in 2000.  Today’s Australian 15 year olds are academically equivalent to Australian 14 year olds in 2000 (and todays 12 year olds in Singapore).  In Maths, Australia has dropped from 5th in the world in 2000 to 24th today.

The usual finger pointing started within seconds of the data release this week.  Depending on the commentator, it was either the Federal Government or the State Governments or the teachers or the lack of teachers or the parents or the quality of graduates or the Universities or not using phonics to teach reading or lack of money, or, well, you get the idea.

The proposed solutions are as tired and worn out as the pointy fingers of blame.  One of the first to be wheeled out is that we need to be more like Finland.  When the first PISA test was published in 2000, it showed that Finland was close to the top of the table in most domains.  And when the second and third tests showed them getting even better, Finland became a superstar of education. Finland has been the darling of many education consultants (and professional development salespeople) ever since.  The only trouble is, that PISA tells us their results have been plummeting just as fast as ours since 2006.

Finland does do education differently to many in the OECD, but that is a recent phenomenon.  In the mid-1990s, they copied reforms implemented in Sweden over the preceding decade.  Both countries had been leaders in school education since the 1950s using a model of public education for all.  Both demanded that a student would be guaranteed the same high-quality education delivered to the same high standards wherever they lived.  Schools were strictly and centrally controlled, had state-prescribed curriculums, external school inspections and detailed regulation. Everyone had the best school in country just down the road.

But during the 1980s and early 1990s, a revolution in education practice occurred first in Sweden and then in by the mid-1990s in Finland.  Both embarked upon what could be described as knit-your-own-adventure education. Both countries disbanded their school inspection programs, central control was loosened and local administrators and teachers were empowered on matters of curriculum, teacher training and grade criteria.  Teachers were given enormous autonomy in the classroom.  They could choose whatever teaching methods they liked and were largely free from standardized testing and school inspections.

The changes introduced assessment by objectives.  The curriculum no longer included prescribed content and detailed syllabi.  It simply established goals and expected schools to interpret and implement them as they saw fit.  Sweden also introduced school choice, allowed the entry of for-profit private operators and encouraged competition for taxpayer funded ‘vouchers.’

When Finland blitzed the 2000 PISA test, the commentators attributed that performance to the newly implemented high autonomy design, forgetting perhaps that the 15 year-olds tested in 2000 (and even 2003) had, crucially, had their early education under the old system.

Sweden’s PISA results in 2000 were nowhere near as stellar as Finland (nor Australia), but they weren’t terrible, so no-one worried too much.  When the 2003 results showed a slight decline, alarms started to sound.  Internal national testing was showing that the average 15 year old in 2004 was achieving at the same level as 14 year olds in 1996. Action plans were drawn up, but an education system is a large ship to turn.

In 2009, Sweden’s experienced what they described as a PISA-Shock.  Sweden’s PISA maths result dropped below the OECD average, something Australia has just managed to emulate. In 2012 Sweden’s results plummeted even further, but by then plans to recentralize the Swedish education system were well under way due to a series of reforms implemented as a direct result of the 2009 PISA-Shock.

They decided quality education requires quality control. A new school inspection office and regime of standards enforcement was created in 2008 and a new curriculum which was much more prescriptive about what should be taught, how it should be taught and how it should be graded was introduced in 2011. And the results are beginning to show.  The 2015 results arrested the plummet and dragged Sweden just above the OECD average.  The 2018 results have confirmed it wasn’t an anomaly, with Sweden almost surpassing Finland and scoring significantly better than the flailing Australian Education system.

Sweden is still a long way from perfect.  Its privatized school choice voucher system is strapping a rocket to inequity and this is likely to put a ceiling on what can be achieved. It still hasn’t clawed its way back to where it was in even 2003 but its results are heading in the right direction.

Sweden and Finland both threw out a system of old-school equal education-for-all, centralized control, school inspections and prescribed teaching practices in favour of more experimental, loosey-goosey methods.  Both have suffered significantly as a result.  And while Sweden accelerated its demise by simultaneously introducing school choice that exacerbated inequity, there can be little doubt that flower-power education did neither of them any favours.

We can learn a lot from the Nordic experience, but not what most people think.  It tells us education needs structure, rules, tests and inspections and if you want it to do even better, it needs all of that, without school choice.

Australia needs to have its own PISA-Shock moment.  We are in accelerating decline and we need to act quickly to arrest it.  We have failed a generation of Australian kids.  When one in five Australian kids is not functionally literate, we are in the middle of a full-blown education disaster.  For those children and their families, this is a crippling impairment.  And for the country that depends on every child being an active contributor, it is a rapidly accelerating catastrophe demanding an urgent solution.

Gaming under the guise of sport has no place in our schools

By | Teens, Uncategorized | No Comments

Exposing high school students to addictive gaming under the guise of sport is reprehensible and is no better than addicting them to booze. Parents must wake up to the risks and stop schools from allowing it.

AUSTRALIAN high schools are increasingly signing up to eSports programs. They might as well be opening lunchtime pubs in their canteens. Addicting their students to gaming is no better than addicting them to booze and it certainly isn’t sport.

From the very beginning of computer gaming, just as with real life games, people have been keen to watch others play.

In 1980, just two years after the release of the first major commercial computer game, Space Invaders, Atari organised the world’s first tournament. Ten thousand players battled little green invaders across the US, with Rebecca (then Bill) Heineman being crowned the ultimate winner, and taking home a Missile Command video game console then worth US$3000.

For a long time the revenue earning power of computer gaming competitions was limited by the inability to compete directly against other humans. The competitions were essentially overblown High Score shootouts, where every player was pitted against the game algorithm and the winner was the one who understood how it worked the best. It understandably had limited mass appeal.

And then came the internet and with it, the ability to design games which pitted people against people. Sure, the game controlled the environment and its rewards and punishments, but now for the first time the skills of other humans could affect your ability to win. It was suddenly a lot more like a physical sport. And with that, a new age of gaming dawned, the age of eSports.

That industry is now worth around US$1 billion a year and growing very fast. It is predicted to have worldwide revenue of US$1.8 billion by 2022, when eSports will be included as a full medal sport in the Asian Games in China, the world’s second largest multi-sport event (behind the Olympics).

These “eSports” are free online computer games played in teams. Usually five players co-operate and attempt to destroy a base protected by another team of five players while protecting their own base. The most popular games at the moment are DOTA 2, League of Legends and Overwatch but the list is growing all the time and the new kid on the block is the wildly popular, Fortnite.

And just like real sports, the audiences are eating it up. The global audience is currently well north of 380 million people. Needless to say, an audience that big attracts hundreds of millions in sponsorship dollars, not to mention in-game purchases and merchandise.

It is this potential honey pot and massively accelerating growth that has attracted media, telecom and the owners of traditional sports. Telcom companies are buying teams and securing streaming rights and sporting organisations are funding leagues to expand their audiences.

Locally, several AFL franchises have ploughed money into eSports. In 2017. the Adelaide Crows purchased a franchise. It was quickly followed by Essendon the following year and North Melbourne, Collingwood, Geelong, West Coast and GWS are actively considering following suite. Adelaide now run the Meta High School eSports League, with the 2019 season involving 160 schools in Australia and New Zealand.

Participating schools establish “teams” of competitive gamers who “train” for hours each week after school and compete in the online leagues. The games are free to play and can be played all the time regardless of being in a “team”, so I suspect most of the players get in a lot more “training” than the hour or two they do at school. And probably use the need to “train” as an excuse for access to their devices at home.

The graphics and sound are exhilarating. The excitement and tension in the players is real.

These games are the very best, the most addictive, the most evolved, the gaming industry has to offer. Their purpose is to addict young minds to the point of obsession, so that billions can be drained from their bank accounts in the form of micro purchases (of costumes and characters) and billions more can be drained from the accounts of sponsors who want access to the players and their fans. And our schools have just signed up as part of the gaming industry sales force.

We wouldn’t tolerate a brewery sponsoring a Chug-a-lug competition at the local high school. And we wouldn’t be too keen on a casino installing pokies, sorry eMaths machines, in the library.

So why on earth are we allowing companies whose entire purpose is to addict young minds open up shop in our schools.

It isn’t sport just because they call it sport. eSport is addictive gaming, pure and simple, so don’t let your school fall for the marketing BS designed to turn your kids into a product for sale to the highest bidder.

 

First published in the Courier Mail.

Excerpt from Teen Brain

By | Teens | 8 Comments

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I started researching this book because two mothers of teenagers told me to. My wife, Lizzie, said she was barely able to get through a conversation with another mother of teens without hearing about a child in counselling or on medication for anxiety and depression. Then my publisher, Ingrid, said exactly the same thing. Both of them felt something wasn’t right. This wasn’t how they grew up. They felt something was going on in the world of teenagers that was being hidden by the happy selfies on Facebook and Instagram, and they both wanted me to start digging to see if their hunches were right.

Before I started, I really wondered why I was bothering. Surely, I thought, everything that could possibly be written about parenting teens had already been done, and done better than I could ever do. Sure, there seemed to be more fuss in the media about teens overusing their phones, but I put that down to the perennial intergenerational problem of ‘teens these days’. Yes, it was a minute-by-minute fight in our house to keep the kids away from their school mandated iPads. And yes, the presence of those devices in the house had introduced a whole new level of sneaky behaviour and teen angst. But I put all that down to normal growing pains.

Then I started reading the research on the significant changes in reward pathways in adolescence. I wondered why I’d seen nothing much in the press about that well established biological reality. And I wondered why I saw even less about why that might be a problem in an age when billions are being spent by tech companies to encourage teenagers to become addicted to their products.

I knew software is engineered to addict. When it comes to non-business-related software, addictive products sell. Non-addictive products die a fast death. This is especially the case when every product in the category is ‘free’. I’d worked long enough in the industry to know how product management and marketing work. But I didn’t know that teens are particularly susceptible to addiction.

I knew it was always a struggle to prise a screen from our teenagers’ hands, but I tended to have a vaguely dismissive, ‘What harm can it really do?’ approach. And yes, I felt devices in schools were a significant distraction likely to impair performance, but I had no sense of how uniquely destructive to teen wellbeing they could be.

In short, I was happy to drift, uncomfortably, through allowing teen access to devices and accept, uneasily, the assurances that while they might be distracting, it was for the best or at least would do no permanent harm. That was until the union-of-the-mothers-of-teens told me to have a good hard look at it. In a nutshell, here’s what I found:

  1. The biology of puberty makes the teen brain uniquely fragile. It makes teens susceptible to addictions that can last for life and usher in mental illness.
  2. Parenting is much more permissive and parents need to harden up to save their kids.
  3. Unfettered access to screens is driving an epidemic of addiction, depression and anxiety, the likes of which we have never witnessed before.

What I found was frankly terrifying. In less than a decade we’ve totally changed the future of the human race, and we’ve done it without so much as a backward glance. Think that’s an overreach? Bear with me while I explain. …

Excerpt from Taming Toxic People

By | Psychopaths | 2 Comments

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Imagine for a minute that you are carving your way, machete in hand, through impenetrable jungle in some terribly exotic place. You happen upon a clearing when suddenly you notice you are not alone. On the other edge of the glen, a stone’s throw from you, stands a tiger. He is staring intently at you. Assessing you. He doesn’t care whether you love your mother, what your favourite colour is or even that tomorrow is your birthday. To him, you are one of just three things: a meal, entertainment or too nasty to bother with.

The tiger will test you. He will growl, bare his teeth, or make an imperceptible, but swift, movement in your direction. These are all tests. He is probing you. Monitoring you for signs of strength or weakness. He will use every faculty millions of years of adaptation have given him, to determine whether you are trouble, or lunch.

You cannot reason with him, you cannot threaten him, you cannot plead for mercy. Your only chance of survival is to convince him that you are more trouble than you are worth. If you manage that, he will turn and walk away without a backward glance. If you can’t, your goose is cooked. Well, eaten.

The tiger’s cold assessment of your meal-worthiness is the same as the one your psychopathic boss, workmate, relative or lover performed on you within the first few seconds of meeting you. This is a book about convincing the tiger you are more trouble than you’re worth. And if you are really brave, it is a book that can tell you how to catch and tame the tiger. After all, who wouldn’t want a pet tiger?

I’ve had the misfortune to encounter a large number of psychopaths. No, I don’t work in a psychiatric unit or a prison. I’ve run across these people in all manner of benign social and work settings. None of these people would satisfy a test for overt criminality. But many skate very close to the edge. Their skill is obtaining a benefit – using criminal or at least, immoral, means – without ever exposing themselves to the force of the law.

I’ve been thinking about writing an easy to understand guide to dealing with psychopaths for a long time. Over the years, I’ve spoken to hundreds of people about the ideas in this book. Every single one (and I mean Every. Single. One.) of those people, often complete strangers, knew exactly what I was talking about. Every single one of them had worked for, been related to, been taught by, been married to or been in a relationship with someone who they felt to be a psychopath. Every one of those people had been profoundly damaged by the experience and most wanted to share their stories as a warning to others and never speak of it again. I didn’t seek out people affected by psychopaths. These were just people I chatted to after giving book talks or interviews, or people I ran into at the coffee shop. The truly amazing thing is that once I described how I believed a psychopath behaved, not a single person could say they had never experienced it. Many did not know that they were describing a psychopath, but believe me, if you have been, or are, a psychopath’s victim, you are not alone.

Why are we throwing money at people who choose not to use Public Education?

By | Education | 11 Comments

The Government has just decided to throw another 4.6 billion taxpayer dollars at a sector which already sucks up $12 billion a year of Australia’s education funding.  On equity grounds alone, the increase for ‘private’ and not public schools is outrageous.  But it highlights an even more egregious fact.  Almost 90% of Australian households are being asked to subsidise the private choices of the other 10%.

According to the Australian Bureau of Statistics, of every 100 Australian households, 33 will have children under 15 or dependent students aged 15-24.  In 21 of those households the school age children will be attending public schools, 7 will be attending Catholic schools and 5 will be attending independent schools (such as Protestant and Islamic schools).

Together the 12 households that have chosen not to use the education system funded by all taxpayers are asking the other 88 households to pay for their choice.  They argue that in choosing not to use a public service they are saving the community money and so they should be compensated.  But that is the equivalent of an avid reader suggesting he is saving the local library by buying his own books and then expecting his collection to be paid for by the taxpayer.  Or the chap installing a pool in his backyard to be expecting it be paid for by the government because he is taking load off the public pool.

The reality is that our voracious reader or our keen swimmer may be choosing to spend money on books and pools for any number of reasons including convenience, variety and perhaps just because they don’t like sharing.  And they are perfectly free to make those choices for those reasons.  But they don’t get to ask the rest of us to subsidise those preferences.

Likewise those 12 families are choosing not to avail themselves of the public education system for a multitude of reasons.  Maybe they like religion mixed with their education.  Maybe they want a single sex education.  Or maybe its just that they think they can get a better education than the government is offering.  Whatever is driving their choice, they should be free to make that choice.  But they should not be given taxpayer funds for electing not to use a public service, any more than our book lover or water enthusiast should be given tax dollars to build and maintain their private library and private pool.

When the governments of Australia collectively decided that education was a public service that should be free, secular and accessible to all in the late 19th century, the Catholic church opted out and declared that it would fund an alternative.  It did this knowing that to do so would cut it off from taxpayer funds. But such was its religious conviction that children of Catholics should be educated by Catholics, that this was the price it was prepared to pay.

The Church stuck to this ideal for the better part of a century, but the decline in availability of low cost teaching labor provided by religious orders and the increasing cost of providing more complex education meant they were very much the paupers’ option by the mid-1960s.  Some strong-arm tactics by the Catholic church in Goulburn resulted in the first dribble of public money.  In the half century since, those drips have turned into a torrent and not just to Catholic schools.  In many cases, including in Goulburn, Catholic schools now receive as much or even more public money than their so called ‘public’ neighours.  And still they want more.  And they tell their customers how to vote to ensure they get more.

There is nothing wrong with parents choosing not to use a public service. But that doesn’t mean the taxpayer should pay for their choice any more than the government should pay for my subscription because I pay for Foxtel rather than watch the ABC.

Australians don’t want our governments throwing our money at people who opt-out of our public services.  We want every precious education tax dollar focused on improving the skills of every single child in this country. Yes, they can choose not to be educated by the State.  But if they do so, they also forgo access to the State’s money.  The sooner we shut down the notion of privatised delivery of government funded education the sooner we can begin to claw our way back to the top of the list of the world’s best education systems.