Notes on Engineering Health, November 2020: Thoughts for Food

Although the maxim “Let food be thy medicine, and let medicine be thy food” is generally agreed to be an apocryphal quote by Hippocrates, there are good reasons why it still resonates as an immutable truth. Looking at the healthcare industry from a standpoint of health—as we try to do at Digitalis—regularly brings us back to nutrition as a key pillar of a healthy life. In particular, our attention this month was attracted by a number of studies carefully looking at large datasets that highlight again the key importance of diet and nutrition.

A large (over 65 million participants worldwide) study published in The Lancet earlier this month compared height and body-mass index trajectories for school-aged children and adolescents in different countries. The height and BMI trajectories over age and time were highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks based on diet. By many measures, the population in the US is the unhealthiest of any high-income country and diet makes a real difference. In an enlightening article in STAT news, the authors, Rahman and Rees, expose the failings of the American food system by citing new data from the CDC and propose a few avenues to fix it including refocusing federal research on nutrition, making healthy food more affordable, and educating doctors more rigorously about nutrition. These solutions are public health measures and while they don’t always require engineering or enabling technologies, they are essential tools in a broad arsenal to promote health.

Alongside these public health measures, some more dieting recommendations came from a study published in PNAS showing that macronutrient supply is a strong predictor of mortality in different age classes. The idea is that each age of life require different supplies of macronutrients - in early life, equal amounts of fat and carbohydrate are predicted to improve survival, while later in life, reducing fat in exchange for carbohydrates is associated with the lowest rates of mortality.

Despite the growing knowledge-base indicated by the studies, the search for the perfect diet that will pave the way for a lengthy life devoid of chronic diseases is still an elusive pursuit for scientists, clinicians, and food makers alike. Although it sounds like hard advice on the day before Thanksgiving, for now we’ll repeat what seems to be the current scientific consensus as brashly summarized by Michael Pollan: "Eat food. Not too much. Mostly plants." Happy holiday.

– Jonathan Friedlander, PhD & Geoffrey W. Smith



First Five
First Five is our list of essential media for the month which spans a range of content including scientific papers, books, podcasts, and video. For our full list of interesting media in health and science, updated regularly, follow us on Twitter or Instagram.

1/ Bet the Jockey?
One piece of received wisdom in venture capital is that the strength of a start-up's founder and leadership team is the most important factor when deciding whether or not to back a company. However, an Institutional Investor article points to a new study that casts doubt on how much the founder actually matters…

2/ Gut Microbiome Everywhere
Studies of gut microbiome are turning up more and more evidence of its involvement in … everything? Recent papers implicate gut microbiome in:
– Atherosclerosis (Nature Biotech)
– Alzheimer’s Disease (Journal of Alzheimer’s Disease)
– Multiple Sclerosis (Science Immunology)
– Childhood Asthma (Nature Medicine)

3/ Gut-Brain Axis
In addition to its microbiome, the gut is turning up elsewhere, including in our brains. A new study in Nature indicates that the same cells that line our intestines also provide protection from infection in the meninges (three watertight membranes that surround the brain and spinal cord). Scientists sequenced immune cells found in the meninges that make antibodies against viruses or bacteria, and then quite surprisingly, they traced these cells back to the gut.

4/ Chemputers
Professor Lee Cronin at the University of Glasgow has been building chemical computers that use natural language processing to translate organic chemistry literature directly into editable code which in turn can be compiled to drive automated synthesis of the compound on the group’s automated synthesis robot. CNBC provides an overview of Cronin’s work. And a recent paper in Science provides the detail including the automated syntheses of 12 compounds from the literature.

5/ Blast From the Past
Daniel De Carvalho, a self-described “genome archeologist,” has recently published work that identifies ancient embedded elements in our DNA from past generations that can activate a powerful immune response to kill cancer cells like an infection. His group has also discovered a key enzyme used by cancer cells to prevent this from happening in order to survive. By knocking out this enzyme causes cancer cells to become vulnerable to epigenetic drugs that induce the antiviral response.



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