Friday, October 28, 2011

The Brain Controls Insulin Action

Insulin regulates blood glucose primarily by two mechanisms:
  1. Suppressing glucose production by the liver
  2. Enhancing glucose uptake by other tissues, particularly muscle and liver
Since the cells contained in liver, muscle and other tissues respond directly to insulin stimulation, most people don't think about the role of the brain in this process.  An interesting paper just published in Diabetes reminds us of the central role of the brain in glucose metabolism as well as body fat regulation (1).  Investigators showed that by inhibiting insulin signaling in the brains of mice, they could diminish insulin's ability to suppress liver glucose production by 20%, and its ability to promote glucose uptake by muscle tissue by 59%.  In other words, the majority of insulin's ability to cause muscle to take up glucose is mediated by its effect on the brain. 

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GMAHN Library and Website Launched...the Un-Conference and SO much more...

Musique et Sante
The wonderful Musique et Sante who regularly work with our collegues at the Royal Northern College of Music, (RNCM) have developed their own website, which I recommend to you all. Partners and allies of the finest quality. 

Bi-Monthly Networking Evening
(a change to our advertised programme)
I'll be 'out of service' for much of November, and instead of cancelling the networking evening planned for the end of the month, I'm thrilled that Holly at the RNCM has offered network members the opportunity to attend a talk on Music for Health as part of the RNCM Research Forum Series. It will take place on Wednesday 23 November at 5.15pm – 6.45pm in the RNCM Lecture Theatre and is entitled ‘Creating musical space in a medical place’. Holly Marland will be sharing insights into the role that music can play in hospital settings and the training and support that can be offered to musicians. There will be an opportunity for discussion and some informal networking in the RNCM bar afterwards. Places are limited so if you’d like to come along, please drop holly an email at

An Evidence Review of the Impact of Participatory Arts on Older People
A very important contemporary review of arts participation conducted by the Mental Health Foundation.

Greater Manchester Arts Health Network Library
I am thrilled to be supporting the Greater Manchester Arts Health Network website which was formally opened last week. This on-line resource provides a fantastic one-stop-shop for some of the latest thinking, research and development in the field. Please check it out and in particular the extensive LIBRARY.
Fantastic work Anne and Phil.

Brief thoughts on the Un-Conference
Last Thursday’s Un-Conference was a (long) day of challenging, exciting and provocative debate and activity around our arts/health field. Divided into 4 themed sessions, the day gave the opportunity to participants to engage in 1 or more of the day’s events.

Langley Brown and Phil Burgess were quick to provoke and excite, getting people on their feet and active and using deeply personal stories of their own experiences as artists to question narratives and in part suggest, that its never too late to have a happy childhood.
Lynn Frogett and her team shared their psychosocial approach to understanding how the arts can change individuals and communities through theory and practice in an interactive workshop exploring how practitioners and organisations can evidence this.
Clive, Dorothy and Anne
Dorothy Rowe was utterly compelling and shared some of her thoughts on the myth of depression and its chemical origins, alongside notions of imagination. The repose to Dorothy’s session has been quite overwhelming.
                   Thought Provoking
                          Moving and concise

Mark O’Neil and Leisa Gray gave an excellent two-hander to round the day off, exploring the potential of museums and galleries to impact on public health at a population level, and a more intimate hands-on experience of literally handling objects. A perfect end to a wonderful day.
A Gentle Prod at those who take for granted...
The venue wasn’t perfect for the day, with some distracting noise from people working, and a couple of people complained there wasn’t food! I do have some sympathy about the ambient distractions, but for those demanding food…the day was free to all participants, and cost a fortune to host. So, no more greedy bleating please.

And finally a big thanks to everyone who made it possible.

Sunday, October 23, 2011

Harvard Food Law Society "Forum on Food Policy" TEDx Conference

Last Friday, it was my pleasure to attended and present at the Harvard Food Law Society's TEDx conference, Forum on Food Policy.  I had never been to Cambridge or Boston before, and I was struck by how European they feel compared to Seattle.  The conference was a great success, thanks to the dedicated efforts of the Food Law Society's presidents Nate Rosenberg, Krista DeBoer, and many other volunteers. 

Dr. Robert Lustig gave a keynote address on Thursday evening, which I unfortunately wasn't able to attend due to my flight schedule.  From what I heard, he focused on practical solutions for reducing national sugar consumption, such as instituting a sugar tax.  Dr. Lustig was a major presence at the conference, and perhaps partially due to his efforts, sugar was a central focus throughout the day.  Nearly everyone agrees that added sugar is harmful to the nation's health at current intakes, so the question kept coming up "how long is it going to take us to do something about it?"  As Dr. David Ludwig said, "...the obesity epidemic can be viewed as a disease of technology with a simple, but politically difficult solution".

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Monday, October 17, 2011

Losing Fat With Simple Food-- Two Reader Anecdotes

Each week, I'm receiving more e-mails and comments from people who are successfully losing fat by eating simple (low reward) food, similar to what I described here.  In some cases, people are breaking through fat loss plateaus that they had reached on conventional low-carbohydrate, low-fat or paleo diets.  This concept can be applied to any type of diet, and I believe it is an important characteristic of ancestral food patterns.

At the Ancestral Health Symposium, I met two Whole Health Source readers, Aravind Balasubramanian and Kamal Patel, who were interested in trying a simple diet to lose fat and improve their health.  In addition, they wanted to break free of certain other high-reward activities in their lives that they felt were not constructive.  They recently embarked on an 8-week low-reward diet and lifestyle to test the effectiveness of the concepts.  Both of them had previously achieved a stable (in Aravind's case, reduced) weight on a paleo-ish diet prior to this experiment, but they still carried more fat than they wanted to.  They offered to write about their experience for WHS, and I thought other readers might find it informative.  Their story is below, followed by a few of my comments.

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Power, Older People, Australia, Young People, Drugs and St Perry of Essex

Ai Weiwei tops the art world’s ‘power 100 list’…whatever that is! ‘His art activism has been a reminder of how art can reach out to a bigger audience and connect with the real world…Institutions, while they are really important, can be great tombs.’
Mark Rappolt, Editer, Art Review

How we value older people, the arts and the 'market'
I’m thrilled to be giving the opening key-note at the 3rd Annual Art of Good Health and Wellbeing International Arts and Health Conference, which is taking place at the National Gallery of Australia, Canberra between the 14 and 17 November 2011. I’ve written a paper which explores the role of the arts when we are faced with serious illness and which asks, in the face of our own mortality, just what relevance can culture and the arts play, if any. An article in today’s Gurdian chimes with much of the sentiment of my paper (see directly below)

The Hon Simon Crean MP Minister for Regional Australia, Regional Development and Local Government, Minister for the Arts, will be opening the conference and I’ll be giving my paper at around 6:15 on Monday the 14th, so if you want to hear it and get involved in our international debate, please come along.

Illustration by Andrzej Krauze
 NHS end-of-life care has been crippled by a marketised mindset that sees everything in terms of its economic value 'Our market-shaped way of life has no time for the elderly or the art of caring.' Madeline Bunting captures some of the outrageous issues affecting us all, around how we age; end of life care and the insidious ‘market led’ approach to ‘care.’  

What young people are really thinking?
The Art of Protest is a pop-up exhibition organised that will take place in empty shops on Manchester's Market Street from 19 to 27 October. The charity Noise sent photographers Liam Carter, Sebastian
Heise, Lucia Zapata and Marta Julve out on the streets of Manchester, Madrid, Valencia and Berlin, to ask young people the question: 'What would make you protest?' Displaying the resultant images in an area hit by the recent riots is a powerful statement of disillusioned youth

To find out more go to:    

Why Americans Pay So Much More For Brand-Name Drugs (and Canadians don’t)
Brilliant Graphics and another sharp commentary on the pharmaceutical industry from
…and a Big Thanks to Cheryl Godden

On the Secular Beatification of St Perry of Essex
I’m often asked if I’m after a ‘celebrity’ to be a patron of Arts for Health, and in truth, we’ve had some great people behind our work over the years including Lord Attenborough; Joan Bakewell; Melvyn Bragg and Sam Taylor-Wood, but the current obsession with fame and all its glories, has left a bit of doubt in my mind around publicity, for publicity’s sake. Much of this has been reflected by the vapid self-celebration of contemporary British art.

This said, I had an almost revelatory moment at the British Museum this weekend, in the exhibition by Grayson Perry: Tomb of the Unknown Craftsman, which I would recommend to anyone, particularly the people who ask, ‘what’s the relationship between arts and heath?’ I tend to open up a conversation about it being more than just a prescription...

Perry has produced something completely exquisite in his curation of artifacts’ from the British Museum and creation of his own work. I don’t particularly think he lays it on with a trowel either. It’s a beautiful show, with some challenging work that whilst exploring Perry’s own experience of being human, offers though the arts, far wider thoughts on being individual and part of a community. It’s not dumbed down in the slightest…if anything, he ups the ante.

Grayson Perry (b. 1960), The Rosetta Vase, 2011. © Grayson Perry. Courtesy Victoria Miro Gallery, London.
So on the basis of his enduring wit, cynicism and piercing beauty, I suggest some kind of secular beatification of Perry, and instead of approaching him to be a patron, he could be co-opted as our very own (and exquisitely flawed) Patron-Saint of the Arts.

An artists answer to the credit crisis…
Michael Landy’s Credit Card Destroying Machine was unveiled at the Frieze Art Fair last week. The huge Jean Tinguely-inspired contraption, pieced together from a random collection of found objects such as mannequin limbs and Mickey Mouse figures, is surrounded by tiny bits of shredded credit cards on the floor. In return for a drawing made by the machine that bears Landy’s signature, people have to hand over a valid credit card for shredding. An assistant feeds pre-signed sheets of paper into the machine and off it goes, with a marker pen attached to a metal arm doing an automated random drawing (you can choose the colour). Some 300 credit cards were shredded during the first day alone (including the private view). Landy, of course, is best known for shredding all his worldly possessions a few years ago. (Thanks to and Thomas Dane)

...and for all of you eagerly awaiting Part 1 of the m a n i f e s t o for arts/health, I can confirm that the wonderful Kamila Kasperowicz has been creating a stunning digital and hard copy version for your delectation…

Monday, October 10, 2011

Chile: a World Summit on Arts and Culture and Student Uprising...

Chile...a World Summit on Arts and Culture
The International Federation of Arts Councils and Culture Agencies (IFACCA) has announced that Chile would host the 6th World Summit on Arts and Culture in its capital, Santiago, on 13-16 January 2014.

This will be the first time that the World Summit has been staged in Latin America and will be presented in Santiago’s award-winning EstaciĆ³n Mapocho Cultural Centre. One of IFACCA’s most significant initiatives, the World Summit on Arts and Culture provides national arts councils, ministries of culture and other agencies with an opportunity to discuss key issues affecting public support for the arts and creativity. Previous World Summits on Arts and Culture has been held in Canada (2000), Singapore (2003), England (2006), South Africa (2009) and Australia (2011).

Provisionally entitled Creative Citizens: Technology and Culture for Diversity, the theme for the 6th World Summit will address the current context of globalisation and the challenges in the cultural arena, specifically in relation to safeguarding and protecting cultural diversity and cultural identities. New technologies in culture represent an opportunity to impact positively on the visibility and legitimatisation of cultural identities, to foster increased cultural diversity, and to enhance access, production and exchange of cultural goods. At the General Assembly, IFACCA also launched WorldCP, an international database of cultural policies [].
For further information please see 

Hola hermanas y hermanos en Chile y la solidaridad de artistas y profesionales de la salud en el Reino Unido ...
Camila Vallejo on a march in Santiago held on the anniversary
of the Pinochet coup that toppled
President Salvador Allende in 1973. Photograph: Aliosha Marquez/AP
Chile...Girls Demand Free University Education
‘It was the most beautiful moment, all of us in school uniform climbing over the fence, taking back control of our school. It was such an emotional moment, we all wanted to cry.’ Angelica Alvarez 14
With the IFACCA announcement freshly ringing in our ears, its worth noting how a group of teenage girls kick started what is known in Chile as  the ‘Chilean Winter’. There’s not been much in the UK press on this story, with our focus facing towards the ‘Arab Spring’, but here’s a synopsis.

A group of young girls have occupied Carmela Carvajal primary and secondary school for five months fighting for a single goal: free university education for all. The girls took a vote on their action too, with a 10/1 in favour of action, and their days are organised through a democartic voting system for managing all aspects of their lives, but their argument is simple; that education is recognised as a common right for all, not a consumer good to be sold on the open market.

This is part of a vast student uprising across Chile, with weekly protest marches gathering between 50,000 and 100,000 students. The girls are still having a rich education, supplemented by yoga and salsa and music gigs. There’s an excellent article on this story by Jonathan Franklin at:

So, with a World Summit on Arts and Culture and a democratic Student Uprising, lets hope that the IFACCA board see it in their remit to explore how culture and the arts are a force for social change, and if a core part of their agenda is about Creative Citizens and Technology, then this is potentially an exciting and provocative summit and one where our ever-evolving arts/health/well-being agenda is central.

And whilst use of facebook and twitter is being used as evidence of dissent in the UK resulting in lengthy prison sentences for those who advocate civil dissobedience, in Chile we can see how creative citizens have in fact harnessed this technolgy. Here are two links to the student leader, Camila Vallejo Dowling's blog and twitter...!/camila_vallejo  

Anyone Who Has a Heart is a light sculpture that displays your heart rate. It is a landmark and signature artwork sited at the entrance to the new Royal Manchester Children’s Hospital. The sculpture aims to catch attention through its form, textures and movement. giving a sense of fun and playfulness for all ages. Walking around the sculpture triggers sensors and changes the light display. Holding onto the stainless steel hand grips monitors your heart rate and translates that into a red light display synchronised with your pulse. It can also tell you the time as every hour, the sculpture turns into a clock. The sequence is explained on floor panels along with information about the heart rate of a range of animals.

It was commissioned by Lime in collaboration with the Central Manchester University Hospitals NHS Foundation Trust. This stunning work was made by artist Andrew Small commissioned through a special arts programme allocation from the hospital’s Charitable Funds.

Friday, October 7, 2011

The Case for the Food Reward Hypothesis of Obesity, Part II

In this post, I'll explore whether or not the scientific evidence is consistent with the predictions of the food reward hypothesis, as outlined in the last post.

Before diving in, I'd like to address the critique that the food reward concept is a tautology or relies on circular reasoning (or is not testable/falsifiable).  This critique has no logical basis.  The reward and palatability value of a food is not defined by its effect on energy intake or body fatness.  In the research setting, food reward is measured by the ability of food or food-related stimuli to reinforce or motivate behavior (e.g., 1).  In humans, palatability is measured by having a person taste a food and rate its pleasantness in a standardized, quantifiable manner, or sometimes by looking at brain activity by fMRI or related techniques (2).  In rodents, it is measured by observing stereotyped facial responses to palatable and unpalatable foods, which are similar to those seen in human infants.  It is not a tautology or circular reasoning to say that the reinforcing value or pleasantness of food influences food intake and body fatness. These are quantifiable concepts and as I will explain, their relationship with food intake and body fatness can be, and already has been, tested in a controlled manner. 

1.   Increasing the reward/palatability value of the diet should cause fat gain in animals and humans

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Tuesday, October 4, 2011

What is Madness? - and so much more.

Illustration by Clifford Harper/
What is Madness? This is the title of a new book by psychoanalyst Darian Leader, which was reviewed in the Guardian on Saturday 1st October. Whilst I haven’t yet read the book, it looks incredibly interesting and relevant to our field. The review was by Jacqueline Rose and made for interesting reading itself, particularly her discussion around the government sponsored ‘therapy of choice,’ Cognitive Behavioural Therapy (CBT).

Rose reflects the Governments No Health without Mental Health and their commitment to evidence based therapy, which allows session-by-session outcome monitoring, predominantly measured by employment rates. Secretary of State for Health, Andrew Landsley, she notes, acknowledges that unemployment is a key factor in precipitating anxiety disorders and depression. You can see where this is leading I’m sure!

Joblessness is above 2.5 million and rising as a result of government policy, and it seems that,’ the government by its own account, is provoking the problem it is trying to cure.’

The article then eloquently discusses the commodification of humans and the emptying of our unconscious mental life. It’s a great article and one that I feel would benefit from an arts/health lens, but for me the question of what madness is, perhaps lies in the Joseph Heller inspired governance of our disconnected leaders.

See the review here:

Un-Conference 2011
Click here for more information about the free event at MMU on October 20th.

Library Theatre Company & Cornerhouse are seeking:
Storybox Project Co-ordinator
£21,473 pro rata for 3 days a week (3-year fixed term contract)
Based: Manchester City Centre

We are looking to appoint a highly motivated, passionate and experienced individual to deliver an exciting and innovative arts workshop programme for older people living with Alzheimer’s & dementia. 

Start2 (Change your life with Art)
Change your life with Art is an NHS service that is totally unique. Created by Start in Manchester with the support of the Strategic Health Authority and the Department of Health, it will be a collection of creative ‘courses’ with wellbeing themes, and that will encourage people to connect to the world differently, see their own strengths, be aware of their own stress triggers and have ways to handle that stress better – all through evidence based creative activities. Although it’s not launched formally until January 2011, you can get a sneak peak here and register for updates:  

Lucy Sparrow
A Health Lottery...
Did you know about the new Health Lottery? No, not government policy, or our world famous post-code lottery, this is the one that gives a massive 20p of every pound you spend towards a good cause! The rest presumably goes to Richard Desmond, the 57th richest man in the UK and owner of Express Newspapers, OK, Television X and Red Hot TV.
A taste of things to come...?

Artist in Residence Opportunity
LIME are seeking two artists for a short term experimental residency project. This is a ‘paired residency’ scheme whereby each artist will work with a similar hospital department but in two hospitals, one in Bolton and one in Manchester.

Fee for each artist: £3,000 (including materials costs)
Application Deadline: Tuesday 11th October
Start Date: Week of 7th November

Full Details at:

Saturday, October 1, 2011

The Case for the Food Reward Hypothesis of Obesity, Part I


When you want to investigate something using the scientific method, first you create a model that you hope describes a natural phenomenon-- this is called a hypothesis.  Then you go about testing that model against reality, under controlled conditions, to see if it has any predictive power.  There is rarely a single experiment, or single study, that can demonstrate that a hypothesis is correct.  Most important hypotheses require many mutually buttressing lines of evidence from multiple research groups before they're widely accepted.  Although it's not necessary, understanding the mechanism by which an effect occurs, and having that mechanism be consistent with the hypothesis, adds substantially to the case.

With that in mind, this post will go into greater detail on the evidence supporting food reward and palatability as major factors in the regulation of food intake and body fatness.  There is a large amount of supportive evidence at this point, which is rapidly expanding due to the efforts of many brilliant researchers, however for the sake of clarity and brevity, so far I've only given a "tip of the iceberg" view of it.  But there are two types of people who want more detail: (1) the skeptics, and (2) scientifically inclined people who want mechanism.  This post is for them.  It will get technical at times, as there is no other way to convey the material effectively.

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