Category: Biological Insights

Why would sunlight improve diabetes?

In October of last year, Italian police raided a ‘Ndrangheta mafia strong house in Reggio Calabria, Italy. As expected, they found a hoard of cannabis. But a less expected find was a freezer full of mice. Apparently, the mafia had a tradition of serving plump mice at special feasts of reconciliation between warring factions.

This type of mice, called dormice, was very popular in the Roman times. The Romans would fatten them up in special jars, by feeding them chestnuts and keeping them in the dark to make them believe it was time to get ready for hibernation.

I bring this story up because it’s germane to one of the scourges of modern life: diabetes.

Type 2 diabetes is a curious disease. In my opinion and in the opinion of some scientists (and this is a minority view, not the mainstream orthodox view), it’s not a disease caused by failure of an organ or tissue. It’s a disease where the body becomes mis-programmed and executes a series of metabolic changes that are supposed to be used under a different circumstance. Your body is doing something it’s programmed to do, but at the wrong time.

The changes that happen in diabetes – higher levels of sugar in the blood, increase in fat stores, etc. are all changes that happen in animals when they (and we) get ready for winter. In some species (such as bears and squirrels that hibernate), these changes are pronounced – their glucose, cholesterol, and weight all increase dramatically as they approach winter. In humans, they are usually less pronounced, but we also store up fat for winter.

Type 2 diabetes is an exaggerated, wrongly-timed version of what naturally happens. Something tells your body “winter is coming, get ready for it.” (Type 1 diabetes is something altogether different.)

What causes this? It’s not clear. Some people think it’s the fructose in our diet. Fructose is normally never seen by our bodies except during fall, when fruits ripen. And certainly it is not normally seen in the quantities many of us consume. In studies, you can trigger insulin resistance (the first step toward diabetes) by giving healthy volunteers just a few cans of fructose-containing soft drink for just a few weeks. So drinking fructose-containing soda or eating fructose-enhanced food may signal to the body that winter it coming. (Fructose also wreaks havoc on the liver and increases body weight so it’s just bad all-around.)

Another intriguing possibility, though, is exposure to sunlight. Most organisms use the length of day to sense the change of seasons. And most organisms are biologically programmed to respond to changes in seasons – by changing their habits, metabolism, fur, etc.

In fact, if a scientist didn’t know about Type 2 diabetes, and someone asked her how we might make people gain weight, increase cholesterol, and increase blood sugar levels, one idea that she might come up with might be: make the body think it’s wintertime by reducing the length of sunlight exposure per day.

In modern society, many of us spend more time indoors than outdoors. This might make it hard for our bodies to track seasons.

Or, alternatively, we use a lot of artificial light, including blue light-emitting computer screens. This may confuse our seasonal clocks and may make it difficult for our bodies to tell whether the days are getting longer or shorter, and whether winter is coming or not. And our bodies may just default to the safe choice, which is to store up fat for the winter (and one of the best way to store up fat is for our cells to ignore insulin signaling, and become diabetic). In fact, studies have shown that artificial light correlates with disrupted circadian rhythms and increase in obesisty.

This hypothesis is supported by data. In one study of over 10,000 subjects, increased exposure to sunlight had a statistically significant beneficial impact on blood glucose levels (sunlight also lowered cholesterol levels, as would be expected). To be clear, the cause of diabetes is probably multi-factorial, but this study’s results make sense, since the amount of sunlight probably has a significant effect on your body’s seasonal clock.

Of course, more sunlight may make people more active, which may have a beneficial effect on diabetes. But, recall that the Romans used to keep dormice in the dark to make them think it’s wintertime, which made the mice fatter (and probably also threw them into diabetic state).

This sunlight hypothesis is not widely studied, partly because most scientists believe that diabetes is a failure of our body, rather than a legitimate program that is mis-triggered. (This is, I believe, the same mistake some aging researchers make when they see aging as deterioration of our body rather than a programmed process.)

Interestingly, one of the best medicines for diabetes is bromocriptine. By best, I mean the one with very impressive effect on survival (many drugs that lower glucose actually worsen survival, which is why the FDA now requires pharma companies to prove their drug doesn’t increase mortality before the drug will be approved). One of the hypothesis about how bromocriptine works is that it resets the seasonal clock in our bodies, and pulls us out of the winter-preparation mode.

As I said, this is a minority view, that Type 2 diabetes is a problem of mis-signaling. But as a biologist, I tend to think that our bodies, after billions of years of evolution, is a pretty well-functioning machine. It’s rare that it breaks down in the absence of injury or pathogens. I think it’s more likely that there is something in our modern life that is sending a wrong signal to our bodies, and diabetes is probably a normally a beneficial program that is being executed at the wrong time.

Can You Taste with Your Kidneys? Can You See with Your Blood Vessels?

I’ve only seen scurvy once. I was in training at Barnes Hospital in St. Louis, and a homeless man was admitted with weakness, muscle and bone pain, bleeding gums, and shortness of breath. It turned out that his diet consisted solely of hotdogs (no condiments) and Coke. It’s a good thing he came to tertiary care hospital, because scurvy is so rare now that many physicians wouldn’t even consider it in their diagnosis.

I will admit, though, that I’ve been watching a friend of my son for years, expecting to see my second case of scurvy. This friend only eats white rice. Well, he also eats white bread, and a few other things, but only bland things. I thought he would grow out of it but he still hasn’t, and he’s teenager.

I’ve been puzzled about his dietary habits, but I just read something that might explain this.

In The Medical Detective, Roueché describes a baker who suddenly developed a similar problem. The baker, named Rudy, had a perfectly normal sense of smell and taste until one day, he came down with a cold. Then suddenly, his smell and taste perception changed (and persisted). He couldn’t handle the smell in his pizza bakery any more. The ripe tomatoes smelled rotten. The entire kitchen smelled like burnt plastic. Continue reading “Can You Taste with Your Kidneys? Can You See with Your Blood Vessels?”

Gout and Cardiovascular Disease

My best friend was diagnosed with gout recently. I told him to stop ingesting fructose immediately.

Only twenty five years ago, when I was in training, gout looked like it was like a disease on its way to extinction, sort of like tuberculosis. We were taught it used to be common hundreds of years ago but that it was pretty rare. Sure, I had a few patients with gout in my clinic with gout but I would see a case once every couple of months at most.

Now, it’s exploded in frequency.

Gout is very, very bad. Not only because it is excruciatingly painful. (In some patients, you can’t even let a gouty big toe brush against tissue paper without unbearable pain. It’s one of the few things that may rival childbirth in the intensity of pain.) And not only because it is a major risk factor for heart disease. Not only because it causes heart disease. No, it’s very bad because your risk of dying goes up by 25% if you have gout. Continue reading “Gout and Cardiovascular Disease”

Metas, Or, Biology is Non-Transitive

Ed Thorpe is the mathematician who wrote “Beat the Dealer.” In that book, he detailed his invention of card counting. He  proved for the first time that it was possible to beat the Las Vegas casinos in blackjack, something that was believed to be impossible. He also invented the Black-Scholes equation several years before Black and Scholes (and in fact Black and Scholes directed credited Thorpe’s writing for inspiring them), which resulted in a Nobel Prize. Except he didn’t share in the Prize because he used the equation to make millions of dollars on Wall Street rather than publishing it. But that’s another story.

Thorpe writes about the time he was asked to dinner with Warren Buffett. Ralph Gerard, the dean of UC Irvine, where Ed was a professor of mathematics, was thinking about moving his money from Buffett to Ed. Warren was secretly assessing Ed’s bona fides.

Ed passed muster when he correctly answered Warren’s question about the oddly numbered dice. This is a curious phenomenon. Let’s say you have three dice. The first die A is numbered 3,3,3,3,3,3. The second die is numbered 6,5,2,2,2,2. The third die C is numbered 4,4,4,4,1,1.

If you roll the dice, then most of the time, die A will beat B, B will beat C, and… C will beat A. Continue reading “Metas, Or, Biology is Non-Transitive”

Hand of God or A Viral Shockwave?

Let’s talk about what happened when Europeans first tried to settle North America. They failed and never came back. The entire Eastern seaboard was covered Native American farms and there was hardly a fertile spot left. And the Native Americans overwhelmed the settlers and drove them out.

I am, of course, talking about the Vikings who tried to settle Newfoundland and failed.

Continue reading “Hand of God or A Viral Shockwave?”

If You Can’t Culture It, It Doesn’t Exist

We were taught in medical school that the bladder was sterile. That’s because urine is sterile. So naturally, so is the bladder, right?

Wrong. It turns out that there are numerous organisms in the bladder, and that probiotics that might change the microbiome in the bladder may enhance effectiveness of chemotherapy for bladder cancer.

The reason we thought bladder was sterile is Continue reading “If You Can’t Culture It, It Doesn’t Exist”

Terra Incognita of Science

“Drug Development: When Scientists Try to Build Things”

In 1968, Gunther Stent, a prominent biologist and part of the “band” that included Watson and Crick, wrote a famous paper, subsequently followed by a book. In it, he bemoaned the fact that everything there was to know about molecular biology had already been discovered. That there was to be no more Continue reading “Terra Incognita of Science”

Reductionism and Redundancy

When Xerox launched model 914, the first real copier in history, they didn’t know if it would be a success or a miserable failure. Before then, no one copied anything, mainly because it would take hours to days to make a single copy of a single page of a document, and it was horrendously expensive. In short, there was no market for copiers. The initial estimates were that the entire market may be a few million dollars. Continue reading “Reductionism and Redundancy”

Emergent Phenomena

“Reductionism: Instagram approach to science”

One of the greatest strengths, and one of the greatest failings, of modern science is reductionism. Reductionism has allowed us to dissect and understand some of the most important natural phenomena. Some would argue that reductionism is at the heart of the Scientific Method. Marvin Minsky has said, “In science one can learn the most by Continue reading “Emergent Phenomena”

Hiding in Plain Sight

Jakob Vinther was the first person who figured out that you could tell what colors dinosaurs were by looking at melanosomes, the tiny bags that hold pigments in a cell.

The first time he discovered the melanosomes in dinosaur fossils, he was just a graduate student. Elated, he immediately sent photos of them to his mentor, Derek Briggs. Briggs almost laughed. Continue reading “Hiding in Plain Sight”